Bacterial Vaginosis

Bacterial vaginosis is a common condition in which the normal balance of bacteria in the vagina is disrupted, leading to an overgrowth of certain bacteria. It is not classified as a sexually transmitted infection, though sexual activity can influence risk.

• Thin, greyish-white vaginal discharge
• A distinctive fishy odour, often more noticeable after sexual intercourse
• Mild itching or irritation in some cases
• Many cases cause no symptoms at all

• Results from an imbalance in the normal vaginal bacterial environment, with a reduction in protective bacteria and overgrowth of other bacterial species.
• Risk is increased by douching, having a new or multiple sexual partners, and, in some cases, use of an intrauterine device.
• It is not caused by poor hygiene, and excessive washing or douching can actually increase risk by disrupting the normal vaginal environment.

• Diagnosed clinically based on the characteristic discharge and odour, supported where available by examination of vaginal fluid under a microscope or pH testing.
• It is important to distinguish bacterial vaginosis from other causes of vaginal discharge, such as yeast infection or trichomoniasis, as treatment differs.

Bacterial vaginosis is treated with an oral or topical antibiotic, commonly metronidazole, for about a week.

Treatment is generally recommended for anyone with symptoms, and also for pregnant women with the condition, given a link to certain pregnancy complications.

Avoiding douching and other practices that disrupt the natural vaginal environment can help reduce recurrence, which is common.

Recurrent bacterial vaginosis may need a longer or repeated course of treatment, and can be discussed further with a health worker if it keeps returning.

• Avoid vaginal douching, which disrupts the natural balance of vaginal bacteria.
• Use mild, unscented soap for washing the external genital area only.
• Avoid scented feminine hygiene products.
• Consistent condom use may reduce the risk of bacterial vaginosis in some people, though the exact relationship with sexual activity is not fully understood.