04 Jan 2023

A Complete Guide on Bacterial Vaginosis (BV)

What is Bacterial Vaginosis?

A common vaginal infection, bacterial vaginosis (BV) occurs when the naturally occurring bacteria of the vagina begin to overgrow and gives rise to an imbalance of the bacteria.

Sufferers will usually notice a grey or off-white coloured discharge from the vagina that can smell fishy. Quite often, bacterial vaginosis will resolve without treatment but if it is persistent then treatment with antibiotics will clear it up successfully.

This type of infection is most seen in younger women who have not yet reached menopause.

Usually, this type of infection is not serious but it can give rise to problems in pregnant women where premature birth or an infection, after a patient has had a hysterectomy for example, can be a problem. The condition could also make sexually transmitted infections, including HIV, more of a risk as women with BV maybe most susceptible to them.

Although around 85% of women suffering from BV will not have any symptoms, when they do the following may be observed:

Vaginal discharge that is grey has a greenish tinge or is off-white
A fishy odour from the vaginal discharge where the smell becomes more pungent during a woman's period or after intercourse.
Less commonly soreness or itching may be experienced in the vaginal area.

What is the most common cause of bacterial vaginosis?

The vagina has various different bacteria held in a very delicate balance. BV will occur when some types of naturally occurring bacteria start to multiply in much larger amounts than they should. When this happens the ‘good’ bacteria usually keeps things in check but will be overwhelmed by the ‘bad’ bacteria that are now present in much greater numbers. Scientifically there is no definite answer to why this should happen but it is more common in women who are sexually active and is very rarely seen in those who are not.

How is BV diagnosed?

If you suspect you may be suffering from BV, getting an accurate diagnosis is the first step. When you visit a private Gynaecologist in London they will usually start by giving you a physical examination and may also take a swab from the vagina so that the types of bacteria that are present can be identified. This is necessary because it is important to rule out other conditions such as a yeast infection, which may have very similar symptoms. It should also be kept in mind that as bacteria levels change constantly a negative test cannot be relied upon to give you a definitive negative result.

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When should I see my doctor?

Usually BV will not need any medical intervention but there are some instances where you should make an appointment without delay:

If you have developed a vaginal odour associated with the discharge and especially if you also have a fever.
You have suffered from BV or other infections before and the symptoms or discharge that you have looks very different this time.
You have been having sexual intercourse with a new partner or with multiple partners. This is particularly important as STIs often have similar symptoms to BV.
You have tried an over-the-counter treatment designed to treat a yeast infection but you still have symptoms.

How will my BV be treated?

If your BV is more persistent you will probably be diagnosed and then prescribed medication with antibiotics, possibly with gel or a cream or a tablet that will treat your infection and may include:

Cream to use internally such as Clindamycin
A pill to take or a gel to be inserted internally like Metronidazole
A single tablet to be taken once such as Tinidazole

If you are prescribed any of this medication it is important that you take it as instructed by your doctor and do not stop taking it before you are advised to do so. If you do stop taking the medication too early there's a very real chance that your BV will return. It is not advised to drink alcohol while you were taking medication and you should not resume taking any alcohol until at least a day after you have finished the prescription. This will lessen the chance of developing nausea or an upset stomach.

Will I be able to treat my BV at home?

Although it's always a good idea to see your health provider if you have BV there are something you can do to help resolve this condition, at home.

Home remedies include things like:

Eating a diet that is high in probiotic foods as found in yoghurt with active and live culture or you could achieve the same by taking a probiotic supplement.
Make sure that your underwear is made of breathable cotton and loose fitting
Pay particular attention to vaginal cleanliness and use soaps and tampons that are not scented.
Shower instead of bathing.
Do not use vaginal deodorants douches or washes
Steer clear strong detergent or fabric softeners when you're washing your underwear
Do not put any type of antiseptic liquid in a bath
Do not smoke

Is it Ok to have sex If I have BV?

It is not usually possible to pass on BV to a male partner but the symptoms you are experiencing may make intercourse uncomfortable for you. Female to female infection however is very possible and if you have a female partner and have developed BV they should also be checked for the infection.

What happens if BV is not treated?

If you have treated your BV with over-the-counter remedies but it has not cleared up then you leave yourself at risk of contracting STI infection such as chlamydia, gonorrhoea or HIV. For women who are pregnant and develop BV, if untreated the infection could lead to premature birth.

Another condition that you may become more susceptible to if you have untreated BV is pelvic inflammatory disease (PID). This is a serious condition that may also risk of premature delivery in a pregnant sufferer and can also affect fertility.

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How do I avoid developing BV?

There is no obvious way to avoid developing BV but there are certainly some things that can be done so that your risk is reduced. These are:

Using barriers such as condoms when you are sexually active, this is particularly important because when semen mixes with vaginal discharge there is an increased risk of BV developing.
Avoid scented products because washing with them can interfere the with the pH in the vagina making you more susceptible to developing BV.

BV is a condition that if you've had it once in the past you can very easily develop it again and in fact some data report that half the number of women who were treated for BV develop the condition again within a year of their treatment. If you find yourself developing recurrent bouts of BV then you should speak to your private GP about this as it may be that you should have antibiotic treatment for a longer period.

Can I have treatment for BV if I I'm expecting a baby?

Provided that your doctor knows that you are pregnant they will be able to prescribe you medication that will be safe for you to use during your pregnancy. If you are pregnant it’s particularly important that you get treated whether you have symptoms or not. This is to avoid the complications in pregnancy that are known to occur with untreated BV such as low birth weight and premature delivery.

In conclusion

Bacterial Vaginosis is a condition that is quite common and occurs when harmful and helpful bacteria in the vagina, become imbalanced. Although there is no concrete scientific evidence as to why this condition should occur there are certain things that increase the risk such as having different sexual partners and excessive use of scented hygiene products. Although the infection in itself is rarely very serious, the consequences of leaving it untreated can be very serious for pregnant sufferers and for those hoping to start a family.