Bacterial vaginosis (BV) is a widespread yet poorly understood condition, in which the balance of bacteria inside the vagina gets disrupted.
BV doesn’t often cause any vaginal soreness or itching, but often causes unusual vaginal discharge. If you have the condition, your discharge may:
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- develop a strong fishy smell, particularly after sexual intercourse
- become white or grey
- become thin and watery
BV isn’t serious for the vast majority of women, although it may be a concern if symptoms of BV start in pregnancy and you have a history of pregnancy-related complications.
About half of women with bacterial vaginosis have no symptoms.
When to seek medical advice
See your doctor or visit a sexual health or genitourinary medicine (GUM) clinic if you notice any abnormal discharge from your vagina, especially if you’re pregnant. It’s vital to get this checked to rule out other infections and avoid complications.
Your doctor will inquire about your symptoms and may examine your vagina. In some cases, a small sample of the vaginal discharge will be taken using a plastic loop or swab, so it can be checked for signs of BV.
Why it happens
The vagina naturally contains a mix of several different bacteria. In cases of BV, the number of certain bacteria increases thereby affecting the balance of chemicals in the vagina.
What result to these changes in the levels of bacteria is not clear. BV isn’t classified as a sexually transmitted infection (STI), but you’re at a higher risk of developing the condition if you are sexually active.
Women with BV may be able to pass the condition to other women they have sex with, although it’s not clear how this occurs.
There’s no evidence to suggest the bacteria causing BV can affect male sexual partners.
There are also a number of other factors that can increase your risk of developing BV, inclusive of:
- using scented soaps or bubble baths
- having an intrauterine device (IUD) fitted
- using vaginal deodorant
BV is more frequent in women who use a coil for contraception and those who perform vaginal douching (cleaning out the vagina).
BV can usually be successfully treated with the use of a short course of antibiotic tablets or an antibiotic gel you apply inside your vagina.
In most situations, you’ll be prescribed antibiotic tablets to take twice a day for five to seven days.
However, it’s common for BV to resurface. More than half of women successfully treated with BV find their symptoms return, usually within three months. Women who have frequent episodes of BV may be referred to a GUM specialist.
If BV starts in pregnancy, it may increase the risk of pregnancy-related complications, such as premature birth or miscarriage. However, this risk is small and appears more great for women who have had these complications in a previous pregnancy. BV causes no issues in the vast majority of pregnancies.
As a precaution, you should contact your caregiver or GUM clinic if you’re pregnant and you start to have vaginal discharge (although discharge can be a normal part of pregnancy).
Bacterial vaginosis can also increase your risk of getting some STIs.
The causes of BV are not fully understood, so it’s not possible to completely prevent it. However, you may be able to reduce your risk of developing the condition if you avoid:
- using scented soaps, perfumed bubble bath and antiseptic bath liquids
- using vaginal deodorant
- vaginal douching
- using strong detergents to wash your underwear
These can distort the natural bacterial balance in your vagina, making it more likely that you’ll develop BV.