Bacterial Vaginosis
WHAT IS BACTERIAL VAGINOSIS
Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge. 1 in 3 people with a vagina will have BV at some time in their life.
WHAT CAUSES BV?
BV is caused by an imbalance in the bacteria that is naturally found in the vagina.
Healthy vaginas usually have high numbers of a bacteria called lactobacilli. Lactobacilli protect the vagina and keep it healthy. When BV occurs, lactobacilli is replaced by BV causing bacteria. It is not really understood why this happens.
However, BV is more common in people who:
• have had a new sexual partner
• have sexual partners with a vagina
• do not use condoms for penis-vagina sex
• do vaginal douching
• have a Copper intrauterine device (IUD)
How do you get BV?
BV usually only affects people who are sexually active. The organisms that cause BV are transmitted through sexual intercourse.
What are the symptoms?
Up to half of people with bacterial vaginosis will not have any symptoms. However, if symptoms do occur, they can include:
- Increased or changed vaginal discharge (often white or grey watery).
- A vaginal odour change (usually slightly offensive or ‘fishy’ and may be more noticeable after sex).
- Vulval itching or irritation.
How do you diagnose BV?
BV is diagnosed based on symptoms and an examination. A vaginal swab is also usually collected.
Do I need treatment?
In up to one-third of cases, BV goes away by itself without treatment. However, treatment is recommended in the following circumstances:
- To relieve symptoms that don’t go away.
- If you are having a gynaecological procedure.
- If you are pregnant.
What is the treatment?
The treatment for BV is antibiotics. These antibiotics restore normal balance in the vagina. Antibiotic treatment can be oral tablets, vaginal creams, or vaginal gels. Please discuss your preferred method with your doctor.
If BV keeps recurring after treatment your doctor may recommend an extended treatment over a 4-month period.
Are there any side effects from BV treatment?
Most people tolerate the treatment well. However, some people may experience some side effects from the oral antibiotics, such as abdominal pain, cramps, nausea & vomiting, flushing, or headache.
The oral antibiotics can interact with alcohol, so you need to avoid alcohol during treatment and for up to 3 days afterwards.
The vaginal treatment preparations weaken latex condoms, so abstaining from sex or using a non-latex condom during treatment is important
What happens if BV is not treated?
BV is a very common condition. Most of the time there are no problems if it is not treated, and treatment is not usually advised if you have no symptoms. However, there are situations where complications can occur so treatment will be advised. This includes:
- If you have BV when you are pregnant, you may be at higher risk of having problems in pregnancy and immediately after birth.
- If you undergo a gynaecological procedure when you have BV, you are at greater risk of developing a pelvic infection afterwards.
- If you have untreated BV it may increase your risk of contracting a sexually transmissible infection and HIV.
Can BV recur?
While treatment is very effective, BV can recur. About a third of people who are treated will have another episode of BV within three months, and more than half will have a recurrence within a year.
How can I reduce BV recurring?
How can I reduce BV recurring? We do not know how to prevent BV. However, avoiding anything that changes the balance of vaginal bacteria may help reduce recurrences. This includes:
• Good vulval care. This involves using warm water only to wash the vulval and vaginal area and avoiding using scented soap, shower gels, perfumed bubble baths, and commercial ‘feminine hygiene’ products such as sprays, vaginal deodorants, washes, or wipes.
• Avoiding douching.
• Using condoms with partners with a penis.
Does my sexual partner need testing or treatment?
There is no test available for people with a penis. However, if you have a regular sexual partner with a penis there is some evidence that it may be useful to treat them while you are being treated as this may reduce recurrence. Discuss this with your doctor.
References:
Australian STI Management Guidelines for use in primary care.
Victorian Sexual Health Network. Bacterial vaginosis - STI Testing and Prevention - Stay STI Free
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