Bacterial vaginosis

What is bacterial vaginosis?

Bacterial Vaginosis (BV) is an infection that develops in the vagina. It is not sexually transmitted, but is caused by an overgrowth of anaerobic bacteria in the vagina.

The vagina normally contains a mix of bacteria including lactobacilli and anaerobic bacteria. With BV, something triggers the anaerobic bacteria to multiply, and the lactobacilli bacteria to decrease. This upsets the normal balance and causes symptoms of BV. Sometimes, women can identify a trigger that has caused this imbalance to occur - but often it is not clear why.

Common triggers include :

• Sexual intercourse

• Having a new sexual partner

• Hormonal changes such as puberty or menopause - or in some women, their regular menstrual period

• Douching (washing out the vagina)

• Smoking

• Using perfumed ‘vaginal deodorants’ or soaps

• Bubble baths

• Having the copper IUD coil for contraception

BV is not a serious condition and will not cause a woman long-term complications. However, it can be irritating and, for some women, can be a recurring problem.

Symptoms of bacterial vaginosis?

• Vaginal discharge - often white/grey in colour

• Odour - often described as ‘fishy’

However, many women experience no symptoms of BV.

How to treat bacterial vaginosis?

BV can clear up on its own, however it is more quickly treated with antibiotics. These can either be given orally, or as a gel applied into the vagina.

It is advisable to refrain from sexual activity until BV has been fully treated. Although BV cannot be passed to a partner, having sex can be a trigger for BV in some women, and so it is best to allow the infection to fully resolve before resuming sexual intercourse.

Some women suffer with recurrent episodes of BV. To reduce the risk of this, avoid using vaginal deodorants, strong detergents and perfumed bubble baths. In fact, women suffering recurrent BV are best avoiding baths altogether and having showers instead. It is also advisable to avoid douching; the vagina does not need to be cleaned, and attempting to do so increases the risk of unbalancing the natural bacterial balance.

Some women notice BV is more common after they have unprotected sex. If so, consider trialling using condoms when having sex to see if this reduces episodes of BV.

Gels or pessaries which aim to restore the natural pH and bacterial balance of the vagina can also be helpful (as anaerobic bacteria start to multiply at higher pH’s, while lactobacilli start to die off). Most pharmacies stock these and a pharmacist would be able to advise further.

If the above measures fail to help, women can be prescribed repeated courses of antibiotics for recurrent episodes, or be referred on to a gynaecologist.

When to see a GP?

If you have a new vaginal discharge, particularly if you have recently had unprotected sexual intercourse with a new partner, then you should see your GP or local sexual health clinic for a full sexual health screen

If you have BV and are pregnant you should discuss this with your GP.