Bacterial Vaginosis (BV): Causes, Symptoms, and Treatments

You might have noticed something's different, maybe an unusual odor or a change in your discharge. It's completely natural to feel concerned when your body signals that something's off, especially when it involves such a private area.

Bacterial vaginosis is more common than you might think, affecting countless women just like you. Knowing what's happening can bring relief and help you take the next steps with confidence.

What is bacterial vaginosis?

Bacterial vaginosis, or BV, happens when the balance of bacteria in your vagina gets disrupted. Think of your vagina as having its own ecosystem of bacteria. Some are helpful, while others can cause problems if they grow too much.

When you have BV, the good bacteria (called Lactobacillus) decrease, while harmful bacteria multiply. This imbalance can lead to symptoms like abnormal discharge, odor, and irritation.

What causes bacterial vaginosis?

We don't fully understand why BV develops, but it involves a shift in your vaginal environment. Normally, beneficial Lactobacillus bacteria, particularly Lactobacillus crispatus, keep your vagina slightly acidic, which prevents harmful bacteria from taking over.

When these good bacteria decrease, harmful bacteria can overgrow and create the bacterial imbalance that we call BV. The healthy vaginal flora produces hydrogen peroxide, which naturally protects against harmful bacteria.

Types of bacterial vaginosis based on symptoms

There are different types of bacterial vaginosis depending on how the symptoms appear and progress.

Acute BV

This type appears suddenly with noticeable symptoms like increased vaginal discharge with a fishy smell, itching, and irritation. These symptoms come on quickly and are usually the first sign that something's changed.

Recurrent BV

Sometimes BV returns shortly after you've finished treatment. If you're experiencing this, it's important to follow up with your doctor so we can work together to find a treatment approach that works better for your body.

What are the signs and symptoms of bacterial vaginosis?

Many women with BV don't notice any symptoms at all. But when symptoms do appear, here's what you might experience:

• Thin and watery vaginal discharge

• Grayish-white or greenish vaginal discharge 

• Fishy vaginal odor

• Vaginal itching or irritation

• Burning during urination

• Discomfort or pain during sexual intercourse

Because BV symptoms can look similar to other vaginal infections, it's important to visit your doctor for a proper diagnosis rather than trying to self-diagnose.

If you’re experiencing any of these symptoms or notice changes in your vaginal discharge or odor, request an appointment with Thomson Medical. Our women’s health specialists can provide an accurate diagnosis, explain the cause, and recommend the right treatment to help you feel comfortable again.

Who can get bacterial vaginosis?

Anyone with a vagina can develop bacterial vaginosis. It most commonly occurs in people who are sexually active, though it's rare in those who've never had sex.

Your risk of developing BV may be higher if you:

• Are pregnant

• Engage in unprotected sex without condoms or dental dams

• Have an intrauterine device (IUD, a T-shaped contraceptive device placed in your uterus)

• Have multiple or new sex partners

• Use douches (liquid solutions used to rinse the vagina)

• Are taking antibiotics

What's the difference between bacterial vaginosis and a yeast infection?

Both BV and yeast infections are vaginal infections that cause increased discharge, but they're quite different:

How bacterial vaginosis is diagnosed

To diagnose bacterial vaginosis, your doctor will ask about your medical history and perform a pelvic exam. During the pelvic exam, your provider will place gloved fingers inside your vagina to look for signs of infection, like an increase in discharge or foul-smelling discharge that has a white or gray color. 

They'll take a sample of your vaginal discharge to test for bacteria and may check your vaginal pH level.

How to get tested for bacterial vaginosis?

If your doctor suspects BV, they'll take vaginal swabs for testing. These samples are sent to a lab where specialists can identify what type of infection you have.

For women who are sexually active, your doctor may recommend additional testing to rule out sexually transmitted diseases like chlamydia and gonorrhoea, since the symptoms can sometimes overlap. Common BV tests include:

• pH testing

  • One key indicator of BV is a high vaginal pH level

  • Your vagina is normally slightly acidic, but with BV, the pH of vaginal fluid becomes less acidic, typically rising above 4.5

• Microscopic examination

  • Wet mount test where vaginal fluids are examined under a microscope to look for clue cells and bacteria

  • Gram stain used to examine the bacteria present in your vaginal fluids and identify specific types

• Laboratory scoring

  • Nugent score, a standardized system that evaluates the types and amounts of bacteria to confirm BV (scores range from 0-10, with 7-10 indicating BV)

How is bacterial vaginosis treated?

Treatment for BV focuses on eliminating the overgrowth of harmful bacteria. Your doctor will prescribe antibiotics, which can come in different forms:

• Oral antibiotics like metronidazole or tinidazole

• Intravaginal antibiotics that are applied directly inside the vagina, such as metronidazole gel or clindamycin cream

In some cases, your doctor might suggest probiotics or lactobacillus supplements alongside antibiotics to help restore the balance of good bacteria in your vagina.

What are the potential complications of bacterial vaginosis?

BV doesn't cause complications very often, but leaving it untreated can sometimes lead to:

• Increased risk of sexually transmitted infections like HIV, herpes, chlamydia, or gonorrhoea

• Pelvic inflammatory disease (PID), an infection of your uterus and fallopian tubes that can affect fertility

• Higher risk of infection after gynaecological procedures

• Increased risk of preterm birth or low birth weight in pregnant women

How to prevent bacterial vaginosis

While we can't prevent BV entirely, there are steps you can take to reduce your risk:

• Avoid scented products and harsh soaps and washing your genital area with warm water

• Rinsing with water during regular bathing is enough to maintain its balance.

• Use latex condoms or dental dams during sexual activity

When should you see a doctor?

Make an appointment with your doctor if:

• Your vaginal discharge smells unusual and you're experiencing discomfort

• You've had vaginal infections before but your discharge seems different this time

• You have a new or different sex partner

• You thought you had a yeast infection but still have symptoms after trying over-the-counter treatment

If you’re noticing any of these changes or ongoing discomfort, don’t ignore the signs. Request an appointment with Thomson Medical to get a proper diagnosis and the right treatment. Our specialists can help identify the cause and ensure your vaginal health is well cared for.

FAQ

Who is at risk of bacterial vaginosis?

Having multiple or new sex partners can disrupt your vaginal balance. Engaging in unprotected sex, using vaginal douches, smoking, and hormonal changes during pregnancy or menopause can affect your vaginal flora. Certain medications like antibiotics or corticosteroids may also increase risk.

Can bacterial vaginosis be cured?

Yes, bacterial vaginosis can be effectively treated and cured with proper medical care. It's essential to take the full course of antibiotics your doctor prescribes, even if symptoms improve early. This ensures complete elimination and reduces recurrence risk.

What are the complications of bacterial vaginosis?

Bacterial vaginosis typically doesn't cause complications when treated promptly. However, if left untreated, it can increase your risk of sexually transmitted infections, lead to pelvic inflammatory disease (which can affect fertility), cause pregnancy complications, or result in infections after gynecologic procedures.

What are the impacts of bacterial vaginosis on sexual health?

Bacterial vaginosis can cause discomfort or pain during sex due to vaginal irritation or inflammation. Treating BV symptoms and restoring your vaginal health can improve sexual function and intimacy. While BV isn't considered a sexually transmitted infection, male partners of women with recurrent bacterial vaginosis may carry the bacteria, so your doctor might consider partner treatment to reduce the risk of reinfection.

Can men get bacterial vaginosis?

No, men cannot get bacterial vaginosis because BV is specific to the vaginal environment. However, men can carry the bacteria that cause BV and potentially spread them to female partners, which can lead to the infection recurring in women.

Can a woman give another woman bacterial vaginosis?

Yes, bacterial vaginosis can spread between female sex partners through sexual activity. Since BV can be transmitted this way, both partners may need treatment if one is experiencing symptoms.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique situations, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.