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Bacterial Vaginosis

WHAT IS BACTERIAL VAGINOSIS 

Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge. One in ten will have BV at some time in their life. 

WHAT CAUSES BV?

BV is caused by a change in the number and type of bacteria found in the vagina. A healthy vagina contains many different kinds of bacteria. In BV, there is a decrease in the number of a particular bacteria called lactobacillus and an increase in other bacteria called anaerobic bacteria. The most common of these anaerobic bacteria is Gardnerella. 

The increase in the anaerobic bacteria in the vagina changes the chemistry of the vaginal fluid, making it more alkaline. BV is not the same as vaginal thrush and is caused by different organisms.

IS BV A SEXUALLY TRANSMISSIBLE INFECTION?

BV is associated with sex but is not considered a sexually transmissible infection. However, having a new sexual partner or multiple sexual partners increases the risk of BV. Using condoms is known to reduce the risk of BV.

WHAT ARE THE SYMPTOMS?

50% of people with bacterial vaginosis will have no symptoms. If symptoms do occur, they include:

  • Increased or changed vaginal discharge (often white or grey watery).
  • A change in vaginal odour - usually slightly offensive or ‘fishy’.
  • The odour may be more noticeable after sex. 
  • Vulval itching or irritation.  

HOW IS IT DIAGNOSED?

A doctor usually diagnoses BV based on symptoms and an examination and is generally confirmed by collecting a vaginal swab. 

DO I NEED TREATMENT?

In up to one-third of cases, BV resolves without treatment, however, treatment is advised 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 FOR BV?

BV is treated with antibiotics. These antibiotics reduce the anaerobic bacteria and allow the lactobacilli to increase in number and restore normal balance in the vagina. Antibiotics can be given as oral tablets, vaginal creams, or vaginal gels.  Please discuss your preferred method with your doctor.

ARE THERE SIDE EFFECTS FROM BV TREATMENT?

Some people may experience side effects such as abdominal pain, cramps, nausea & vomiting, flushing, or headache when taking oral bacterial vaginosis treatment. 

You may be advised to avoid alcohol during treatment and for up to 3 days afterward.

The vaginal preparations weaken latex condoms, so using non-latex condoms or avoiding sex is advised during treatment.

WHAT HAPPENS IF BV IS NOT TREATED?

BV is a common condition, and most of the time, there are no problems if it is not treated.  However, there are situations where complications can occur:

  • If you have BV when you are pregnant, you may be at higher risk of late miscarriage, premature birth, and developing a womb infection after birth.
  • If you undergo a gynaecological procedure when you have BV, you are at greater risk of developing a pelvic infection.
  • You are more likely to contract a sexually transmitted infection if you have untreated BV.

CAN BV RECUR?

About a third who respond to treatment will have another BV episode within three months; more than half will have a recurrence within a year.

HOW CAN I REDUCE BV RECURRING?

The best ways of preventing BV are not known. Avoiding anything that changes the balance of vaginal bacteria may help.  You may reduce the chance of getting BV if you avoid the following:

  • Vaginal douching.
  • Scented soap, shower gels, perfumed bubble bath, and antiseptic bath liquids.
  • Using any commercial ‘feminine hygiene’ products such as sprays, vaginal deodorants, washes, or wipes.
  • Using condoms also reduces your risk of developing BV.

References:
Australian STI Management Guidelines for use in primary care. 
Melbourne Sexual Health Centre.


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