Diagnosis of bacterial vaginosis (BV) has two main methods: Amsel’s criteria and Nugent score. Amsel’s criteria is much cheaper than Nugent scoring, despite Nugent scoring having been considered the gold standard – it requires expensive lab equipment and takes a lot of time. Amsel’s criteria, however, has been found to be just as effective as Nugent scoring in diagnosis of BV.

Amsel’s criteria, however, can be done in your doctor’s office.

Amsel’s criteria – three out of four criteria must be met for a diagnosis of BV

  • Vaginal discharge is homogenous – that is, all looks the same, with colour and amount varying, can be grey or off-white
  • Fishy odour when potassium hydroxide (KOH) is added to the vaginal secretions (the whiff test)
  • Clue cells make up more than 20 per cent of cells in sample when examined under a microscope
  • Vaginal pH over 4.5 (normal vaginal pH is 3.8 – 4.5)


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