Bacterial Vaginosis

Bacterial vaginosis or BV is the commonest infection of the vagina and it is caused by an increase in gardnerella bacteria and a decrease in lactobacillus bacteria. This change in balance is associated with a change in the pH of the vagina to be more alkaline. It is not a sexually transmitted infection (STI) but is more common in sexually active women. It can cause a discharge that is often watery, grey or green and smells a little fishy. Sometimes it causes no symptoms at all. It doesn’t normally cause pain or itching but if untreated can cause irritation in the vaginal area. Sometimes for this reason it can be misdiagnosed as a urinary tract infection.

Why does it matter?

Having BV can often make women feel embarrassed. The smell can be more noticeable after sex but often more to the women herself than her partner. Women can pass it to female partners during sex and although it is not a STI it can make a woman more susceptible to catching STIs in particular Chlamydia. Having BV when she is pregnant increases a woman’s chance of miscarriage so it is important if you have a change in discharge during pregnancy that you get it checked out. You will be more prone to get this if you have an intrauterine device like a Mirena coil and untreated the infection can lead to a pelvic infection which can be serious.


How do we treat it?

The first thing is to recognise the symptoms and attend your GP, practice nurse, midwife if pregnant or gynaecologist (if you have one). They will take a swab and sometimes will use some litmus paper to check the pH of the vagina. They will prescribe either a gel or an oral antibiotic. Unfortunately BV can come back and be recurrent which can be frustrating and upsetting.


How do we prevent it?

Anything that changes the pH of the vagina will make this infection more common so it is important to avoid scented soaps, creams or sprays around the vagina. Avoid excessive washing and use a shower rather than a bath. Similar to thrush, BV is more likely to thrive when a woman wears tights or tight fitting trousers or if the area is wet, so it is a good idea to wear cotton underwear and ensure the area is dried properly after showering. Some lubricants can cause BV so again look for unscented and try changing the brand. Sometimes changing to a latex free condom can help. Faecal matter from the anal area can also cause infection in the vagina so it is important to always wipe from front to back after going to the toilet. It can be helpful to pass urine after sex to clean the area. Regularly changing tampons and pads is also good practice and will help keep your vagina healthy.