Bacterial Vaginosis

Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance of the natural bacteria in the vagina. It occurs when harmful bacteria outnumber healthy Lactobacilli. BV is not a sexually transmitted infection (STI), but it can increase the risk of STIs or complications if untreated.

Common Symptoms

• Fish-like odour, especially after sex (most noticeable symptom).
• Thin, greyish-white vaginal discharge.
• Mild itching or burning (less common than in yeast infections).
• Up to 50% of women have no symptoms.

Causes & Risk Factors

• Imbalance of vaginal bacteria: Overgrowth of harmful bacteria like Gardnerella.
• Triggers:
  • Douching or using scented vaginal products.
  • New or multiple sexual partners.
  • Smoking or hormonal changes (e.g., menstruation).
• BV is not caused by poor hygiene.

Diagnosis

1. Test pH: BV often raises vaginal pH (>4.5).
2. Microscopic analysis to detect “clue cells” (bacteria-coated cells).

Treatment Options

1. Antibiotics:
   1. Metronidazole: Pills (oral) or gel (applied vaginally) for 5–7 days.
   1. Clindamycin cream: Applied vaginally for 3–7 nights.
2. Avoid alcohol during metronidazole treatment (causes nausea).
3. Follow-up: Recurrence is common; retest if symptoms return.

Prevention Tips

• Avoid douching or scented soaps/sprays.
• Wear cotton underwear and loose clothing.
• Practice safe sex: Condoms may reduce risk.
• Consider probiotics (containing Lactobacilli)—evidence is mixed but safe.

Frequently Asked Questions

Q: Is BV an STI?
A: No, but sexual activity can disrupt vaginal bacteria balance.

Q: Can men get BV?
A: No, but male partners don’t need treatment.

Q: Can BV affect pregnancy?
A: Yes—untreated BV increases preterm birth risk. Tell your doctor if pregnant.

Q: Why does BV recur?
A: The vaginal balance is delicate. Recurrence is common; long-term treatment may help.

Q: Is yogurt helpful?
A: While safe, evidence for yogurt/probiotics preventing BV is limited.

eGynaecologist Advice:

• BV is treatable with antibiotics and early treatment lowers complications (e.g., STI risk).
• BV is very common (1 in 3 women experience it) and you should openly discuss concerns with your gynaecologist.
• Avoid triggers like douching to reduce recurrence.
• You must seek gynaecological opinion if symptoms persist after treatment, or you notice new or worsening odour/discharge and if you are planning pregnancy or pregnant.
• You must seek urgent gynaecological consultation if you have high temperature, pelvic pain, or unusual bleeding as this may indicate pelvic inflammatory disease.