Bacterial Vaginosis
Bacterial vaginosis (BV) occurs when the balance of natural bacteria in the vagina is disrupted. It is the most common cause of unusual vaginal discharge, which is the fluid that comes from the vagina. Although not usually serious, BV requires treatment as it can increase the risk of certain STIs, like chlamydia, by reducing the vagina’s natural acidity and thus lowering the body’s defenses. In pregnant women, BV can occasionally lead to complications.
What causes bacterial vaginosis?
The vagina naturally contains a variety of bacteria. BV develops when certain types of bacteria increase and disrupt the natural balance. While not classified as an STI, BV is more likely to occur in sexually active individuals and those who smoke.
Although the changes of BV don’t usually cause pain or itching, they do tend to cause a discharge which can smell stronger than usual. Sometimes it smells ‘fishy’, particularly after sexual activity. It can be watery and greyish in colour.
This can be distressing and make women feel unclean. Some women then try to douche or wash themselves with soaps or perfumes – but this will only disturb the vagina more (because soaps are too alkaline for the inside of the vagina) and will make the problem worse
What are the symptoms?
About half of those with BV experience no symptoms, and it does not pose a threat to health or pregnancy if asymptomatic. BV typically does not cause vaginal soreness or itching, so these symptoms should be checked for other possible causes.
BV usually affects vaginal discharge, which may:
- Have a strong fishy odor, especially after sex
- Turn white or gray in color
- Become thin and watery
Pregnant women with symptoms should seek medical advice promptly.
How do you test for bacterial vaginosis?
You can get tested for BV at a sexual health clinic or by your GP. The clinician will inquire about your symptoms and may perform a vaginal examination. A small sample of vaginal discharge may be taken for testing.
How is bacterial vaginosis treated?
BV is typically treated with a short course of antibiotics, either in tablet form or as an antibiotic gel applied inside the vagina. Treatment is available from your GP, local sexual health clinic, and pharmacies.
Some creams and gels for BV can weaken latex condoms and diaphragms, so inform your healthcare provider if you use these contraceptives.
BV often recurs, with over half of treated individuals experiencing a return of symptoms, usually within three months. If BV recurs more than four times a year, you may be referred to a genitourinary medicine (GUM) specialist for long-term treatment options.