What is bacterial vaginosis?

Bacterial vaginosis (BV) is a type of vaginal inflammation caused by the overgrowth of natural anaerobic bacteria in the vagina. It is a common condition that usually affects women and teenage girls of childbearing age (generally 14 - 50) but can affect women of any age. It is not considered to be a sexually transmitted infection, although it may be triggered by sexual activity. You can also suffer from the condition if you have never been sexually active. The symptoms of BV may include unusual vaginal discharge that is often thin and watery, ranging in colour from grey to white, or even green. It can be accompanied by a foul smelling ‘fishy’ odour. If you’re suffering from bacterial vaginosis, you may experience vaginal itching or a burning sensation when you urinate. 

Many women are embarrassed by bacterial vaginosis, particularly if the symptoms are first noticed by a sexual partner. If it is the first time that you have suffered from the condition you may worry that you have caught a sexually transmitted infection, or experience negative feelings regarding your own body image. You should remember that BV is a common condition that affects millions of women in the UK and is treatable with antibiotic tablets, gel, or cream. Some women suffer from recurring bacterial vaginosis and may require multiple treatments. Medical understanding of the problem is developing and there are new scientific advances in therapy, including treatments to transplant ‘good bacteria’ to the vagina. 

Causes of bacterial vaginosis

Your vagina contains a variety of natural bacteria. These can broadly be divided into ‘good bacteria’ (lactobacilli) and ‘bad bacteria’ (anaerobes). A healthy vagina is usually slightly acidic, which prevents the growth of anaerobes and maintains a healthy natural balance. If the pH level in your vagina changes, or something causes bacteria to multiply, you may suffer from bacterial vaginosis (BV). 

The causes of BV are not fully understood, although medical knowledge is improving. But there are some identifiable causes of bacterial vaginosis, these may include:

• Having a new sexual partner or multiple sexual partners
  Although BV is not a sexually transmitted infection, it may be triggered by sexual activity. Women who have sex with women may have up to a 60% higher risk of experiencing bacterial vaginosis.

• Douching or washing with soap
  A healthy vagina is self-cleaning. If you douche or wash your vagina with scented soaps, use bubble baths, or apply perfumed products to the genital area you may disturb the natural pH balance and cause bacterial vaginosis.

• You have an IUD
  If you have a contraceptive IUD (Intrauterine device or coil) fitted, it may cause BV.

• Natural lack of lactobacilli bacteria
  Some women do not produce enough lactobacilli (good bacteria). This creates an environment where anaerobes (bad bacteria) can easily multiply, causing bacterial vaginosis. There is new research into ‘bacterial transplants’ that may treat women who suffer from recurring BV.

Symptoms of Bacterial Vaginosis

Bacterial vaginosis usually causes distinctive and easily recognisable symptoms, although it is possible to have BV and not show any obvious symptoms. 

• Unusual vaginal discharge
  A healthy vagina is naturally moist and produces liquid discharge (leukorrhea or whites) particularly when you are sexually aroused. If you suffer from BV you may notice an unusual vaginal discharge.

• Thin and watery discharge
• White, grey, or green in colour
• Foul smelling with a ‘fishy’ odour

• Burning on urination or vaginal itching
  Some women may experience a burning sensation when they urinate, or suffer from vaginal itching. Your GP may conduct an internal examination to confirm that this is caused by BV and not by a different condition.

The symptoms of bacterial vaginosis can be embarrassing or even distressing. If you do experience feelings of embarrassment, or even disgust towards your body, it’s important not to allow your feelings to interfere with seeking treatment. Left untreated, bacterial vaginosis may increase your risk of contracting sexually transmitted infections, it may also cause other health problems. BV is a very common condition that doctors are accustomed to treat on a regular basis. The Doctors on our platform will always treat you with sensitivity and consideration.

How to diagnose bacterial vaginosis

An initial diagnosis of bacterial vaginosis (BV) may often be made on the basis of reported symptoms, especially if you have previously suffered from the condition. These may include:

• Unusual vaginal discharge
• Burning sensation on urination
• Vaginal itching

It is possible that you may only experience some of these symptoms, or none at all. 

Medical history

Your doctor will ask some simple questions about your symptoms, lifestyle, and medical history. This is to get the necessary background information for an accurate diagnosis. 

Pelvic examination

Your GP may carry out a simple pelvic examination that involves inserting two fingers into your vagina and pressing down gently on your abdomen with the other hand. This is to check that there are no other signs of disease and to check for any obvious infection.

Vaginal swab

It may be necessary to collect a sample of your vaginal discharge for examination under a microscope. This is a quick and painless procedure that involves wiping the inside of your vagina with a cotton bud. The sample can be checked for bacterial overgrowth that points to bacterial vaginosis. 

Test your vaginal pH

The natural acidity of your vagina is reduced when you are suffering from BV. Your GP may insert a pH strip into your vagina to test the acid/alkali balance. This is a quick and painless procedure.

Treatments for bacterial vaginosis

Current treatments for bacterial vaginosis use antibiotic tablets (taken orally) or antibiotic creams and gels (applied to the vagina). They work by preventing the growth of bacteria and clearing the infection. Three prescription medications available in the UK include, Metronidazole, Dalacin Cream and Zidoval Gel. 

Metronidazole

Metronidazole 400mg tablets may be prescribed to treat bacterial vaginosis. The antibiotic tablets are taken orally, as instructed by your online doctor. Metronidazole effectively targets a variety of bacteria, including the anaerobic bacteria that cause BV. 

Dalacin Cream

Dalacin Cream is a prescription only antibiotic cream that is used to treat bacterial vaginosis. Each packet of cream comes with a set of disposable plastic devices for inserting the cream into your vagina. You can do this quickly and painlessly while lying on your back. 

Zidoval Gel

Zidoval Gel is an antibiotic gel that can be used to treat bacterial vaginosis.  Each packet of gel comes with a set of disposable plastic devices for inserting the gel into your vagina. You can do this quickly and painlessly while lying on your back. 

DoktorABC provides a quick and convenient online prescription service for Metronidazole, Dalacin Cream and Zidoval Gel with free next day delivery of your prescription and medications. Prescriptions are provided subject to an online health questionnaire and are only issued if the medication is safe for you to use. 

How to prevent bacterial vaginosis

Bacterial vaginosis (BV) is a common condition that millions of UK women will suffer from at least once during their lives. In some cases it can be prevented, or the likelihood of an outbreak reduced, by following a few basic rules.

• Use plain unperfumed soap and water to wash your genital area.
• Take showers instead of baths.
• Wear loose underwear made of natural fabrics.
• If you take a bath, don’t use perfumed soap, bubble baths, shampoos, shower gels, or antiseptic liquids.
• Don’t use vaginal douches, vaginal deodorants or washes.
• Don’t use strong washing powder to wash your underwear.
• Don’t smoke.