Bacterial Vaginosis (BV)

Causes, Symptoms, and Treatment

Many women will experience bacterial vaginosis (BV) in their lifetime. The main symptom is a watery discharge with a fishy smell, but there are often no symptoms. BV is not a sexually transmitted infection (STI), but it can make it easier to catch STIs and can cause complications if you suffer with BV in pregnancy. You can treat BV easily and quickly using antibiotics available from our doctors.

Read on to learn more about BV, what causes the condition, its symptoms and how to treat it quickly and effectively.

What is BV?

Bacterial vaginosis (BV) is a common condition that anyone with a vagina can get. The main symptom is a watery, grey or white discharge with a strong fishy smell, but around 50% of people with BV do not have symptoms at all.

The cause of BV is a change in the balance of bacteria in your vagina. It is not a sexually transmitted infection (STI), but sex can trigger it. The change in bacteria means you are more likely to get an STI as your body’s natural defences against infection are weaker.

BV is a condition that affects the vagina only, so men cannot get it. The bacteria that causes BV (Gardnerella Vaginalis) is a bacteria that normally lives on the skin on the genitals in both women and men but usually only causes vaginal symptoms.

What are the Symptoms of BV?

It is common to have no symptoms with bacterial vaginosis (BV).

If you have symptoms, it will be a thin or watery discharge that is white or grey and has a strong fishy smell. Some women find that this discharge is more noticeable during their period or when they have sex.

BV does not usually cause itching, soreness or pain.

While BV can clear up on its own in a few days, it is not uncommon for it to come back within 3 months. BV can increase your chance of catching an STI and increase the risk of pelvic inflammatory disease (PID). If you are pregnant and have BV you should contact your midwife or GP. Treatment is usually recommended in pregnancy as BV can lead to complications in pregnancy.

You know BV has cleared up when your discharge returns to normal.

What Causes BV?

The cause of bacterial vaginosis (BV) is a change in the natural balance of bacteria in your vagina.

It is not clear from research exactly why these changes happen, but you are more likely to get BV if:

  • you are sexually active
  • you have a new sexual partner
  • you use a contraceptive coil (IUD)
  • you use scented products around your vagina
  • you have your period or are experiencing menopause

What increases your risk of getting BV?

Your risk of getting BV is higher if you are of African-Caribbean heritage. Research has also found a link between increased incidences of BV and smoking. This is because smoking changes the balance of bacteria in your vagina.

Why do I keep getting BV?

BV will often reoccur if the trigger factors have not changed. For example, if you get BV when you get your period, you are likely to get it again when you get your period.

It is common to keep getting BV. Over 50% of those who are treated for BV will experience symptoms again within 12 months. If you get BV within 3 months of an episode, it is called recurring BV.

How is BV Diagnosed?

You can only be sure that you have bacterial vaginosis (BV) if you do a swab test. This test involves you or a doctor taking a sample from the discharge in your vagina using a cotton bud.

Though your doctor can diagnose BV without the need for a test if you have typical BV symptoms, have an up to date STI screen, haven’t had any recent gynaecological procedures and are not pregnant.

How is BV Treated?

Bacterial vaginosis (BV) is treated with a course of antibiotics. Antibiotics kill the bacteria causing the symptoms of BV and usually get to work within 2 to 3 days of taking them. Provided you don’t have any side effects, you should finish the course even if your symptoms have stopped, so you can be sure that the infection has cleared up completely.

The antibiotics are either tablets that you take orally or a gel or cream that you insert into your vagina using an applicator. The creams and gels can be a good choice if the tablets give you side effects.

Here at Superdrug Online Doctor, we prescribe the following antibiotics to treat BV:

Metronidazole tablets

  • taken with water during or after food for either 1 day or 7 days
  • avoid alcohol when taking these tablets and for 48 hours after you stop taking them as alcohol can cause unpleasant side effects

Zidoval (metronidazole 0.75%) cream

  • cream administered daily before bed for 5 days
  • apply with an applicator that is inserted directly into the vagina
  • avoid using during your period
  • avoid having sex while using Zidoval
  • be aware that Zidoval can weaken contraception like condoms and diaphragms

Dalacin (clindamycin 2%) cream

  • similar to Zidoval as it is a cream inserted into the vagina
  • the course lasts for 7 days

All of these treatments are 70-80% effective at treating the symptoms of BV. These antibiotics can cure the specific episode of BV but cannot stop it from coming back. Talk to your doctor if you keep getting BV as they can prescribe you a different medication or a more extended treatment.

Other medical treatments for BV did include the antibiotic called tinidazole. Tinidazole has been discontinued in the UK and is not suitable if you are pregnant, drink a lot of alcohol and have specific blood conditions.

Can I treat BV naturally?

Some women report that using apple cider vinegar, natural yoghurt, and hydrogen peroxide improves their BV symptoms. There is little scientific evidence to support the claim that these treatments work effectively and they can potentially be harmful.

How to Prevent BV

Taking antibiotics will not prevent future episodes of bacterial vaginosis (BV). You can reduce the chances of another episode by the following lifestyle measures. These all work to prevent changes to the bacteria in your vagina:

  • avoid using vaginal deodorants, washes or douches
  • avoid strong detergents to wash your clothes and perfumed soaps to wash your body
  • stopping smoking
  • using condoms every time you have sex
  • using hormonal contraception if this is suitable for you
  • reducing your stress levels

It is also helpful to know what triggers your BV. For example, if you regularly get BV after having sex with a man, you can try using a condom. If your period triggers BV, you can try using different sanitary products.