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Bacterial vaginosis

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Bacterial vaginosis (BV) is a common condition and can affect any woman. BV has noticeable symptoms like a change in vaginal odor and discharge.

If left untreated, BV can increase the risk of sexually transmitted infections (STIs) and cause other complications. Luckily, BV can be easily treated with prescribed medication.

Continue reading to learn more about BV and treatments to improve your vaginal health.

Dr. Adrian Rawlinson

Medically reviewed by Dr. Adrian Rawlinson

Written by our editorial team Last reviewed 04 January 2024

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What is bacterial vaginosis?

Bacterial vaginosis is the most common vaginal condition affecting women between the ages of 15 and 44. In the United States, BV is estimated to affect around 21.2 million women (29.2%) aged 14 to 49.

Although BV can be triggered by sex, it is not an STI. You may be more likely to get an STI if you have BV. This is because it changes the acidity of the vagina and reduces your natural protection against infections.

What causes bacterial vaginosis?

Researchers don’t fully understand the cause of BV however, the condition most commonly occurs in sexually active people.

BV occurs when there is an imbalance of the bacteria normally present in the vagina. A type of healthy bacteria called Lactobacillus makes lactic acid which keeps the vagina slightly acidic. This stops bad bacteria from overgrowing.

In people with BV, the normal good bacteria are replaced by bad bacteria. This imbalance leads to the infection.

Anything that upsets the balance of bacteria in your vagina can increase your risk of getting BV, this includes:

  • having multiple sexual partners
  • having a new sexual partner
  • not using barrier methods (such as condoms)
  • vaginal cleansing or douching (washing the inside of the vagina)
  • having an IUD

What are the symptoms of bacterial vaginosis?

Some people with BV may not notice any symptoms, while others may have symptoms that vary in severity. Some bacterial vaginosis symptoms include:

  • discharge from the vagina that is not usual for you (this may be thin and light gray or white)
  • a strong fishy odor from the vagina (especially after sex)
  • vaginal discomfort, itching, or irritation
  • a painful or burning feeling (usually when you’re peeing)
Symptoms of bacterial vaginosis (BV)

These symptoms may be similar to other vaginal infections. This is why it is important to see your doctor or nurse to get a proper diagnosis.

Bacterial vaginosis in men

Although men cannot directly get BV, they may experience similar symptoms resulting from an imbalance in their genital microbiota. Men with symptoms may be dealing with another condition.

Bacterial vaginosis vs yeast infection

Both BV and yeast infections are vaginal conditions that increase the amount of vaginal discharge produced. There are some key differences between the two:

Bacterial vaginosis Yeast infection
Cause Bacteria Fungi
Discharge Thin and white/gray Thick and creamy (cottage cheese-like)
Odor Strong ‘fishy’ smell Usually no strong odor
Treatment Prescription antibiotics Antifungals (may be available over-the-counter without a prescription)

BV vs vaginitis

Vaginitis is soreness and swelling in and around the vagina. It is common and can have many causes including thrush, STIs or hormonal changes. Some symptoms may include vaginal discharge, dryness or sore, swollen or cracked skin around the vagina.

How is it diagnosed?

To diagnose BV, your doctor will ask about your medical and sexual history. They may also:

  • Perform a pelvic exam to look for grayish-white, thin discharge that has an odor.
  • Test your vaginal discharge by using a swab to collect a sample of fluid from your vagina. This is sent to a lab to see what types of bacteria are present.
  • Test your vaginal acidity by doing a pH test. A pH higher than 4.5 may indicate BV.
  • Perform a ‘wet mount’ test. This involves looking at a sample of your vaginal discharge on a glass slide under a microscope.

Bacterial vaginosis in pregnancy

If you get BV during pregnancy, it’s important to treat it quickly. Research shows that having BV increases your risk of certain pregnancy-related complications, such as:

  • delivering your baby early (preterm birth), which can lead to issues for your baby, such as being born with a low birth weight
  • your water breaking early (preterm labor)
  • miscarriage
  • postpartum complications (such as endometritis and wound infections)

Pregnant women can be treated with any of the recommended regimens for nonpregnant women. Data has shown that treatment with metronidazole has a low risk during pregnancy.

How can I prevent bacterial vaginosis?

Using condoms correctly and consistently may help prevent BV, but they are not completely protective.

Some other things you can do to lower your risk of BV include:

  • Avoid antiseptic bath products.
  • Avoid using deodorants or perfumed products (marketed as 'feminine products') in and around the vagina.
  • Always wipe from front to back after you use the bathroom.
  • Only use warm water to clean the outside of your vagina (you do not need to use soap).
  • Wear cotton or cotton-lined underwear.
  • Avoid douching as this can change the balance of bacteria in your vagina.
  • Limit your number of sexual partners.
  • Avoid having sex until you’ve finished taking your medicine and your symptoms are gone. If your partner also has a vagina, they should see their doctor to find out if they need treatment.

Are there any home remedies for bacterial vaginosis?

You should always talk to a doctor before trying to treat BV at home. Some home remedies people have used include:

Probiotics

These are live bacteria and can be found in some foods such as yogurt, sauerkraut, or kefir. You can also take probiotics as a supplement.

Using probiotics can help the vaginal flora by increasing the beneficial bacteria and reducing the number of harmful bacteria. This can create a stable environment vaginal flora environment. Some research shows that taking antibiotics and probiotics together reduces the chance of BV returning compared with taking antibiotics alone.

Boric acid suppositories

There haven’t been many studies conducted to investigate the use of boric acid in BV. Talk to your doctor before considering this option. Boric acid should not be used in pregnancy or be taken by mouth as it is toxic.

How can I treat bacterial vaginosis?

BV is easily treatable and cured. An antibiotic tablet called Flagyl (containing metronidazole 500 mg) can be used to treat BV. This can be prescribed online for you here at SpeedyHealth after completing a consultation.

Other bacterial vaginosis treatments include:

  • metronidazole gel (used inside the vagina)
  • tinidazole
  • clindamycin tablets or gel (used inside the vagina)

It’s important to complete your course of this medication, even if you start to feel better. If you stop taking it early, there is a risk that BV will come back.

What happens if BV is left untreated?

Although it can be uncomfortable, BV generally doesn’t cause serious any complications. However, if it’s left untreated it may:

  • cause problems in pregnancy
  • increase the risk of getting STIs (including HIV, genital herpes, and chlamydia)
  • cause pelvic inflammatory disease

Can I buy treatment for bacterial vaginosis online?

You can buy Metronidazole, the treatment for BV online from SpeedyHealth by completing a quick online consultation. Once your consultation has been submitted, one of our registered doctors will check to see whether or not this medication is suitable for you.

If your consultation is approved, your prescription will be sent to our pharmacy and delivered promptly to you.

If this medicine is not suitable for you, you will not be charged.

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