What is bacterial vaginosis?
A normal, healthy vagina is home to a variety of different bacteria. However, in Bacterial Vaginosis (BV) the balance is disturbed, and an overgrowth of some of these bacteria occurs. It is not entirely clear why this happens. The most common symptom is a vaginal discharge which is often white-grey in colour and may have a fishy smell. However, many women with BV do not have any symptoms at all (up to half of cases).
Is bacterial vaginosis a sexually transmitted disease?
BV is not a sexually transmitted infection (although using condoms does seem to make it less likely to develop). It can affect all women, whether they have had sex or not, but it is more common in sexually active women. Male sexual partners of women who have BV do not need any treatment, though female sexual partners may.
Who gets bacterial vaginosis and what are the risk factors?
In women of reproductive age, BV is the most common cause of vaginal discharge.
Women are more likely to get BV if they:
- are sexually active
- have recently changed sexual partner
- have a history of sexually transmitted infections ( STIs)
- are smokers
- have a copper coil for contraception
- use bubble bath
Women are less likely to get BV if:
- they use the combined oral contraceptive pill
- they have a partner who has had a circumcision
- their partner uses a condom
How is bacterial vaginosis diagnosed?
BV is usually diagnosed on the basis of symptoms, and is confirmed by taking a vaginal swab, which can be performed by a doctor or nurse. You may also need tests for STIs such as chlamydia and gonorrhoea. If you are pregnant, and suspect you may have BV, it’s important to get tested and treated, as it can increase the risk of pregnancy-related complications.
What are the possible complications of BV?
In most women, BV causes no harm. However, if you have untreated BV during pregnancy, there is a slightly higher risk of premature labour, miscarriage, preterm birth and having a baby with a low birthweight. If you are pregnant and suspect you may have BV, you should see your GP or midwife. BV can also cause complications if you have had recent gynaecological surgery- the chance of developing an infection of the womb is higher.
There is also some evidence that women with untreated BV may be at an increased risk of getting other STIs and Pelvic Inflammatory Disease (PID).
What is the treatment for bacterial vaginosis?
If you are diagnosed with BV, you may wish to take antibiotics to get rid of the symptoms. There are two types of antibiotic tablet that may be used. Metronidazole is taken twice a day for 7 days. Tinidazole is another option- it’s taken as a single dose (made up of 4 tablets). Some people may get side-effects with these treatments, such as nausea. You shouldn’t drink alcohol while taking these antibiotics, or for 48 hours after stopping treatment, as it can lead to vomiting and facial flushing.
There are also topical creams and gels that can be inserted into the vagina to treat BV. Metronidazole vaginal gel and Clindamycin vaginal cream are two options- they are used for 5-7 nights in a row, and are just as effective as oral antibiotic.
If symptoms are mild, there is a good chance that BV will gradually clear by itself. And if BV is picked up on a swab but you have no symptoms, there’s generally no need for treatment at all. However, in pregnancy, or just after gynaecological surgery, there’s a higher chance of complications, and it’s usually recommended to have treatment.
Do I need a test to make sure it’s gone?
No, if symptoms get better, you do not usually require any further testing, though if you are pregnant, retesting may be advisable.
What if it comes back?
If your symptoms come back immediately or do not get better after treatment, you may need a vaginal swab and other tests to make sure there’s nothing else going on. If you’ve had treatment for BV and it settled, but then comes back again after weeks or months, another course of antibiotics will often be successful. But any symptoms that do not get better should be discussed with a doctor.
Does my partner need testing?
Although BV is not an STI, if you have a female partner, she should consider being tested if she also has symptoms. However, a male partner does not need to be tested.
If you have further questions or concerns regarding Bacterial Vaginosis, speak to your GP.