Bacterial Vaginosis

What is bacterial vaginosis?

Bacterial vaginosis (BV) is a very common condition that affects the vagina. It happens when the balance of bacteria in your vagina changes. The good bacteria that normally keep your vagina healthy reduce, and other bacteria increase.

BV is not a sexually transmitted infection (STI). However, having BV can make it easier to catch an STI like chlamydia.

Signs you might have bacterial vaginosis

The main signs of BV are:

• Unusual vaginal discharge with a strong fishy smell, especially after sex
• Changes to your discharge - it may become greyish-white, thin and watery
• The smell may be stronger during your period

Many women with BV have no symptoms at all. Unlike thrush or other vaginal infections, BV does not usually cause:

• Soreness
• Itching
• Pain when passing urine

When to see your GP

Speak to your GP or visit a sexual health clinic if:

• You think you might have BV
• Your vaginal discharge has changed and smells different
• You're pregnant and notice changes to your discharge

BV is not usually serious, but you may need antibiotic treatment. If you're pregnant, it's especially important to get help as there's a small chance BV could cause problems during pregnancy.

Sexual health clinics are good places to get help with BV. Many offer walk-in appointments, and they often get test results faster than GP surgeries.

What happens at your appointment

Your doctor or nurse will:

• Ask about your symptoms
• May look at your vagina
• Use a cotton bud to take a sample of discharge to test for BV and other infections

This helps them work out what's causing your symptoms and rule out STIs.

How BV is treated

BV is usually treated with antibiotics. These come as:

• Tablets
• Gels you put in your vagina
• Creams

Your GP or sexual health clinic will prescribe these for you. If you have a female partner, they may also need treatment.

If BV keeps coming back

BV often comes back within a few months. If this happens, you'll usually get more antibiotics.

If you get BV more than 4 times in a year, your GP might give you antibiotic gel to use for several months. This helps stop BV returning.

Your doctor can help work out what might be triggering your BV, such as sex or your period.

Things you can do to help

Do:

• Wash your genital area with water and plain soap
• Have showers instead of baths

Don't:

• Use perfumed soaps, bubble bath, or shower gel in the bath
• Use vaginal deodorants, washes or douches
• Put antiseptic liquids in the bath
• Use strong washing powder on your underwear
• Smoke

What causes BV?

We don't fully understand why some women get BV. You're more likely to get it if you:

• Are sexually active (but women who haven't had sex can get it too)
• Have a new sexual partner
• Have a coil (IUD) for contraception
• Use perfumed products around your vagina

Remember, BV is not an STI, but it can make you more likely to catch one.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.