Bacterial Vaginosis (BV) – FAQs
This information is general only and does not replace advice from your GP or healthcare professional.
1. What is bacterial vaginosis (BV)?
Bacterial vaginosis is a common vaginal condition caused by an imbalance in the natural bacteria of the vagina. Normally, “good” bacteria (lactobacilli) help keep the vaginal environment acidic and healthy. In BV, these are reduced, allowing other bacteria to grow and cause symptoms such as odour and discharge.
2. What are the common symptoms of BV?
Many people with BV have no symptoms. When symptoms occur, they often include a thin, grey or white vaginal discharge and a strong “fishy” smell, especially after sex. BV usually does not cause itching or significant pain, which helps distinguish it from thrush.
3. What causes BV?
BV is caused by changes in the vaginal bacterial balance. Triggers may include new or multiple sexual partners, vaginal douching, using scented products in the genital area, or changes in hormones. However, BV can also occur without clear triggers and is not strictly considered a sexually transmitted infection.
4. Is BV a sexually transmitted infection (STI)?
BV is not classified as an STI. However, sexual activity can influence the vaginal bacterial balance and increase the risk of BV. It can also be more common in people with new or multiple partners. BV does not come from poor hygiene and is not caused by a lack of cleanliness.
5. How is BV diagnosed?
A GP can diagnose BV by discussing your symptoms and performing a simple swab test. The test checks the pH level of the vagina and looks for specific bacteria under a microscope or via lab testing. Diagnosis is usually quick and straightforward.
6. How is BV treated?
Treatment generally involves antibiotics, either as oral tablets or vaginal gels/creams. These help restore the normal balance of bacteria. Symptoms often improve within a few days. It’s important to complete the full course even if you start feeling better.
7. Can BV come back after treatment?
Yes. BV can recur, sometimes within weeks or months. Recurrence is common because the underlying bacterial imbalance can be difficult to maintain long-term. Avoiding scented products, douching, and practising good genital hygiene may help reduce the risk of recurrence.
8. What happens if BV is not treated?
Most cases of BV are mild, but untreated BV can increase the risk of pelvic infections, complications after gynaecological procedures, and pregnancy-related issues such as premature birth. BV can also increase susceptibility to certain STIs due to changes in vaginal acidity.
9. Can BV affect pregnancy?
Yes. BV during pregnancy has been linked with premature birth, low birth weight, and infections after delivery. Pregnant women with symptoms should see their GP or midwife for safe treatment options.
10. How can I prevent BV?
Prevention includes avoiding vaginal douching, using mild unscented soaps, wearing breathable cotton underwear, practising safe sex, and avoiding irritants such as scented wipes or sprays. Staying aware of triggers and discussing any recurrent BV with your GP can help guide long-term management.
