Symptoms of Bacterial Vaginosis (BV)

Bacterial vaginosis (BV) is often symptomless, but if you do get symptoms the most common are watery discharge or discharge with a strong fishy smell. Because BV often has no symptoms or symptoms that can be confused with other conditions, the best way to get a diagnosis and treatment is by speaking to a doctor.

Here, we’re taking a look at the different symptoms of BV, how they affect you, and what to do if you think you’ve got the condition.

Dr Babak Ashrafi Clinical Lead for Service Development

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 27 Jun 2024

What are the symptoms of bacterial vaginosis?

Studies have shown that around 84% of women who have BV have no symptoms. However, if you do have symptoms they often include a change in vaginal discharge, such as:

  • watery, thin or greyish discharge
  • discharge with a strong fishy smell
  • discharge that is more noticeable during sex or when you have your period

BV does not usually cause itching, soreness or pain.

Discharge with a strong smell can also be a symptom of several other conditions, such as sexually transmitted infections (STIs) like trichomoniasis.

Thrush vs BV

Bacterial vaginosis is often mistaken for thrush, although the symptoms of thrush and causes of thrush are very different. The common symptoms of thrush are:

  • itching and irritation in and around the vagina
  • a burning sensation, especially during intercourse or while urinating
  • discomfort or pain during sexual intercourse
  • redness and swelling around the vagina and vulvar
  • a thick, white odourless vaginal discharge that often has a cottage cheese-like consistency

Getting tested to know if you have BV, thrush, or another condition is essential to get the right treatment quickly.

How long does BV last?

BV usually clears up within 5 to 7 days with prescribed treatments, such as metronidazole. Some over-the-counter treatments can help, but prescription medications are typically more effective.

Without treatment, BV may take months to clear up. In some cases, BV can clear up by itself – especially when you have no symptoms.

Recurrent BV

It is common for BV to come back a few weeks or months after an initial episode, which is known as recurrent BV. A longer course of antibiotics may be necessary to help clear up the infection. Talk to your doctor if you have recurring BV.

How do I know if I have BV or a sexually transmitted infection (STI)?

Many symptoms of BV are similar to some common STI symptoms including:

  • vaginal irritation and swelling
  • unusual discharge
  • foul-smelling discharge

BV is not an STI, but it can lead to STIs and cause complications if you are pregnant. The best way to know for sure if you have BV or an STI is by getting examined by a doctor or taking an STI test.

Your doctor can speak to you or examine you to confirm if you have BV or an STI. They will need to take a swab test to understand what’s happening to the bacteria in your vagina. You can also order an STI test to take from the comfort of your home. Our tests are discreetly packaged, easy-to-use, and you will get your results within 48 to 72 hours.

If you notice unusual discharge recently after having sex with a new partner, an STI test can confirm if you have an STI rather than BV.

Complications of BV

Bacterial vaginosis doesn’t often cause complications but it may lead to:

What can increase your chance of getting BV?

Medical research is not clear on why exactly the changes in bacteria happen to cause BV, but you are more likely to get BV if you:

  • are sexually active
  • have a new sexual partner
  • have your period
  • are experiencing menopause
  • use scented products for your vagina
  • use a contraceptive coil (IUD)
  • are taking antibiotics

Research has found that your risk of getting BV is twice as high if you are a woman of African-Caribbean heritage. There is also a link between smoking and an increased chance of getting BV because smoking can impact bacteria in your vagina.

How to treat BV

BV can clear up by itself, but you may need treatment. Treatment is usually a course of antibiotics. Antibiotics work by killing the bacteria that cause the infection. It’s important you finish the full course of antibiotics to make sure the infection clears up, even if your symptoms have gotten better or this could increase the risk of recurrent BV.

Here at Superdrug Online Doctor, you can get the following treatments for BV:

Metronidazole tablets:

  • Available as an oral tablet
  • Taken with water during or after food
  • The course lasts either 1 day or 7 days
  • Alcohol can cause unpleasant side effects, so avoid alcohol while taking it and for 48 hours after

Zidoval (metronidazole 0.75%) cream

  • Cream used daily before bed for 5 days
  • Apply with an applicator that is inserted directly into the vagina
  • Avoid using during your period or having sex
  • Be aware that Zidoval can weaken contraception like condoms and diaphragms

Dalacin (clindamycin 2%) cream

  • Also a cream that you insert into the vagina
  • The course lasts for 7 days

In the past, doctors also could prescribe another antibiotic called tinidazole. It has now been discontinued in the UK and, in particular, is not suitable if you are pregnant, drink a lot of alcohol and have specific blood conditions.

Are there natural treatments for BV?

Some women find that natural treatments such as probiotics (yoghurt, kefir, fermented foods), apple cider vinegar and hydrogen peroxide help their symptoms of BV to clear up. There is little medical evidence to back this up. If you try natural treatments, research them carefully to ensure you understand any potential risks.

Are there any home remedies for BV?

Some lifestyle changes may help relieve BV symptoms and prevent it such as:

  • avoiding scented soap or other scented vaginal products
  • practising safe sex with condoms
  • maintaining good vaginal hygiene
  • avoiding douching

How do I know if my BV has cleared up?

You know BV has cleared up when your discharge returns to normal. If you’re still having symptoms over a week after treatment you may need to go back to a doctor to make sure your BV is resolved.

How to prevent BV

Taking antibiotics will help stop a current outbreak of BV but will not prevent you from getting it again. BV is caused by the bacteria in your vagina changing, so you can reduce the chances of getting it again by following these tips:

  • wear cotton, loose-fitting underwear
  • wipe from front to back
  • use plain, unperfumed soaps, deodorants and washing powders
  • avoid douches and vaginal deodorants
  • reduce your stress levels
  • stop smoking
  • reduce fat intake in your diet and increase calcium, folate and vitamin A intake (which you can find in certain foods or vitamin supplements)

Having sex or hormone changes around your period can trigger BV. If you keep getting BV, keeping a diary and noting if anything is causing you to get BV can be helpful.


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