Bacterial vaginosis

What is bacterial vaginosis?

Bacterial vaginosis (BV) is a bacterial infection of the vagina. Research shows that BV affects up to 30% of women at some stage in their life. Sexually active women of all ages can be affected.

It’s important to see your doctor as early as possible if you notice any symptoms.

Symptoms

More than half of all women with BV do not have any symptoms. But some women may experience the following symptoms:

• Watery, white, grey or greenish vaginal discharge.
• An unpleasant or ‘fishy’ smell.
• Discomfort and itching.
• A burning sensation when weeing.

Causes

BV is caused by an overgrowth of ‘bad’ bacteria in your vagina. Most cases are related to sexual activity, but other factors can increase your risk.

Women may be more likely to experience BV if they:

• have had multiple sexual partners during their lifetime
• have a new sexual partner
• practise unprotected sex
• practise douching, which allows ‘bad’ bacteria to grow
• have a copper intrauterine device (IUD).

Diagnosis

To diagnose BV, your doctor will ask questions about your symptoms, medical history and sexual history, including details about past sexually transmitted infections (STIs). They might also do a pelvic examination and take a vaginal swab to test for abnormal bacteria, or a pH test to check the acidity of your vagina.

Treatment and management

BV is usually treated with a course of antibiotics taken as tablets or applied into your vagina as a cream or gel. You will need to take the full course of antibiotics, even if symptoms go away before the end of the course. Stopping treatment early may increase the risk of the infection coming back.

BV can reoccur with sexual contact, so avoid sexual activity until you have finished your antibiotics and your symptoms have gone.

BV can spread between female sexual partners. So, if your partner is female, she should follow up with her doctor. It’s not necessary to treat a male sexual partner.

What you can do

Safe sexual practices (e.g. using condoms) can protect against infection, regardless of your sexual partner’s gender.

Avoid using deodorants or perfumed products (e.g. toilet paper, tampons, pads, soaps and washes) in and around your vagina.

Don’t use any douches, as they cause an imbalance in vaginal bacteria, which increases the risk of vaginal infection.

Risks and complications

While treatment is usually effective, about 50% of women will have a recurrence of BV within 12 months. If you notice new symptoms, visit your doctor for more treatment.

BV can increase the risk of :

• pregnancy and birth issues
• sexually transmitted infections (STIs), such as HIV, herpes, chlamydia or gonorrhoea
• infection after surgery, for example, a laparoscopy (keyhole surgery via the abdomen)
• pelvic inflammatory disease (PID) – an infection of the uterus, fallopian tubes and ovaries that can lead to infertility.

When to see your doctor

BV symptoms can be like those of other infections, so it’s important to get the right diagnosis and treatment. If you experience any BV symptoms, see your doctor.

Related resources

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This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at April 2023.