Bacterial vaginosis (BV) is an infection associated with a change in the vagina’s natural balance of bacteria signaled by a strong fishy smell in vaginal discharge. Vaginal discharge is a normal fluid or mucus secretion that keeps the vagina moist. It can occur at any age, and most women and girls will get it at some time. Everything is OK if the discharge is free of any strong or nasty odor, clear or white, thick and sticky or slippery and wet. But if it has a strong fishy odor, especially after penetrative sex, this is a sign of infection by BV.

BV’s causes aren’t fully understood, but some factors make infection more likely: if you are sexually active, if you have had a change of partner, are using an IUD for contraception or if you use scented products on your vagina.

Although sexual activity can trigger BV, it is not a sexually transmitted infection. While male partners do not need to worry about being infected, it can be passed by a woman to another woman during sex, but women who are not sexually active can also get BV.

It is unusual for BV to cause symptoms like soreness or itching and it is harmless, although potentially embarrassing. (Note that there is a potential small increase in the chance of complications if you have BV during pregnancy, for example, premature birth or miscarriage, but it doesn’t cause problems for most pregnancies. Even so, you should consult your doctor or midwife if there is any change in your vaginal discharge.) However, it is easy to get treatment from your GP or a sexual health clinic. Sexual health clinics don’t just deal with STIs but treat patients for many other genital or urinary problems, including BV. Many offer a walk-in service and will be able to give you your test results sooner than your GP can.

Your GP or Sexual Health Clinic Appointment

Your doctor or clinician will want to confirm that your symptoms are caused by BV and rule out any possible sexually transmitted infection. You will be asked to describe your symptoms, and if it is unclear that BV causes them, you will be examined by a doctor or nurse. They may use a cotton bud to collect some vaginal discharge for tests. This swab won’t be painful, but it may feel a little bit uncomfortable.

Treatment

Bacterial vaginosis can be treated by your doctor or sexual health clinician with prescription gels or tablets. Over-the-counter gels are available from pharmacies and supermarkets, but there is no proof that these products are effective. Treatment for BV should be OK during pregnancy.

There is a possibility that your BV will return within three months of initial treatment, but you can do reduce the likelihood of this happening by washing your vagina with water and plain soap or an emollient and showering instead of bathing.

Avoid perfumed or antiseptic bath products, vaginal cleansers, and douches, and washing your underwear in strong detergents.

If you get BV more than twice in six months, your GP or clinician can determine if anything is triggering it, for example, your period, and recommend the right length of treatment.