What is bacterial vaginosis (BV)?
Bacterial vaginosis (BV) is a common vaginal condition caused by an overgrowth of bacteria. When this happens, it can change the natural balance of bacteria within the vagina and cause a variety of symptoms, including a fishy-smelling vaginal discharge.
Estimated to affect up to one in four women of reproductive age, BV is the most common cause of unusual vaginal discharge. But typically, once diagnosed, it can be easily treated.
However, due to having similar symptoms to other vaginal issues, it can often be mistaken for a yeast infection, like thrush. BV can also increase your risk of contracting certain sexually transmitted infections (STIs), such as chlamydia, despite not being classified as an STI itself (but more on that later!). In fact, while we sometimes call BV an ‘infection’, it’s actually a condition caused by an overgrowth of normal vaginal flora, including bacteria such as Gardnerella that are normally present in the vagina in very low numbers.
For these reasons, it’s important to be able to distinguish BV from other vaginal conditions by recognising its main symptoms and potential causes.
Bacterial vaginosis (BV): signs and symptoms
The signs and symptoms associated with BV aren’t particularly pleasant to experience and can lead many people to worry.
Some of the most common symptoms of BV include:
An unusual vaginal discharge with a strong fishy smell, particularly after sex
Changes to the consistency and colour of discharge, typically becoming thinner and either grey or white
BV symptoms can vary in severity, and some people may not notice any symptoms at all.
In fact, only half of women with bacterial vaginosis will actually experience symptoms.
Unlike other vaginal conditions, BV isn’t usually associated with symptoms like soreness or irritation in or around the vagina.
BV or thrush: what’s the difference?
Many women tend to mistake BV for thrush and vice versa, but the two infections are very different. Thrush, for example, is a common vaginal yeast infection that can affect both men and women. BV is a bacterial infection that only affects women.
The easiest way to tell the difference between thrush and BV is by looking at the symptoms.
While both can cause vaginal discharge, BV is associated with a strong, fishy smell that’s much more apparent as a symptom than the odourless, cottage cheese-like discharge associated with thrush.
Thrush can also cause a burning sensation when passing urine, as well as itching and irritation around the vulva and vagina, whereas BV shouldn’t really cause any pain, irritation or itchiness.9
If you’re still unsure, the Canestest® Self-Test for Vaginal Infections is a simple test you can use to help. This allows you to test yourself in the comfort of your home, quickly giving you reliable results that are over 90% accurate.
Since all vaginas are naturally slightly acidic, having either BV or thrush will affect its pH level. Having a pH level of 4.5 or higher will typically indicate BV, for instance, whereas thrush is usually somewhere between 4.0 and 4.5.
Combining the results from your test with your symptoms can help determine which type of vaginal infection you have and allow you to start the right course of treatment.
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Risk factors of bacterial vaginosis
Several things can increase your risk of developing BV. For instance, you’re more likely to get BV if:
You use douches, deodorant and scented products in and around your vagina
You smoke
You are pregnant
You have an intrauterine device (a contraception device)
You are sexually active (but women who have not had sex can also get BV)
You have recently changed your partner
You have multiple sex partners
You have sex with other women
You don’t use condoms
Some studies have also shown that BV is more common in black women.
While BV isn’t an STI, it can also be passed from one woman to another during sex. It can also increase your likelihood of getting an STI. This may be because it reduces the natural acidity of your vagina and leaves you more susceptible to infections.
When to seek medical attention
If you think you might have BV, you’re unsure about your symptoms or you’re simply looking for some peace of mind, talk to your doctor. They'll be able to talk through your symptoms and sexual history before running a few tests to see whether the discharge inside your vagina is caused by BV.
If your doctor confirms a BV diagnosis, they’ll likely put you on a course of antibiotics.
However, if you’d rather be seen more quickly, your local sexual health clinic may also be able to help. Many of these clinics offer a walk-in service, where you won’t need to make an appointment, and will often get test results back quicker than GP surgeries.
Bacterial vaginosis and pregnancy
You should also speak to your doctor if you experience any BV symptoms during pregnancy.
This is because, if you do develop BV while pregnant, there is a small chance of encountering potential complications as a result, such as early delivery or miscarriage. However, in most cases, having BV during pregnancy shouldn’t cause any issues.
How is bacterial vaginosis treated?
While your doctor will often prescribe a course of antibiotics to treat BV, it can also be treated using a gel.
Canesbalance® Bacterial Vaginosis Vaginal Gel, for example, is a seven-day course of treatment that’s clinically proven to treat the symptoms of bacterial vaginosis. Available in a gel applicator or gel pessary format, it starts working immediately to:
Relieve unpleasant intimate odour
Clear up unusual white or grey vaginal discharge
Help stop the growth of bad bacteria
Help encourage the growth of good bacteria
If you experience recurring bacterial vaginosis (more than twice in six months), talk to your doctor.
What happens if bacterial vaginosis is left untreated?
While BV can sometimes clear up on its own, treating it can be a smart move. Treatment manages the symptoms, and BV can also be associated with an increased risk of sexually transmitted infections (STIs).
BV is normally treated during pregnancy* as well, even if your symptoms are mild, to support the best possible outcome for both you and your baby.
How to prevent bacterial vaginosis
To prevent BV, it’s useful to think about the products you use and apply when washing.
Since your intimate area is more delicate than the rest of the body, certain soaps or shower gels can upset the pH balance in your vagina.
Some other ways to help prevent BV from coming back include:
Take showers instead of baths
Avoid using vaginal deodorants, washes or douches in and around your vaginal area
Use water and plain soap to wash your genital area
Don’t use strong detergents when washing your underwear
Stop smoking
Change your tampons and pads frequently
Wipe from front to back when going to the toilet
Change your underwear after swimming or working out
Is bacterial vaginosis a sexually transmitted infection?
No – BV isn’t classed as an STI.
While BV is more common in sexually active people, it can also affect those who aren’t sexually active. It happens when the natural balance of bacteria in the vagina is disrupted, allowing certain types of bacteria to overgrow.
Several factors can increase the risk of this imbalance, from using perfumed products in or around your vagina, to having a copper coil (intrauterine device). Sexual activity – including having sex or changing sexual partners – may increase your likelihood of developing BV, as it can affect the balance of bacteria in the vagina.
Is bacterial vaginosis contagious?
No, BV isn’t considered contagious in the same way that infections like colds or STIs are. BV can develop for many reasons – from hormonal changes to the use of certain hygiene products.
While it’s not something you can ‘catch’ from someone else, BV may come back after having sex. However, developing it after sex doesn’t mean that your partner has been unfaithful.
You can still have sex while receiving treatment for BV, as it’s not sexually transmitted. But it’s important to be aware that the treatment you take may reduce the effectiveness of the condoms and other forms of contraception you use.
If you’re experiencing recurring BV (more than four times in a year) or if you are pregnant and think you may have BV, it’s important to speak to your doctor. You may need an alternative form of treatment to help manage or prevent recurrence and it’s important to treat BV in pregnant women as it can increase the chances of complications.
BV is a very common condition – in fact, many women will experience it at least once in their lives. The good news is, once you understand the symptoms and when to seek treatment, BV is usually easy to manage.
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