Bacterial Vaginosis Patient Information leaflet

What is bacterial vaginosis and what causes it?

• BV is caused by an overgrowth of various bacteria that normally live in the vagina
• The vagina normally has a mix of bacteria, but in BV the balance changes. It is not clear why this happens.
• BV is not caused by poor hygiene. In fact, excessive washing of the vagina may alter the normal balance of bacteria in the vagina, which may make BV more likely to develop.

Is bacterial vaginosis a sexually transmitted disease?

• BV is not  a sexually transmitted infection (but using condoms does seem to make it less likely to develop).
• It can affect all women, whether or not they have had sex, however it is more common in sexually active women.
• Male sexual partners of women with BV do not need any treatment, though female sexual partners may.

Who gets bacterial vaginosis and how common is it?

In women of menstruating age, BV is the most common cause of vaginal discharge.

• Women are more likely to get BV if they:
  • are sexually active.
  • have recently changed sexual partner.
  • have a past history of STIs
  • are smokers
  • have a copper coil for contraception –
  • are of Afro-Caribbean origin
  • use bubble bath

• Women are less likely to get BV if they:
  • use the combined oral contraceptive pill.
  • have a partner who has had a circumcision.
  • use condoms.

What are the symptoms of bacterial vaginosis?

The main symptom is a vaginal discharge which is usually white-grey in colour and often has a fishy smell. Many women with BV do not have any symptoms (up to half of cases), and in this case no treatment is required.

How is bacterial vaginosis diagnosed?

• BV is usually diagnosed on the basis of symptoms.
• Diagnosis can be confirmed by taking a vaginal swab, which can be performed by a doctor or nurse.
• You may need tests for STIs at the same time
• If you are pregnant, and suspect you may have BV, it’s very important to get tested and treated, as it can increase the risk of complications.

What is the treatment for bacterial vaginosis?

• If symptoms are mild, there is a good chance that BV will gradually clear without treatment.
• However, if you are pregnant or have had a recent gynaecological procedure (such as termination of pregnancy, endometrial biopsy etc) you may require treatment, you should speak to your GP.

The main treatment options are:

Oral Antibiotics

• Clears BV in most cases.
• It is important to finish the course and not to miss any tablets.
• Some people may get side-effects such as nausea.
• You should not drink any alcohol while taking the antibiotics prescribed for BV, and for at least 48 hours after stopping treatment. The interaction with alcohol can cause vomiting, facial flushing and an increased pulse rate.
• Breast-feeding: Vaginal Gel is recommended instead if you’re breastfeeding.

Antibiotic vaginal gel

• This is usually used once daily for 5 days
• The ability of this as a treatment to clear BV is about the same as antibiotics taken by mouth.

Do I need a test to make sure it’s gone?

• If symptoms get better, you do not usually require any further testing unless you are pregnant, in which case we advise that you see your GP.

What if it comes back?

• If your symptoms come back, you may need a vaginal swab and other tests.BV may return if you did not complete your course of antibiotics. However, even if you have completed a full course, BV can return. If it does come back, another course of antibiotics will often be successful.

How can I prevent further episodes of bacterial vaginosis?

• Most episodes of bacterial vaginosis (BV) occur for no apparent reason and they cannot be prevented.
• However, the following are thought to help reduce the risk of BV:
  • The vagina needs no specific cleaning- washing it can irritate it and cause BV.
  • Do not add bath oils, antiseptics, scented soaps, perfumed bubble bath, shampoos, etc, to bath water.
  • Do not use strong detergents to wash your underwear.
  • Using condoms seems to reduce the risk

Does my partner need testing?

Although BV is not an STI, if you have a female partner, she should consider being tested, if she has symptoms. However, if you have a male partner, then it is not necessary for them to be tested.

What are the possible complications of bacterial vaginosis?

• BV can cause complications in pregnancy. If you have untreated BV during pregnancy, you have a slightly increased risk of developing premature labour, miscarriage, preterm birth and having a baby with a low birthweight. If you are pregnant and suspect you may have BV, we recommend that you see your GP.
• BV can also cause complications if you have had recent gynaecological surgery- the chance of developing an infection of the womb is higher.
• If you have untreated BV, you may have an increased risk of developing of getting other sexually transmitted infections. There is also some evidence that women with untreated BV may be at an increased risk of developing pelvic inflammatory disease.

Treatment for Bacterial vaginosis is available at qoctor.com.au

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