Bacterial Vaginosis
WHAT IS BACTERIAL VAGINOSIS
Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge. One in ten people with a vagina will have BV at some time in their life.
WHAT CAUSES BV?
BV is caused by an imbalance in the bacteria that is naturally found in the vagina. It is not really understood why this happens.
IS BV A SEXUALLY TRANSMISSIBLE INFECTION?
BV is not a sexually transmissible infection although it is associated with sex. We know that having a new sexual partner or multiple sexual partners can increase the risk of BV. Using condoms can help to reduce this risk.
WHAT ARE THE SYMPTOMS?
Up to half of people with bacterial vaginosis will not have any symptoms. However, if symptoms do occur, they can include:
- Increased or changed vaginal discharge (often white or grey watery).
- A vaginal odour change (usually slightly offensive or ‘fishy’ and may be more noticeable after sex).
- Vulval itching or irritation.
HOW IS IT DIAGNOSED?
BV is diagnosed based on symptoms and an examination. A vaginal swab is also usually collected.
DO I NEED TREATMENT?
In up to one-third of cases, BV goes away by itself without treatment. However, treatment is recommended in the following circumstance
- To relieve symptoms that don’t go away.
- If you are having a gynaecological procedure.
- If you are pregnant.
WHAT IS THE TREATMENT?
The treatment for BV is antibiotics. These antibiotics restore normal balance in the vagina. Antibiotic treatment can be oral tablets, vaginal creams, or vaginal gels. Please discuss your preferred method with your doctor.
ARE THERE SIDE EFFECTS FROM BV TREATMENT?
Most people tolerate the treatment well. However, some people may experience some side effects from the oral antibiotics, such as abdominal pain, cramps, nausea & vomiting, flushing, or headache.
You need to avoid alcohol during treatment and for up to 3 days afterward. The vaginal preparations weaken latex condoms, so abstaining from sex or using a non-latex condom is advised during treatment.
WHAT HAPPENS IF BV IS NOT TREATED?
BV is a very common condition. Most of the time there are no problems if it is not treated, and treatment is not usually advised if you have no symptoms. However, there are situations where complications can occur so treatment will be advised. This includes:
- If you have BV when you are pregnant, you may be at higher risk of having problems in pregnancy and immediately after birth.
- If you undergo a gynaecological procedure when you have BV, you are at greater risk of developing a pelvic infection afterwards.
- If you have untreated BV it may increase your risk of contracting a sexually transmissible infection and HIV.
CAN BV RECUR?
While treatment is very effective, BV can recur. About a third of people who are treated will have another episode of BV within three months and more than half will have a recurrence within a year.
HOW CAN I REDUCE BV RECURRING?
We do not know how to prevent BV. However, avoiding anything that changes the balance of vaginal bacteria may help reduce recurrences.
This includes good vulval care. Good vulval care involves using warm water only to wash the vulval and vaginal area and avoiding using scented soap, shower gels, perfumed bubble baths, and 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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