Bacterial Vaginosis: Symptoms, treatment and prevention

Bacterial vaginosis (BV) is the most common cause of abnormal discharge from the vagina. Any woman or person with a vagina can get BV, not just those who are sexually active.

Normally the vagina contains a mixture of bacteria. BV happens when there is an increase in certain types of bacteria, resulting in an overall imbalance. Although BV can be uncomfortable, it is not a sexually transmitted infection (STI) as you can get it for other reasons than having sex.

How do you get bacterial vaginosis?

The cause of BV is not fully understood – it is not gotten from a sexual partner but sexual activity may play a part. The vagina normally contains mostly ‘good’ bacteria (called lactobacilli), which help to cleanse the vagina, and fewer ‘bad’ bacteria (called anaerobes).

BV develops when there is an increase in the number of ‘bad’ bacteria. This changes the chemistry of the vaginal fluid. Although we do not understand why some get BV and others don’t, we do know that some activities can upset the normal balance of bacteria in the vagina and put women at increased risk.

These include:

• Having a new sex partner
• Smoking
• Douching (rinsing inside the vagina) or using vaginal washes or deodorants
• Having oral sex
• Having sex with multiple partners

What are the symptoms of bacterial vaginosis?

If you had BV, as well as an abnormal discharge from the vagina, common symptoms include an abnormal smell from the vagina, like a ‘fishy’ smell. Sometimes the ‘fishy’ smell is worse after sex. BV does not cause itch, soreness or irritation.

How can I be tested for bacterial vaginosis?

BV can be diagnosed based on the symptoms you describe and some simple tests on the vaginal discharge either by your GP or at a sexual health clinic. 

How is bacterial vaginosis treated?

BV is easily treated with antibiotics. It sometimes comes back and may need to be treated again. Your GP or sexual health practitioner will be able to prescribe you antibiotics and talk you through what to do if your BV comes back.

What about my partner?

If you are having sex with someone with a penis, they do not need to be treated. However, if you are having sex with someone with a vagina they may need to be treated also. Treatment of you and your partner may help to prevent recurrences of BV.

When can I have sex again?

BV is not sexually transmitted, so you do not need to avoid sex. However, some find their symptoms clear up more quickly if they avoid sex.

What happens if my bacterial vaginosis is left untreated?

For most, there are no complications from BV. It often clears up without treatment, but if it persists it is recommended to go to your doctor or STI clinic.

How can I prevent getting bacterial vaginosis again?

To prevent getting BV again, avoid anything that upsets the natural balance of bacteria in the vagina, such as soaps or deodorants.

For example, avoid

• Douching (rinse inside your vagina)
• Bathing too frequently
• Using perfumed washes, bubble baths, antiseptic solutions or feminine wipes or washes

If you are sexually active it is recommended that you go for regular STI check-ups as this is the best way to protect your health and the health of those you have sex with. 

Bacterial vaginosis in pregnancy

If you are pregnant and have BV that is bothering you, your doctor or nurse will speak to you about safe treatment. Treatment can be given even in the first trimester (the first 12 weeks).

If you have had a miscarriage or a premature or low birth weight baby, there is some evidence to suggest that BV may increase the risk of premature delivery in future pregnancies. If you have experienced this, treatment is usually advised in pregnancy (preferably before 20 weeks). Your doctor or obstetrician will speak to you about this. 

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