Bacterial vaginosis (BV) in women occurs when there is an imbalance in the normal vaginal bacteria, specifically when "good" bacteria like lactobacilli decrease and harmful bacteria increase. This imbalance can be triggered by several factors:

• Sexual activity, especially having new or multiple sex partners, can increase the risk of BV. Women who have sex with women are particularly more likely to get BV because they can exchange vaginal bacteria during sex

• BV is not classified as a sexually transmitted infection, and women who have never had sex can also get BV

• Other factors that upset vaginal bacterial balance include douching, using perfumed products or bubble baths, wearing tight nylon clothing, prolonged or heavy periods, and hormonal changes such as puberty, pregnancy, or menopause

• Use of an intrauterine device (IUD), smoking, and not using condoms can also increase the risk of BV

• BV can be passed between female sexual partners but is not directly "caught" from intercourse with men

In summary, BV arises from a disruption of the natural vaginal bacterial environment, often influenced by sexual behavior and other lifestyle or hormonal factors, rather than a straightforward infection transmitted sexually