Bacterial Vaginosis

Posted in Women's Health

Download a PDF copy of the SHFPACT Fact sheet Bacterial Vaginosis here

What is bacterial vaginosis
Bacterial Vaginosis (BV) the commonest cause of vaginal discharge in women of child bearing age.  One in ten women will have BV at some time in their life.   Bacterial Vaginosis is associated with sex but is not considered a sexually transmitted infection.

Causes
We do not know what causes Bacterial Vaginosis or how some women get it. Women with BV have a change in the number and type of bacteria found in the vagina. There is a decrease in the number of ‘good’ lactobacilli compared to the ‘bad’ anaerobic bacteria.  The increase in ‘bad’ bacteria changes the chemistry of the vaginal fluid making it more alkaline.

Having a new sexual partner or multiple partners, and douching (rinsing inside the vagina) all increase the risk of getting BV.  

Symptoms may be mild, moderate or severe or Garderella may have been identified on a pap smear or swab without you noticing any changes.

Symptoms
Half to three quarters of women with bacterial vaginosis will have no symptoms.

Typical symptoms are:

  • Increased or changed vaginal discharge (often white or grey watery)
  • Vaginal odour - usually slightly offensive or ‘fishy’.  The odour maybe more noticeable after sex.
  • Rarely women experience itching or mild vulval irritation

Diagnosis
Bacterial Vaginosis is usually diagnosed by a doctor based on your symptoms and an examination. BV is usually confirmed with a vaginal swab. 

Is bacterial vaginosis sexually transmitted?
Bacterial vaginosis is not considered a sexually transmitted infection as there is not a known link with sexual transmission. However there does seem to be some association with it occurring when there is a new sexual partner, or when there are multiple sexual partners. There seems to be a decrease in occurrence when condoms are used with male partners. Women with female partners seem to be more at risk then women who have only male partners. 

Treatment
BV resolves without treatment in up to one third of non-pregnant women and half of pregnant women.  Treatment is advised to relieve symptoms, if you are planning to have a gynaecological procedure, or if you are pregnant. 

BV is treated with antibiotics that can be prescribed as a single dose or 5-7 day treatment.  These antibiotics kill the ‘bad’ anaerobic bacteria and allow the ‘good’ lactobacilli to restore normal balance in the vagina. Antibiotics can be given as oral tablets, vaginal creams or vaginal gels.  Please discuss with your doctor your preferred method. 

Some antibiotics used to treat BV, such as Metronidazole and Tinidazole, can cause serious side effects including abdominal pain, cramps, nausea & vomiting, flushing and headache.  You should not drink alcohol while taking these medications and for three days afterwards.

The vaginal preparations weaken latex condoms so no sex or non-latex condom use is advised. 

Consequences of untreated infection

  • Women who have BV whilst pregnant are at risk of late miscarriage, premature birth and developing a womb infection after birth.
  • Women with BV who undergo gynaecological procedures are at greater risk of developing a pelvic infection.
  • Women with BV have increased risk of getting a sexually transmitted infection including HIV, chlamydia and herpes.

Reducing recurrences
About a third of women who respond to treatment will have another episode of BV within three months, more than half will have a recurrence within a year.

The best ways of preventing BV are not known.  Avoiding anything that changes the balance of vaginal bacteria may help. You may reduce the chance of getting BV if you avoid the following:

  • scented soap, shower gels, perfumed bubble bath and antiseptic bath liquids
  • vaginal douching
  • using any commercial ‘feminine hygiene’ products such as sprays, vaginal deodorants, washes or wipes.

Using condoms also reduces your risk of developing BV.

Download a PDF copy of the SHFPACT Fact sheet Bacterial Vaginosis here

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