What Does BV Discharge Look Like?

A little vaginal discharge is normal. It’s healthy, even, playing an important role in keeping the vagina clean and comfortable. But if you’ve noticed your discharge is suddenly way off in color, smell, or texture, your body may be trying to tell you something.

Bacterial vaginosis (BV) is the most common vaginal infection, and discharge changes are usually the first sign. Here's exactly what to look for, how to tell BV apart from other vaginal infections, and what to do about it.

This post is for informational purposes only and does not constitute medical advice. See full disclaimer below.

What BV Discharge Actually Looks Like

Normal vaginal discharge is typically clear to milky white, odorless or very mildly scented, and varies throughout your menstrual cycle, picking up around ovulation and tapering off afterward.¹

BV discharge, on the other hand, looks and behaves differently, especially when it comes to:

• Color: BV discharge is most commonly gray or off-white. It can also appear white or slightly yellowish, though green discharge is more associated with STIs, like gonorrhea or chlamydia.
• Consistency: Thin and watery is how most people would describe BV discharge, which is very different from the thick, clumpy, cottage cheese-like texture of a vaginal yeast infection.
• Amount: Many people notice that their vaginal discharge isn’t just different in some way, but there seems to be more of it than usual.
• Odor: This is often the most distinguishing feature of BV discharge: a distinct fishy odor, which tends to be stronger after sex or during your period. The smell comes from amines, or byproducts released by anaerobic bacteria when they overgrow (more on that below).

Of course, not everyone with bacterial vaginosis notices all of these when it comes to their discharge. Some people have minimal discharge but notice that it has a strong smell, for instance, and others have no symptoms at all and only know they have BV when they have their annual appointment with the gynecologist (which is why it’s so important to keep up with them!).²

The Smell: Why It Happens and How Strong It Is

There’s a reason BV discharge tends to have that fishy smell. When anaerobic bacteria (aka the bad guys) displace the protective Lactobacillus bacteria in your vaginal microbiome, they produce something called amines as they grow and take over.³ These amines are more volatile in alkaline environments, and because semen and period blood make your vaginal microbiome more alkaline, smell can intensify during or after these times.

The good news is that the smell is more noticeable to you than anyone else, but that doesn’t mean you should just ignore it.⁴ Any kind of persistent odor is worth paying attention to and scheduling a call with your gynecologist or healthcare provider.

Additional BV Symptoms

Discharge isn’t the only symptom of BV. It may also be accompanied by:

• Vaginal itching or irritation (usually mild)
• Burning during urination
• Soreness of the vagina or vulva
• Cramps

If you’re experiencing unusual discharge along with pelvic pain, that may signal a more serious issue, like pelvic inflammatory disease (PID), which can occur when BV goes untreated.⁵

BV vs. Other Infections: How to Tell the Difference

Unusual vaginal discharge is a common symptom of BV, but it’s also not unique to BV.⁶ In fact, several common vaginal infections, including sexually transmitted ones, can cause discharge that’s out of the norm.

While diagnosis is best left to the professionals (aka your doctor), here are some differences between BV and other common infections to help you have a more productive conversation during your appointment.⁷

BV vs. Yeast Infection

Vaginal yeast infections (which are caused by Candida overgrowth) produce thick, white, clumpy discharge, usually along with significant vaginal itching, burning, and vulva soreness.⁸ BV discharge is thin and watery, and while it can cause mild irritation, intense itching is more of a yeast infection hallmark.

Yeast infections are also available to treat with over-the-counter antifungals; BV requires prescription antibiotics.⁹ This is why it’s important to let your doctor make the ultimate call. You don’t want to treat the wrong infection!

BV vs. Trichomoniasis

Trichomoniasis (aka trich) is a sexually transmitted infection that can also cause thin discharge, but it’s more often frothy and yellow-green and accompanied by more pronounced itching and irritation.¹⁰

BV vs. Normal Vaginal Discharge

Discharge is part of having a vagina, and white or clear discharge is considered normal.¹¹ While normal discharge can also have a mild, sort of musky smell, it would never be described as strong or dishy.

BV Causes and Risk Factors

While most people blame the harmful bacteria involved in BV, the root cause runs a little deeper.¹²

BV develops when the natural balance of bacteria in the vaginal environment shifts. More specifically, BV happens when levels of Lactobacilli (aka the protective, acid-producing bacteria that maintain a healthy vaginal pH) drop, and anaerobic bacteria move in and multiply.¹³

As for what causes these levels to drop, well, that’s part of what makes BV so frustrating.¹⁴ The trigger isn’t always obvious, and it might not even be any one thing, but a combination of small things that add up. These include:

• Hygiene practices: Douching is one of the most well-established risk factors for BV. That’s because it doesn’t just wash away bad bacteria, but the healthy Lactobacilli that protect you. Perfumed soaps, washes, sprays, and even some lubricants used in or near the vagina can have a similar effect on the healthy vagina's bacterial balance.
• Sexual activity: While BV is not exclusively a sexually transmitted infection, sexual activity is one of the biggest triggers. Having a new sexual partner, multiple partners, or unprotected sex all increase risk.
• Contraception: In some studies, IUD use has been associated with higher rates of BV, possibly due to altered discharge patterns or localized inflammatory changes. This doesn't mean IUDs cause BV in everyone, but it's worth knowing and discussing with your doctor if you're prone to recurrence.
• Hormonal changes: Estrogen plays a key role in maintaining a Lactobacillus-dominant environment. That's why BV rates tend to be higher after menopause, during certain phases of the menstrual cycle, and during hormonal shifts associated with pregnancy or new contraception.
• Smoking: The connection between smoking and BV is well-documented, though not fully understood. Smokers have significantly lower levels of vaginal Lactobacilli and are more likely to develop vaginitis, BV included.
• Stress and immune health: Chronic stress can affect immune function in ways that make it harder for the body to maintain a balanced microbiome. Just another friendly reminder that the vaginal environment doesn't exist in isolation from overall wellness.¹⁵

BV During Pregnancy

Increased discharge is a normal symptom of pregnancy. It’s one of the ways your body works to protect the baby, flushing out more bad bacteria from the vagina.¹⁶

That being said, like with other types of normal discharge, pregnancy discharge does not have a strong odor.¹⁷ If you notice increased discharge with that fishy odor, call your doctor right away. If left untreated, bacterial vaginosis has been associated with complications including preterm labor, premature birth, and increased risk of miscarriage. Luckily, early treatment reduces this risk.

Treating Active BV

Antibiotics are the standard treatment for an active BV infection, and that’s because they work well.¹⁸ Your healthcare provider will typically prescribe one of the following to treat BV:

• Metronidazole, which is available as oral tablets or a vaginal gel
• Clindamycin, which is available as a vaginal cream, gel, or suppository

Your doctor will only prescribe antibiotics for BV once they determine you actually have it, through a pelvic exam and lab analysis of your vaginal fluid.

Preventing Recurrence

Along with knowing what BV discharge looks like, it’s also important to know this: BV often comes back. In fact, up to 50% of people experience recurrence within a year of treatment, and for some, it becomes a chronic cycle.¹⁹ That's because antibiotics treat the overgrowth, but they don't rebuild the microbiome imbalance that allowed the bad bacteria to overtake the microbiome in the first place.

To keep symptoms from coming back, aim to eliminate the risk factors that may be contributing to microbiome imbalance, like douching, unprotected sex, and unmanaged, chronic stress.²⁰

Another great tool in your prevention toolbelt? Daily probiotics, especially ones like Happy V’s Prebiotic + Probiotic that contain strains of Lactobacilli clinically studied for their ability to support vaginal health and vaginal pH balance.²¹ In a preclinical study, Happy V’s unique formula was actually shown to not just support Lactobacillus dominance, but also inhibit the growth of Gardnerella vaginalis, the top baddie behind most BV infections.

If antibiotics are helping to put out the fire, the right probiotics can make the conditions less flammable in the first place.

Bestseller

Prebiotic + Probiotic

4.9

Rated 4.9 out of 5 stars

5,561

Maintains vaginal pH and restores gut health.

Regular price From $38.24

Regular price $134.97 Sale price From $38.24

Add Quick Add

Add to cart Sold out

Buy Once - $44.99 Sold out

Final Thoughts

BV is incredibly common, but that doesn't mean you have to just live with it or keep cycling through it. Understanding what BV discharge looks like, what causes it, and how to treat it puts you in a much better position to advocate for yourself at your next appointment and take steps toward lasting vaginal health.

When in doubt, see your doctor. And in the meantime, the daily habits that support your microbiome, like the right probiotics, avoiding known irritants, and managing stress, are never a bad place to start.

Keep the Conversation Going

• Visit our blog for more women's health tips.
• Join our private Happy V Facebook group to hear from others who've been there.
• Explore supplements designed to support your vaginal health journey.

Disclaimer: This blog is for informational and educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Statements about supplements have not been evaluated by the Food and Drug Administration. For more information about vaginal infections, visit the CDC or speak to a licensed healthcare provider.