What is bacterial vaginosis?

Bacterial vaginosis is a common condition. It is sometimes known as BV, non-specific vaginitis, or Gardnerella.

Bacterial vaginosis occurs when the types of bacteria that live in the vagina are out of balance.

It is normal to have vaginal discharge. But any change in what you usually experience might mean there is an underlying issue.

What are the symptoms of bacterial vaginosis?

In about half of all cases of bacterial vaginosis, there are no noticeable symptoms.

When symptoms do occur, they usually include:

• a white or greyish, wateryvaginal discharge
• an unpleasant or ‘fishy’ vaginal smell
• mild irritation around the vagina and vulva

Sometimes the symptoms come and go. They may be more noticeable during menstrual periods or after sexual activity.

What causes bacterial vaginosis?

The exact cause of bacterial vaginosis is not known. It is thought to happen when there is an overgrowth of bacteria that live naturally in the vagina.

You are more likely to get bacterial vaginosis if you:

• are sexually active (BV usually only happens in people who are sexually active)
• have a new sexual partner
• don’t use a barrier method of contraception (such as condoms)
• have a sexual partner with a vagina
• regularly douche (rinse or flush your vagina) or clean inside your vagina
• are a smoker

Having a copper intra-uterine device (IUD) may also increase your risk of getting BV.

When should I see my doctor?

You should see your doctor if you have symptoms of BV, or a change in your normal vaginal discharge. BV can be uncomfortable and lead to other problems.

How is bacterial vaginosis diagnosed?

Your doctor or nurse will ask you about your symptoms and will usually perform a physical examination.

Your doctor may recommend taking a swab sample from your vagina for testing to diagnose BV. You may be able to take the swab yourself.

The vaginal sample will be examined under a microscope to make the diagnosis.

How is bacterial vaginosis treated?

Bacterial vaginosis doesn’t necessarily have to be treated if there are no symptoms. If you have symptoms, especially if you are pregnant, it’s important you get treatment to avoid complications.

Treatment is with antibiotics. They may be given as oral tablets, or a vaginal antibiotic cream or gel.

Unfortunately, BV often comes back. So, you may need more than one course of treatment.

It’s not normally necessary to treat sexual partners, but it is possible to spread bacterial vaginosis between female sexual partners.

Can bacterial vaginosis be prevented?

If you’ve had bacterial vaginosis, there are some things you can do to help prevent it coming back.

• Stop smoking.
• Avoid douching.
• Only use water to clean your vagina.
• Don’t use perfumed talcs or deodorants around your vagina.
• Use barrier contraception, such as condoms during any type of sex.

Complications of bacterial vaginosis

Having BV can put you at an increased risk of other conditions. These can include:

• sexually transmitted infections
• pelvic inflammatory disease (inflammation of organs in the pelvic area)
• complications if you have a procedure such as insertion of an intrauterine contraceptive device (IUD)

Untreated BV during pregnancy can cause pregnancy complications, such as:

• premature (early) birth
• miscarriage
• infection in the uterus

See your doctor or midwife if you have symptoms of BV for treatment during pregnancy. Treatment of BV can help prevent pregnancy complications.