Bacterial Vaginosis

What is bacterial vaginosis?

Bacterial vaginosis (BV) is caused by the pH in your vagina getting out of balance. This usually happens because there are too many of a certain kind of bacteria.

The vagina is normally acidic. It is very good at keeping the right level of good bacteria, known as lactobacilli. However, lots of things can cause changes in the natural balance of bacteria. These include:

• Periods

• Semen

• Antibiotics

• Washing too much

These things can make the vagina less acidic. This changes the vaginal flora by allowing bad types of bacteria to grow. As a result, bad bacteria can replace good bacteria. This often leads to BV.

Bacterial vaginosis symptoms

While about half of women with BV have no symptoms, others may notice a change in their vaginal discharge. It can become thinner and turn white or grey. You may also notice a stronger (sometimes fishy) smell, especially after sex. BV rarely causes pain or itching. 

If you notice unusual vaginal discharge or other changes in your vagina, go to your doctor or a sexual health clinic to get it checked as soon as possible.

Although BV is not a sexually transmitted infection, it can increase your risk of catching one such as chlamydia.

What causes bacterial vaginosis?

The vagina is naturally slightly acidic, with a pH between 3.8 and 5.0. This is because of bacteria called lactobacilli found in the vagina. This acidity keeps the vaginal microbiome healthy by stopping other bacteria from growing and causing infections. If something upsets this pH, you can get BV, urinary tract infections and/or yeast infections. 

It's not yet known exactly how this works, but risk factors include:

• Using an IUD for birth control

• Douching

• Having a new or multiple sexual partners

• Using a strong laundry detergent

• Using antiseptic bath liquids, vaginal deodorants and scented soaps

Many people think that BV is a sexually transmitted infection (STI). It is not. You cannot catch BV from a partner. And women who are not sexually active can also get BV. 

However, BV is more common in women with multiple sexual partners. Practising safe sex reduces your risk of getting BV. Other factors, such as ethnicity, may also increase the risk of infection.

How effective is bacterial vaginosis treatment?

Various effective options exist for treating bacterial vaginosis. These include tablets, creams and gels. Your doctor will prescribe the one most suitable for you. Some can work in as little as 2 days, but you should always complete the treatment course to stop the infection from returning.

Creams are inserted directly into the vagina. You will usually have to do this every night for up to 2 weeks. Creams are better if you are taking medicines that don't mix well with antibiotic tablets, or if you struggle to swallow pills. Because creams are absorbed through the skin and do not go through your digestive system, they can also cause fewer side effects.

Courses of antibiotic tablets, such as metronidazole or clindamycin, are also highly effective. They can help your body fight back quickly so that your immunity kicks in to destroy any remaining bacteria. And over 90% of women show no further BV symptoms after this type of treatment.

How is bacterial vaginosis diagnosed?

The symptoms of bacterial vaginosis can be similar to those of other infections, including STIs such as trichomonas and gonorrhoea. So, the first time you have it, a doctor should diagnose you to rule these out. If you get BV again, you can diagnose this yourself if your symptoms are exactly the same as before. However, a doctor should still examine you to treat the underlying cause. 

Your GP will look for a thin white, grey or green discharge and a fishy smell. In most cases, this is enough to diagnose BV. 

They will also ask you about any previous STIs or vaginal infections. For further testing, they might collect a sample of vaginal discharge to examine. This will let them identify vaginal cells covered with harmful bacteria. 

Another way doctors can diagnose BV is to check the acidity of your vagina using a pH strip. A vaginal pH value of 4.5 or above is a sign of bacterial vaginosis.

BV vs thrush

Thrush (a yeast infection) and bacterial vaginosis are both common infections of the vagina. However, their causes, symptoms and treatments are different. Here’s a comparison.

Cause:

• Thrush: Overgrowth of yeast (candida).

• BV: Imbalance in vaginal bacteria.

Symptoms:

• Thrush: Thick white discharge, intense itching, redness.

• BV: Thin grey discharge, fishy scent, mild irritation.

Treatment:

• Thrush: Antifungal creams or oral medicines.

• BV: Prescription antibiotics.

What different treatments for bacterial vaginosis are available?

Zidoval gel (containing metronidazole) is a treatment that you put on using an applicator. You usually do this once a day at bedtime for 5 days. Studies have found that this treatment is up to 90% successful in stopping the bacteria that cause BV to multiply.

Dalacin cream (containing clindamycin) is used in a similar way. It is usually prescribed for up to 7 days. However, it can be effective in as little as 3 days. Often, it's useful in cases where antibiotic tablets are less suitable, such as during pregnancy. It stops the bacteria from making the proteins they need to multiply. This means it can ease symptoms quickly and effectively.

Metronidazole tablets have been used for nearly 50 years to fight lots of infections, including BV. They can start to clear up symptoms within 2 days.

Can I buy BV treatment online?

You can order treatment for bacterial vaginosis online from Click Pharmacy. You can also arrange a confidential online consultation if you have any questions about your treatment.

To order treatment online, you'll need to answer a short online medical assessment. This assessment will help us recommend the right treatment option for you. A member of our team will review your responses. If approved, our pharmacy team will post the medicine to you for discreet next-day delivery. 

What are the side effects of bacterial vaginosis treatment?

Side effects can occur with any medicine. They vary a lot from person to person. Some women may have issues with a certain treatment, while others may have none at all. Our online doctors or your GP will try to choose the treatment with the lowest risk for you.

The side effects of antibiotics are usually mild. This is especially true for creams and gels, because much less of the drug enters your system than with a tablet. Tablets can cause an upset stomach, while the creams or gels used to treat BV can affect the pH in your vagina. This can cause symptoms such as thrush.

You should always talk to a doctor or pharmacist if you have symptoms that could be BV. If you have concerns about the potential side effects of treatment, book a free, confidential appointment with our online doctors at Click Pharmacy. They can answer your questions and put your mind at ease. And you can order the best treatment for you from our online pharmacy. 

How can I prevent bacterial vaginosis?

Since we do not fully understand the causes of bacterial vaginosis, preventing it can be tricky. However, there are ways to lower your risk and help maintain the natural bacterial balance of your vagina. Some tips include:

• Avoiding vaginal deodorants.

• Avoiding vaginal douching.

• Limiting how many sexual partners you have.

• Avoiding strong detergents when washing your underwear.

• Using condoms properly every time you have sex.

• Avoiding scented soaps, antiseptic bath liquids and bubble baths.

Are treatments for bacterial vaginosis safe?

Safety is very important when you consider any new medicine. Your doctor will make sure they prescribe the safest form of treatment that suits you. If you choose to order bacterial vaginosis treatment online from Click Pharmacy, you'll need to fill in a medical questionnaire first. This will ask about any other health issues you have or other medicines, including herbal remedies, you are taking. Our doctors will review all your answers before giving your a prescription. This will let them choose the best medicine for you, whether it's a cream or a tablet.

FAQs

Can I buy BV treatment over the counter?

No, you cannot buy BV treatment over the counter. BV typically requires prescription antibiotics (eg. metronidazole or clindamycin) to treat the infection.

Can BV clear up on its own?

Yes, BV may clear up on its own. However, if you have symptoms, you will need treatment. In women who do not have symptoms of BV, treatment is usually not required.

Can men get bacterial vaginosis?

No, men cannot get BV. Bacterial vaginosis affects the vagina, which men do not have.

Is bacterial vaginosis an STD?

No, bacterial vaginosis is not considered a sexually transmitted disease. It's caused by an imbalance of bacteria in the vagina and is not passed on through sexual contact.