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
- Test pH: BV often raises vaginal pH (>4.5).
- Microscopic analysis to detect “clue cells” (bacteria-coated cells).
Treatment Options
- Antibiotics:
Metronidazole: Pills (oral) or gel (applied vaginally) for 5–7 days.
Clindamycin cream: Applied vaginally for 3–7 nights. - Avoid alcohol during metronidazole treatment (causes nausea).
- 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.
