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Bacterial Vaginosis

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 3 minutes read
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Bacterial vaginosis (BV) is the most common cause of vaginal infection in women of child-bearing age - those between 15 and 44 years old. It isn’t classed as a sexually transmitted infection although it is more likely to occur if you’re sexually active, especially with a new partner, if you smoke, use a copper coil (IUCD) for contraception, use bubble baths or feminine hygiene products, or if you have heavy periods. Having BV can also increase your chances of developing a sexually transmitted infection. It’s estimated that 1 in 3 women have an episode of BV at least once in their life.

BV is usually harmless and can be triggered by sex or your period. It’s due to a disturbance in the balance of bacteria in the vagina. Normally, this is well controlled with lots of ‘friendly’ bacteria (germs) which is normal but in BV the change in bacteria makes the vagina less acidic, encouraging growth of more bacteria called anaerobes that grow in an environment without air. It can also be triggered by overwashing or douching (washing inside of the vagina). This is because overwashing can clear away the ‘good’ bacteria, allowing for bad bacteria to grow. This is unnecessary as BV is not linked to poor hygiene or from being unclean.

When should I see my doctor?

Up to 1 in 2 women with BV don't have any symptoms. You may however notice a change to the colour or smell of your discharge, which is the main symptom. BV is commonly reported to be a strong fishy smell, worse after sex or a period, with a thin watery greyish consistency. It doesn’t usually cause soreness or itching, unless in combination with another infection.

If you have vaginal or urinary symptoms associated with sexual activity, it's best to attend a sexual health clinic or GUM clinic. Here you can be checked for all sexually transmitted infections, and they offer you quicker appointments, with faster results than your doctor's practice.

What will the nurse or doctor do?

The specialist nurse or doctor will ask you about your symptoms and intimate questions regarding your sexual history. It is important to be open and honest with them so that they can identify and manage any infections you may have.

A swab (a stick with a soft cotton bud at the tip) is used to sample any vaginal discharge and this can be tested straight away or sent away to the lab for confirmation.

Is it contagious?

BV is not contagious if your partner is of the opposite sex. However, in same-sex relationships, we usually advise that both people get treatment.

BV can occur in conjunction with other infections caught through sexual contact, so it's always important to get sexual health checks every time you have a new partner, or every couple of years with a regular partner.

How is it treated?

Self-help tips include avoiding any kind of feminine hygiene product including douches, bath additives, vaginal deodorants and harsh soaps. Avoid having sex for a couple of weeks, or use a condom and water-based lube if you don’t want to do this.

You can try treating this yourself with a neutralising cream, such as Balance Activ. If symptoms aren't resolving or symptoms are severe, a doctor can provide you treatment if BV is confirmed, usually in the form of an oral antibiotic called Metronidazole that is usually very effective. If you get BV more than twice in six months, you may need longer treatment and your local sexual health clinic or doctor can help with this.

To reduce the chances of BV returning, it's best to wash only the outside of your vaginal, with plain soap and water, and where possible to have showers instead of baths. You should avoid fragranced or scented shower or bath products, or use any vaginal products in your intimate area. It’s beneficial to stop smoking, and also to avoid long periods of wearing non-breathable clothing such as Lycra or workout gear.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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