Table of ContentsView AllTable of ContentsAt-Home TestsLabs and TestsClinical CriteriaDifferential DiagnosesFrequently Asked QuestionsNext in Bacterial Vaginosis GuideWhat Is Bacterial Vaginosis?
Table of ContentsView All
View All
Table of Contents
At-Home Tests
Labs and Tests
Clinical Criteria
Differential Diagnoses
Frequently Asked Questions
Next in Bacterial Vaginosis Guide
The greatest challenge to getting a diagnosis ofbacterial vaginosis(BV) is that the majority of cases will have no symptoms, according to a report from the Centers for Disease Control and Prevention.If you or your healthcare provider think that you may have an infection, tests that check for bacterial overgrowth in the vagina can confirm your diagnosis. The evaluation would also include a pelvic exam, an analysis of vaginal secretions, and a pH test to check for vaginal acidity.
In addition to lab tests, there are self-testing kits that allow you to check your vaginal pH and other markers of inflammation at home.
The test, which has been available over the counter since 2001, is relatively accurate and may provide enough evidence to seek a definitive diagnosis andtreatmentfrom a clinic.
The test is performed in two parts:
A negative test is an indication that you don’t have BV, but it should not be considered definitive.
In the end, if you have three or moresymptoms of BV, you should see a healthcare provider even if your home test is negative, especially if your symptoms are severe, persistent, or recurrent.
The diagnosis of bacterial vaginosis typically involves four parts:
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Clue Cells vs. Gram Staining
Clue cells describe vaginal cells that, when observed under a microscope, have the characteristics of a bacterial infection. In this instance, the healthcare provider is looking specifically at epithelial cells (the type that line hollow organs). If there is a bacterial infection, the edges of these cells will be peppered with bacteria. Their fuzzy appearance would provide the “clues” needed to help make the diagnosis.
Gram staining is a common technique used to differentiate between groups of bacteria. With BV, bacteria that are part of the normal vaginal flora would be expected to be low (specifically lactobacilli), while harmful bacteria will be in abundance (usuallyGardnerellaorMobiluncusstrains). By differentiating these bacteria with dyes and evaluating their proportion microscopically, healthcare providers can determine whether you meet the criteria for a BV infection.
A healthcare provider can make a definitive diagnosis of bacterial vaginosis with one of two evaluative measures: the Amsel criteria or gram stain grading.
The Amsel criteriatake into account the physical findings alongside the result of the diagnostic tests.
Using these criteria, BV can be confirmed when three of the following four conditions are met:
Gram stainingis an alternate method in which the number of different types of bacteria is used to determine a Nugent score that ranges from 0–10.
The diagnosis is based on the following system:
Grades seven through 10 can be considered a definitive diagnosis for bacterial vaginosis.
Because the symptoms of bacterial vaginosis are similar to other infections, healthcare providers may investigate other causes if the test results are borderline or the clinical symptoms raise concerns about another condition.
Differential diagnoses for BV may include:
It’s best to wait until after your period to test for BV, as blood can make it harder to get the clear sample necessary to check your vaginal fluids for bacteria.
What Is Bacterial Vaginosis?
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Bacterial vaginosis (BV).Huppert JS, Hesse EA, Bernard MC, Bates JR, Gaydos CA, Kahn JA.Accuracy and trust of self-testing for bacterial vaginosis.J Adolesc Health. 2012;51(4):400-5. doi:10.1016/j.jadohealth.2012.01.017Huppert JS, Hesse EA, Bernard MC, Bates JR, Gaydos CA, Kahn JA.Accuracy and trust of self-testing for bacterial vaginosis.J Adolesc Health. 2012;51(4):400-5. doi:10.1016/j.jadohealth.2012.01.017World Health Organization.Bacterial vaginosis.Antonucci FP, Mirandola W, Fontana C.Comparison between Nugent’s and Hay/Ison scoring criteria for the diagnosis of Bacterial Vaginosis in WASP prepared vaginal samples. Clinical Investigation.U.S. National Library of Medicine. Medline Plus.Vaginitis.Additional ReadingHainer, B. and Gibson, M.Vaginitis: Diagnosis and Treatment.Am Fam Physician.Mohammedzadeh, F.; Dolatian, M.; and Jorjani, M.Diagnostic Value of Amsel’s Clinical Criteria for Diagnosis of Bacterial Vaginosis.Glob J Health Sci.2015;7(3):8-14. doi:10.5539/gjhs.v7n3p8
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Bacterial vaginosis (BV).Huppert JS, Hesse EA, Bernard MC, Bates JR, Gaydos CA, Kahn JA.Accuracy and trust of self-testing for bacterial vaginosis.J Adolesc Health. 2012;51(4):400-5. doi:10.1016/j.jadohealth.2012.01.017Huppert JS, Hesse EA, Bernard MC, Bates JR, Gaydos CA, Kahn JA.Accuracy and trust of self-testing for bacterial vaginosis.J Adolesc Health. 2012;51(4):400-5. doi:10.1016/j.jadohealth.2012.01.017World Health Organization.Bacterial vaginosis.Antonucci FP, Mirandola W, Fontana C.Comparison between Nugent’s and Hay/Ison scoring criteria for the diagnosis of Bacterial Vaginosis in WASP prepared vaginal samples. Clinical Investigation.U.S. National Library of Medicine. Medline Plus.Vaginitis.Additional ReadingHainer, B. and Gibson, M.Vaginitis: Diagnosis and Treatment.Am Fam Physician.Mohammedzadeh, F.; Dolatian, M.; and Jorjani, M.Diagnostic Value of Amsel’s Clinical Criteria for Diagnosis of Bacterial Vaginosis.Glob J Health Sci.2015;7(3):8-14. doi:10.5539/gjhs.v7n3p8
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Bacterial vaginosis (BV).Huppert JS, Hesse EA, Bernard MC, Bates JR, Gaydos CA, Kahn JA.Accuracy and trust of self-testing for bacterial vaginosis.J Adolesc Health. 2012;51(4):400-5. doi:10.1016/j.jadohealth.2012.01.017Huppert JS, Hesse EA, Bernard MC, Bates JR, Gaydos CA, Kahn JA.Accuracy and trust of self-testing for bacterial vaginosis.J Adolesc Health. 2012;51(4):400-5. doi:10.1016/j.jadohealth.2012.01.017World Health Organization.Bacterial vaginosis.Antonucci FP, Mirandola W, Fontana C.Comparison between Nugent’s and Hay/Ison scoring criteria for the diagnosis of Bacterial Vaginosis in WASP prepared vaginal samples. Clinical Investigation.U.S. National Library of Medicine. Medline Plus.Vaginitis.
Centers for Disease Control and Prevention.Bacterial vaginosis (BV).
Huppert JS, Hesse EA, Bernard MC, Bates JR, Gaydos CA, Kahn JA.Accuracy and trust of self-testing for bacterial vaginosis.J Adolesc Health. 2012;51(4):400-5. doi:10.1016/j.jadohealth.2012.01.017
World Health Organization.Bacterial vaginosis.
Antonucci FP, Mirandola W, Fontana C.Comparison between Nugent’s and Hay/Ison scoring criteria for the diagnosis of Bacterial Vaginosis in WASP prepared vaginal samples. Clinical Investigation.
U.S. National Library of Medicine. Medline Plus.Vaginitis.
Hainer, B. and Gibson, M.Vaginitis: Diagnosis and Treatment.Am Fam Physician.Mohammedzadeh, F.; Dolatian, M.; and Jorjani, M.Diagnostic Value of Amsel’s Clinical Criteria for Diagnosis of Bacterial Vaginosis.Glob J Health Sci.2015;7(3):8-14. doi:10.5539/gjhs.v7n3p8
Hainer, B. and Gibson, M.Vaginitis: Diagnosis and Treatment.Am Fam Physician.
Mohammedzadeh, F.; Dolatian, M.; and Jorjani, M.Diagnostic Value of Amsel’s Clinical Criteria for Diagnosis of Bacterial Vaginosis.Glob J Health Sci.2015;7(3):8-14. doi:10.5539/gjhs.v7n3p8
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