A review in the November 2001 issue of Clinician Review emphasizes the risks to women associated with bacterial vaginosis (BV), a treatable sexually transmitted infection (STI) once thought to be benign. BV is connected to an increased risk of contracting HIV and other STIs including gonorrhea, chlamydia, syphilis, and trichomoniasis. BV can also lead to miscarriage or premature delivery in pregnant women and is associated with low birth weight and pelvic inflammatory disease (PID). Among the symptoms connected to BV are increased vaginal discharge, an unusual vaginal odor, and mild vulvar burning. While these symptoms may be present, often BV is asymptomatic. BV occurs when the balance of bacteria in the vagina is disrupted. According to Planned Parenthood, most women will have BV at some point in their lives, most typically during their reproductive years. Risk factors associated with BV include multiple sexual partners, receiving oral sex, douching, IUD use, African-American ancestry, and cigarette smoking, among others. Many women are prone to recurrent BV infections and should avoid oral sex, swimming pools, hot tubs, and tampon use, according to the review of the literature. BV can be treated topically with antimicrobial creams.