What is recurring bacterial vaginosis (BV)?

Recurring BV is when you get BV regularly. BV is a condition caused by changes to the natural balance of bacteria in your vagina. The most common symptom of BV is discharge that has a strong fishy smell. Other symptoms can include a change in the colour and consistency of your discharge. According to the NHS, 50% of women with BV do not have symptoms at all.

How do I know if it’s BV and not thrush?

If your discharge is watery, white or grey and has a strong fishy smell, you may have BV. Thicker discharge that looks like cottage cheese and does not smell fishy is more likely to be thrush.

The best way to be sure that your discharge is caused by BV and not something else is to visit your doctor or a sexual health clinic where you can be tested.  The test uses a swab wiped over the discharge in your vagina. After you get your results, the doctor will recommend the most suitable treatment for you depending on what’s wrong.

What is recurring BV?

Recurring BV is when you get BV again within three months of an episode. It is very common to have recurring BV. According to one study, over 50% of those who get BV will experience symptoms again within 12 months.

Do I have chronic BV?

If you keep getting BV, this can be called both recurring BV and chronic BV. Chronic is used to refer to the condition when it is persistently occurring, often over years. If you keep getting BV and the treatments you use are not working, you may have chronic BV. Your doctor will be able to diagnose this for you, usually following an examination. They may also recommend some tests to rule out other causes for your symptoms such as an STI screen if you have not had one since your most recent sexual partner. 

Why do I keep getting bacterial vaginosis (BV)?

Once you have BV, it is common to get it again even if your circumstances have changed. You are more likely to get BV if you:

• are sexually active 
• recently changed your sexual partner or have multiple sexual partners
• use an IUD (coil) 
• use perfumed products around or in your vagina
• are experiencing hormonal changes such as pregnancy, menopause and during your menstrual cycle
• smoke
• have an african-Caribbean heritage 

Why do I keep getting BV after sex?

It is common to get BV after sex, including oral sex and sex with another woman. This is because any activity or anything that causes different bodily fluids to enter the vagina can change the balance of bacteria and cause BV. 

You can get recurring BV after regular sex with the same partner, as well as if you change sexual partners. 

Why does my boyfriend keep giving me BV?

Bacterial vaginosis is caused by a change in the natural balance of bacteria in your vagina. For some people, exposure to semen can alter the bacteria in your vagina and cause BV. If this applies to you, using a condom can help reduce the risk of recurring BV.

Why do I keep getting BV after my period?

The hormonal changes associated with your menstrual cycle can alter the balance of bacteria in your vagina and cause BV. It is also possible that the sanitary products you are using create a change in the balance of bacteria in your vagina. Trying different sanitary products may help prevent recurring BV.

I use a copper coil (IUD). Could this be giving me BV?

It is possible that the copper coil is the cause of your BV.  Studies suggest that this is to do with the presence of the string in the vagina and the fact that the copper coil can cause heavier periods. Both these factors could cause a change in bacteria in the vagina and trigger BV. If you are getting recurring BV and you use a coil, talk to your doctor about trying alternative contraception.

I am not sexually active, so why do I keep getting BV?

While many women find BV is often triggered by sexual activity, there are other factors that cause BV such as: 

• your heritage: women with an African-Caribbean heritage are more likely to get BV
• hormonal changes like those during your menstrual cycle or during menopause can change the bacteria in your vagina 
• how you wash your vagina: using perfumed soaps or sprays and douches can introduce new bacteria to your vagina

Why do I keep getting BV and yeast infections at the same time?

BV is different to a yeast infection such as thrush. BV is caused by a change in bacteria whereas an overgrowth of fungus causes thrush. Although they are different conditions, they can be caused by similar factors such as having sex, using scented soap and hormonal changes. 

Is recurring bacterial vaginosis (BV) dangerous?

Recurring BV is not dangerous if treated. 

It is essential to speak to your doctor if you are diagnosed with or have symptoms of BV if you are pregnant as there is a low chance it can cause complications such as premature labour or miscarriage. Most pregnant women do not experience any problems.

Recurring BV can also make you more susceptible to sexually transmitted infections (STIs) because BV reduces the acidity in your vagina and your body’s natural mechanisms for fighting infection. 

Will my recurring BV get worse if I don’t get it treated?

If you don’t get your recurring BV treated, your symptoms may not change, but your risk of complications such as STIs, pelvic inflammatory disease and issues in pregnancy may increase.

How can I manage bacterial vaginosis (BV)?

You can manage recurring BV with a course of antibiotics which must be prescribed by a doctor. You can do this easily and discreetly using our online consultation service at Superdrug Online Doctor.

Metronidazole is an antibiotic which can be taken either as a tablet by mouth or a gel you insert into your vagina. Another antibiotic is clindamycin, which is available as a vaginal cream. They work by killing the bacteria that cause the symptoms of BV. Your doctor can prescribe you a longer course or a different treatment if you have recurring or chronic BV.

At Superdrug Online Doctor, our doctors can prescribe you metronidazole tablets or metronidazole gel, or clindamycin as a cream called Dalacin.

Usually, your  symptoms will clear up within 2 to 3 days of starting treatment. Providing you don’t suffer with any side effects, you should finish the whole course of antibiotics to make sure BV has been completely treated. 

The treatment for BV is different if you are pregnant so it is essential you contact your GP or midwife if there is a chance you might be pregnant.

How can I stop BV coming back?

The antibiotics to treat BV will not prevent future outbreaks but you can reduce the chance of BV coming back by making sure you avoid using the following:

• strongly perfumed soaps, shampoo, shower gel or bubble bath in the bath
• strong detergents to wash your underwear
• vaginal deodorants, washes or douches
• tight-fitting synthetic underwear

Stopping smoking can also help prevent recurring BV. 

It is also helpful to understand what triggers BV for you. For example, using a condom can prevent recurring BV for women who experience BV after sex wth a man or changing your sanitary products can help if you feel your period is triggering your BV.

Are there home remedies I can try for BV?

Studies show that home remedies vary in how effectively they treat BV. Some women report that their BV symptoms are improved using natural yoghurt, hydrogen peroxide and apple cider vinegar however these are not recommended treatments for BV as they lack evidence and may cause more harm than good .

Sources

Bacterial Vaginosis NHS [accessed 24 November 2021]

Bacterial Vaginosis NHS Scotland  [accessed 24 November 2021]

Bacterial Vaginosis NICE [accessed 24 November 2021]

Bacterial Vaginosis Patient Info [accessed 24 November 2021]

Differences in vaginal microbiome in African American women versus women of European ancestry NCBI  [accessed 24 November 2021]

Which treatments are effective for bacterial vaginosis? NCBI 2018 [accessed 24 November 2021]

Managing recurrent bacterial vaginosis BMJ [accessed 24 November 2021]

Risk of Bacterial Vaginosis in Users of the Intrauterine Device: A Longitudinal Study NCBI [accessed 24 November 2021]

UK National Guideline for the management of Bacterial Vaginosis British Association for Sexual Health and HIV [accessed 9 December 2021)