BV is not really transmitted from one person to another, except possibly in women who have sex with other women. Although it occurs more commonly in women who are sexually active than in women who have never been sexually active, there is no evidence that the causative bacteria are transmitted from men to women. Rather, BV is an imbalance that occurs in the vagina in which the bacteria that are normally there are overgrown by other bacteria, such as Gardnerella, which are also normally found in the vagina, but usually in lower numbers. This imbalance can occur in women who are not currently sexually active. Why some women develop this imbalance is not clear, but, as mentioned earlier, there are several circumstances—such as genital infections, douching, IUD use, and sexual activity—that make it more likely that a woman will develop BV.
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