Knowledge Centre
Providing rapid medical guidance and expert health insights for informational purposes. While our guides are written by Harley Street clinicians, they do not replace a professional consultation.
Bacterial Vaginosis (BV): Causes, Symptoms & Treatment
If you have noticed an unusual vaginal discharge or a persistent fishy odour, you may be wondering what is wrong. These symptoms are often caused by bacterial vaginosis (BV), the most common vaginal infection in women of reproductive age.
BV is not a sexually transmitted infection. It is not dangerous in most cases. And it is easily treated with antibiotics. But it can be uncomfortable, embarrassing, and confusing, particularly if it keeps coming back.
What Is Bacterial Vaginosis?
The vagina naturally contains a mix of bacteria. In a healthy vaginal environment, beneficial bacteria (mainly lactobacilli) keep potentially harmful bacteria in check. BV occurs when this balance is disrupted and other bacteria overgrow.
The result is often a thin, greyish-white discharge with a distinctive fishy smell. The odour may be more noticeable after sex or during your period.
BV is not caused by poor hygiene. In fact, excessive washing, douching, or using scented products can make it more likely by disrupting the natural bacterial balance.
Symptoms & Identification
Typical Symptoms
- • Thin, watery discharge (grey, white, or greenish)
- • Distinctive fishy odour, stronger after sex or during menstruation
- • Mild itching or irritation around the vagina
BV vs. Thrush
Thrush typically causes thick, white "cottage cheese" discharge and intense itching without odour. BV is thinner, greyish, and smells distinctive. Antifungals treat thrush; antibiotics treat BV.
Using the wrong treatment will not help and may delay proper care.
Why Does BV Keep Coming Back?
BV has a frustrating tendency to recur. Studies suggest that around half of women treated for BV will experience another episode within 12 months.
- • Ph balance remains disrupted after treatment
- • Use of scented hygiene products or douching
- • Regular sexual partners reintroducing bacteria
If you have had three or more episodes in a year, speak to a doctor about extended antibiotic treatment or other strategies to reduce recurrence.
When to See a Doctor
- ✓ Unusual discharge that hasn't cleared up
- ✓ Discharge smells unpleasant or distinctive
- ✓ You are pregnant or trying to conceive
- ✓ New sexual partner or multiple partners
- ✓ Symptoms persist after OTC thrush treatment
BV symptoms can overlap with STIs like chlamydia. If there is any possibility of an STI, our screening packages can check for multiple infections in one appointment.
Treatment & Complications
BV is treated with antibiotics (usually metronidazole or clindamycin) via tablets, gels, or creams. It is vital to complete the full course to prevent recurrence. Avoid alcohol during metronidazole treatment to prevent severe nausea.
Potential Complications (if untreated)
- • Increased risk of acquiring STIs, including HIV
- • Pelvic Inflammatory Disease (PID) affecting fertility
- • Complications during pregnancy (premature birth)
Get it diagnosed. Get it treated.
Our Harley Street clinic offers same-day appointments for vaginal symptoms. For recurrent cases, our consultant gynaecologist Mr Hikmat Naoum is available for specialist review.
Mr Hikmat Naoum
Gynaecology and Women's Health • GMC 3047637
"Expert consultant providing advanced gynaecological assessments and imaging interpretation. Mr Naoum has wide experience in obstetrics and gynaecology and has lectured on specialist topics internationally. Mr Naoum carries out all IUD fitting/removal procedures as well as HPV treatment for both men and women. Diagnostic ultrasound and the management of pain, or abnormal bleeding are additional specialist areas for Mr Naoum. Alongside his knowledge and skills, Mr Naoum's patients appreciate the personal and professional expertise he provides."
View TeamCommon Questions
Q.Is BV a sexually transmitted infection?
No, BV is a bacterial imbalance, not an STI. However, having a new sexual partner or multiple partners can increase the risk of developing it.
Q.Can I get BV from a swimming pool?
No. You cannot catch BV from swimming pools, toilet seats, or shared bedding. It is entirely related to the internal bacterial balance of the vagina.
Need Professional Advice?
While our Knowledge Centre provides expert insights, it does not replace a face-to-face consultation with a doctor.
