What is bacterial vaginosis?

Bacterial vaginosis, or BV, is a type of bacterial infection in the vagina. It occurs when the natural balance of bacteria in the vagina is upset, and one type of bacteria grows more than the others. Women of all ages can be affected, although women in their reproductive years are more likely to develop it. 

What is the prognosis?

Bacterial vaginosis is generally a harmless condition that doesn't lead to complications, but it can cause uncomfortable symptoms.

In rare cases, it may lead to pelvic inflammatory disease. Bacterial vaginosis may also increase your risk of getting HIV. 

Bacterial vaginosis is not a sexually transmitted infection (STI), buit it can increase your risk for STIs, such as chlamydia if bacterial vaginosis is left untreated. This is because bacterial vaginosis makes the vagina less acidic, reducing the natural defences against infection. 

What are the symptoms?

Half of women with bacterial vaginosis are asymptomatic (experience no signs or symptoms).

When they do occur, symptoms can include:

• Burning when you pee
• A discharge that is white, grey, or green - especially after sex. Its consistency is thin and watery 
• A foul-smelling vaginal odour

How is it diagnosed?

If you get the symptoms mentioned above, you can visit your GP or nearest sexual health clinic. They will ask you about your symptoms and look at your vagina. A cotton swab may be used to take a sample of your discharge and test it for BV or other infections. Your GP and sexual health clinic will also identify the trigger behind the bacterial vaginosis, such as your menstruation. 

What causes bacterial vaginosis?

Bacterial vaginosis occurs when the natural balance of bacteria in your vaginal is disrupted. This can occur if you:

• Try to use washes or douches to clean your vagina. The vagina is self-cleaning so douches aren't really necessary.
• Have a bath with strong perfumed bubble bath, shower gel or antiseptic solution.
• Wash your underwear with detergent that is too strong
• Use an intrauterine device for contraception
• Have a natural lack of lactobacilli bacteria

Bacterial vaginosis is more common if you're sexually active, have multiple sex partners or a new sex partner – but doctors don’t yet understand why this is the case. The infection also occurs more often in women with same-sex partners. 

How is bacterial vaginosis treated?

Bacterial vaginosis is treated with a prescription of antibiotics for about a week. You could also be prescribed gels or creams. 

To receive a prescription, you can visit your GP or sexual health clinic; alternatively you can visit the pharmacist for a prescription.There's a possibility that your partner may also need treatment, if you are a same-sex couple. It is important to take the full course of treatment, even if your symptoms go away. 

It is common for bacterial vaginosis to come back, generally within three months. If this is the case, you’ll need to take antibiotics for a longer period of time - up to six months - if you get bacterial vaginosis more than twice in six months.

How do I prevent bacterial vaginosis?

You can help prevent bacterial vaginosis by making sure that you:

• Never uses douches to clean your vagina, and don’t use soap – just use water
• Opt for unscented tampons or pads
• Limit your sexual partners and get tested for STIs
• Clean sex toys after use every time

Can I have sex with bacterial vaginosis?

You don't need to avoid sex if you have bacterial vaginosis. However, some women find that having sex whilst having bacterial vaginosis can be uncomfortable and lead to a worsening of symptoms. 

Using a dental dam (a thin piece of latex) and covering sex toys with condoms before use can help to protect your partner during sex if you have bacterial vaginosis. 

You should wait seven days to have sex again following the end of your treatment for bacterial vaginosis. 

Pregnancy and bacterial vaginosis

If you're pregnant, it is important for you to get tested and start medical treatment as soon as possible, because bacterial vaginosis can cause low-birth-weight-babies and premature delivery. Medication for bacterial vaginosis is safe for pregnant women, so you will receive the same antibiotics that are prescribed for women who are not pregnant.

Can bacterial vaginosis cause bleeding and sores?

Bacterial vaginosis doesn't cause bleeding, but the infection may be more present and noticeable when you're on your period. Seek medical attention if you experience heavy bleeding between periods or after sexual intercourse.

Similarly, bacterial vaginosis doesn't cause sores to form on their own. A yeast infection and STIs like herpes or syphilis, may be the reason behind the appearance of sores. 

What is the difference between bacterial vaginosis and yeast infection?

Although both are forms of vaginitis, yeast infection results from an overgrowth of the Candida fungus in the vagina. Yeast infection also causes inflammation and redness of the vulva, as well as vaginal discharge that is odourless and thick.