Has your vaginal discharge changed colour or consistency and started to smell a bit funny? You will be forgiven for assuming you have thrush. But if the odour in question is a bit fishy or it stings when you pee, you might actually have bacterial vaginosis (BV).
Don't panic! Bacterial vaginosis is the most common cause of vaginal infections, and one in three women will experience it at some point in their lives. But what exactly is bacterial vaginosis, how can you be sure you have it and most importantly, how do you make it go away?
We speak to clinical nurse specialist Helen Knox about BV diagnosis, treatment and prevention:
What is bacterial vaginosis?
Your vagina is home to millions of microbes which keep it healthy. A bacteria called lactobacillus helps to stop harmful bacteria from growing. It also keeps the environment at an acidic pH.
So how did you get bacterial vaginosis? BV is a mild infection in the vagina which develops when there's an imbalance between the good bacteria and the bad bacteria. 'Bacterial Vaginosis is the most common vaginal condition for women,' says Knox. 'It's estimated 1 in 3 UK women will experience BV - that's 8.9 million women in the UK alone.'
But how do you tell the difference between good and bad bacteria? 'When this balance gets disrupted, you'll start to notice things aren't quite right and you could be developing BV,' says Knox.
Bacterial vaginosis symptoms
What does bacterial vaginosis look like? Around half of women with BV won't notice any signs or have any symptoms of the condition. But if you do have bacterial vaginosis, you might notice the following:
A change in your usual vaginal discharge. You might have more than usual, or it appears thin and watery, or a white-grey colour.
A strong unpleasant fishy odour, especially following sex.
Burning or pain when you urinate.
Bacterial vaginosis causes
Does bacterial vaginosis occur if you don't wash? Often, it's quite the opposite. Vaginas are self-cleaning. If you suffer from bacterial vaginosis and you wash frequently, you could in fact be overdoing it in the hygiene department. Scented soap and shower washes can upset the natural bacterial balance, which makes you more likely to develop BV.
'You can develop BV at any time, but it's more likely to occur if your vagina, which is an acidic environment is disrupted by something that changes this natural pH balance,' says Knox.
'For example, perfumed products or soaps; semen – which is alkaline, or even menstrual bleeding. Because the pH of this intimate area can so easily change due to many factors, it's no surprise that BV is so common.'
Is vaginal odour abnormal?
A smell "down there" is usually completely normal. It isn't supposed to smell like perfume! So resist the urge to over-wash your vagina and embrace your natural odour. The only time you should be concerned is if it smells unusually bad, foul or fishy.
'All vaginas have a smell. It is something many women feel embarrassed about but it is completely normal,' says Knox. 'However, what they must be aware of is how this smell may change, and can become stronger, depending on monthly hormonal changes or how much you're sweating. If the smell changes significantly or is noticeably unpleasant then it may be best to talk to your doctor or pharmacist to find out if there is a problem.'
Is bacterial vaginosis an STI?
Bacterial vaginosis is not a sexually transmitted infection, but according to the FPA, women who are sexually active and have had a change of partner are more likely to develop it, including women in same-sex relationships. You're also more likely to develop and transmit an STI if you have active BV.
Is it bacterial vaginosis or thrush?
What's the difference between bacterial vaginosis and thrush? You will have heard of thrush, but very few have ever been told about bacterial vaginosis. It means many reach for thrush treatment, which will be ineffective and prolong the symptoms of BV.
Symptoms vary, but bacterial vaginosis is distinctive by its odour and the change in discharge. If you're not sure, seek medical advice.
Bacterial vaginosis diagnosis
The most important thing for any women is to get a correct diagnosis before trying to treat themselves for either thrush or bacterial vaginosis. Knox advises women who think they might have BV to visit their pharmacist. There are home test kits available that will help to distinguish between BV and thrush and you can also have a swab test taken at your GP practice or local sexual health clinic.
'A thrush treatment is not designed to treat BV. I would suggest that any women that has bought a thrush treatment thinking it will treat BV should return to where she purchased it and speak with the pharmacist,' says Knox. 'Your pharmacist will be able to discuss your symptoms and suggest a correct course of action.'
⚠️ If your suspected bacterial vaginosis symptoms have not gone away even if you have tried a treatment, make an appointment with your doctor.
Bacterial vaginosis complications
How long does bacterial vaginosis last and what happens if bacterial vaginosis is left untreated? Having untreated BV can make you more at risk of catching other infections such as chlamydia, or even HIV. These infections can lead to further complications such as pelvic inflammatory disease and problems with fertility, so it is worth being fully tested and treated if it hasn't gone away by itself.
'If you're pregnant it is especially important to speak to your doctor or midwife about treating BV, as it has been associated with pregnancy complications such as premature birth, miscarriage and secondary infections,' warns Knox.
Bacterial vaginosis treatment
Can bacterial vaginosis clear up on its own? It may go away on its own in a few days, but there are a number of effective treatment options available for BV, including antibiotics and over-the-counter lactic acid vaginal gels and pessaries.
If you are experiencing any of the symptoms, consult your GP or pharmacist for the correct diagnosis and appropriate treatment.
Bacterial vaginosis prevention tips
To prevent bacterial vaginosis in the first place, try the following:
✔️ Leave your vagina alone!
Never douche or insert water inside your vagina to wash it. You will flush away the good bacteria and can make things worse.
✔️ Avoid perfumed soaps
Washing your vulva with perfumed soaps or products that are antiseptic can affect the pH balance inside your vagina.
✔️ Don't over-wash
Washing once a day is enough. Your vagina is self-cleaning and relies on the natural balance of bacteria to stay healthy.
✔️ Try using a condom
If you notice that you get BV after having sex with a male partner, use a condom as semen is alkaline and can upset your vaginal pH.
Further help and support
If you think you might have bacterial vaginosis, it's important you get diagnosed by a medical professional. For further help with BV or any other sexual health concern try one of the following resources:
Ask your GP or local pharmacist for advice.
Find a sexual health clinic near you.
Try Brook's Find a Service tool
Find contraceptive services near you.
Call the national sexual health line 0300 123 7123.
Call Worth Talking About on 0300 123 2930 (for under-18s).
Last updated: 18-11-2020
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