Bacterial Vaginosis

Overview

Bacterial Vaginosis (BV) is one of the most common vaginal conditions, affecting up to 1 in 3 women at some point. It happens when the natural balance of bacteria in the vagina becomes disrupted — with fewer “good” bacteria (lactobacilli) and an overgrowth of other bacteria.

This imbalance can lead to unusual discharge and a noticeable odour, but many women have no symptoms at all. BV is not a sexually transmitted infection, though sex can sometimes trigger or worsen symptoms.

The good news? BV is very common and treatable, and with the right care, most women notice improvement within just a few days.

Treatment suitability will always be assessed by a UK-registered prescriber following a secure online consultation.

Symptoms

Common signs of BV:

• Thin, watery discharge (often grey or white)
• A “fishy” vaginal odour, which may be more noticeable after sex
• Slight vaginal irritation or discomfort

Less common:

• Itching or burning (though these are more typical of thrush)
• No symptoms at all — BV can sometimes be silent and only picked up during a check-up or screening

Diagnosis

BV is often diagnosed based on symptoms and a doctor’s examination. Sometimes a vaginal swab test is used to confirm the diagnosis and rule out other conditions, like thrush or STIs. Many women recognise BV when it comes back, as recurrence is fairly common.

Treatments

BV is treated with antibiotics, either as tablets or vaginal gels/creams. The most commonly prescribed options include:

• Metronidazole tablets – taken orally, usually for 5–7 days
• Metronidazole vaginal gel – applied inside the vagina once daily
• Clindamycin cream – applied inside the vagina, typically at night

Most women notice improvement within 2–3 days, though it’s important to finish the course.

Lifestyle tips that may help alongside treatment:

• Avoid scented soaps, bubble baths, or vaginal douches
• Use pH-balanced intimate washes if needed
• Use condoms during treatment to help restore balance

Prevention

BV can sometimes come back, but steps to reduce the risk include:

• Avoiding vaginal douching (washes, sprays, or deodorants)
• Using mild, unscented soaps around the vagina
• Limiting new or multiple sexual partners (though BV is not strictly an STI, sex can trigger imbalance)
• Using condoms regularly
• Considering probiotics (evidence is still mixed, but some women find them helpful)

Misconceptions

“BV is an STI”
False — BV is not a sexually transmitted infection, though sex can influence symptoms.

“Only women with poor hygiene get BV”
False — in fact, BV can be triggered by overwashing or using scented products.

“BV always causes symptoms”
False — some women have no symptoms at all.

FAQ

Is BV dangerous?
Not usually, but untreated BV can increase the risk of STIs and pregnancy complications, so treatment is recommended.

Can BV go away on its own?
Sometimes it does, but it often comes back without treatment.

Can men get BV?
No, but male partners can sometimes contribute to recurrence in women.

Why does BV keep coming back?
BV is caused by a change in vaginal bacteria, which can happen repeatedly. Some women are simply more prone to it.

Can I have sex while being treated?
Yes, but treatment works best if you avoid unprotected sex until the course is finished.

Is BV the same as thrush?
No — thrush usually causes thick discharge and itching, whereas BV discharge is thin and has a strong odour.