Your Guide to Bacterial Vaginosis - HE7024

Simple facts on identifying symptoms, treatment, and prevention.

What is it?

Bacterial vaginosis or “BV” happens when the natural balance of bacteria in the vagina is disrupted. The helpful bacteria that usually protect the vagina reduce in number, allowing other types of bacteria to grow more than usual. This can lead to symptoms such as unusual discharge or a fishy odour. BV is the most common cause of abnormal vaginal discharge in people of childbearing age. Up to half of people with BV have no symptoms.

How do you get it?

BV is not usually classed as a sexually transmitted infection, but sex can play a role in triggering it or in it coming back. It is more common after a change in sexual partner, and can return after treatment. BV may also be linked to vaginal douching, which is the process of cleaning inside the vagina with water, soap or other products. Sex toys or fingers may sometimes play a role in moving bacteria into the vagina. It isn’t always clear why some people get BV and others don’t.

Symptoms

BV may cause an increase in vaginal discharge (fluid leaking from the vagina). The discharge is often thin, watery, white or grey, and there may be a strong sour or fishy smell which may worsen after sex. About 50% of people with BV have no symptoms at all. BV does not usually cause itching, burning, or soreness. If you have those symptoms, it may be another condition such as thrush, or sometimes an STI. Other infections can also cause discharge, so it is important to get checked if you are unsure.

How do you get tested?

If you have symptoms, BV can usually be diagnosed with a vaginal swab arranged by a doctor or nurse.

If you do not have symptoms, testing and treatment are not usually needed.

Male partners do not need testing for BV.

Treatment

Treatment of BV is generally not required if there are no symptoms. A common treatment is metronidazole tablets taken twice a day for 7 days. An alternative antibiotic may be used if metronidazole is not suitable. Metronidazole can sometimes cause nausea or an upset stomach, and taking it with food may help. Do not drink alcohol while taking metronidazole and for at least 48 hours after finishing it, as this can make you feel very unwell.

BV can come back after treatment, and recurrence is common. If it keeps returning, talk with your doctor or nurse, as there may be other treatment options or further advice depending on your symptoms and how often it is happening.

Male partners do not require testing, however if bacterial vaginosis is recurring they may be advised to have treatment.

Prevention

It is not always clear why some people get BV and others don’t - these measures may help to prevent bacterial vaginosis.

• Condoms used correctly every time you have sex from start to finish will provide some protection from BV and offer good protection from many other sexually transmitted infections.
• Avoid douching or bathing with bubble baths or other non-pH balanced detergents. Avoid using soap, vaginal wipes or antiseptics.
• Wear cotton underwear.
• If you use sex toys, clean them well and avoid sharing them unless they are covered with a new condom each time.

Telling your partners

If you are diagnosed with bacterial vaginosis, partner notification is not required as this is not considered a sexually transmitted infection. If you are experiencing recurrent BV infections there is increasing evidence that treating your sexual partner/s may reduce recurrences - speak with your health professional about this.

Where can I get help?

Attend your local sexual health clinic or primary care provider.

For more information on all things sexual health and STIs, visit the Just the Facts website: Life goes on, read Just The Facts about Sexually Transmitted Infections

Cover image courtesy of Death to Stock, models used for illustrative purposes only.