What is bacterial vaginosis?
Bacterial vaginosis (BV) is a very common vaginal infection that women can get. It happens when the balance of good vs. harmful bacteria in your vagina changes, leading to an overgrowth of a group of bacteria called anaerobes. BV is not an STI but can make it easier to catch STIs and, left untreated, can cause problems during pregnancy. It can also seem to get worse after having sex.
What are the symptoms?
Many women have no symptoms. For those that do, the most common symptom is an unusual, often smelly, vaginal discharge – particularly after sex. Your discharge may become white or grey, thick or watery and a strong fishy smell is often noticed. Some women are aware of the smell only, without any change in their normal discharge. Vaginal soreness or itching is uncommon in BV.
How do you get it?
BV is still a relatively poorly understood infection. There are some things we know increase the risk by disrupting the natural balance of bacteria in your vagina. These include having with a new sex partner, having multiple sex partners and flushing the vagina with water (douching).
We know that douching and being over hygienic with soap or vaginal deodorant remove some of the normal bacteria in the vagina that protect you from infection. However, we don’t know why sex increases the risk of BV just that BV rarely affects women who have never had sex.
You cannot get BV from toilet seats, bedding, or swimming pools.
How can you prevent it?
The best ways to lower your risk are:
- Using warm water only to clean the outside of your vagina
- Always wiping front to back from your vagina to your anus
- Avoiding douching
- Using condoms
How can you get tested?
Your doctor or nurse will examine your genital area, look at your vagina for signs of BV and take a sample of your discharge. This is done using a swab which looks like a soft, rounded cotton bud. This is not normally painful and takes a couple of seconds.
You can get a free, confidential BV test at a sexual health clinic, a genitourinary medicine (GUM) clinic, most contraception clinics and some GP surgeries. To find your nearest sexual health service, put your postcode in here.
Want to get tested?
What treatment is available?
Women without symptoms do not generally need treatment for BV and the condition may get better on its own. If you are pregnant or about to have a gynaecological procedure (including coil fitting), treatment may be recommended regardless of symptoms.
If you have symptoms and need treatment this is usually with antibiotics, as either tablets or a vaginal gel. Some more homeopathic options are also available to buy over the counter. Male partners do not need to be treated but female partners should consider getting checked for BV.
- BAASH (British Association for Sexual Health and HIV) has a comprehensive patient information leaflet on BV available in normal and easy read format
- NHS Choices has lots of information about STIs including a specific page on bacterial vaginosis
- Brook has more information and advice on STIs written for people under 25, including bacterial vaginosis