Bacterial vaginosis is an extremely common condition that affects many women. Though there is some evidence that bacterial vaginosis is linked to sexual activity, it's not a sexually transmitted infection (STI).
Causes of bacterial vaginosis
A normal and healthy vagina is home to many species of bacteria. These include Lactobacillus jensenii and Lactobacillus crispatus, which normally maintain a high acidity in the vagina to control the growth of other bacteria in the vagina. Bacterial vaginosis occurs when these two bacteria are suddenly reduced in number. This may be due to a change in the acidity of the vagina due to illness or another medical condition, or because of an antibiotic treatment for an infection elsewhere. This allows other bacteria to multiply and there are many different strains involved in bacterial vaginosis.
There is no evidence that bacterial vaginosis is sexually transmitted. However, there is a correlation between sexual activity with multiple partners or new partners. However, this does not prevent women who are completely sexually inactive developing the condition too.
There is a clear risk of bacterial vaginosis in pregnant women, and also those who have contracted an STI (sexually transmitted infection). Other research has shown that the menopause may also trigger the condition. Women with anaemia are also prone to infection.
Other risk factors include smoking, the use of vaginal deodorants, the use of an IUD (intrauterine device), or the regular use of bubble bath (and/or soaps that have been artificially scented).
Symptoms of bacterial vaginosis
More than half of women with bacterial vaginosis express no symptoms at all. This condition is harmless, and does not pose any risk during pregnancy. In those women who do have symptoms they include; a noticeable change in vaginal discharge which may become thin or watery, it may also change colour (white or grey), and there may be a distinct and unpleasant fishy smell.
Bacterial vaginosis has also been known to cause pain during sexual intercourse, and when urinating. It may also lead to some light bleeding from the vagina. It is not normally associated with irritation or itchiness.
There may be a slight increased risk of complications during pregnancy if you have bacterial vaginosis. See your GP for more information.
Testing for bacterial vaginosis
The test for bacterial vaginosis is conducted from a vaginal swab. The test includes a test for an odour given off when potassium hydroxide is added to the sample, this is sometimes known as a “whiff test”.
There's also a check for a rise in the pH of the vagina, in general bacterial growth is kept in check under mildly acidic conditions (pH of around 4), bacterial vaginosis normally requires a pH of over 4.5.
The final check is to see if certain “clue” cells are visible under a microscope when sodium chloride (salt) is added to the sample.
Treatment for bacterial vaginosis
The good news is that bacterial vaginosis is simple to treat, a course of metronidazole (an antibiotic) is normally all that is required. This can be given as tablets or as a vaginal gel. There are also some alternative treatments that may be used if this fails.
Other measures which can help bacterial vaginosis include avoiding over-washing with perfumed soap and avoiding bubble-bath.
Putting a finger full of plain natural yoghurt into your vagina, as high up as you can put it has been reported by some women as being helpful. However, it is not uncommon for bacterial vaginosis to recur and more than half of those who have been successfully treated will normally have a recurrence within six months.
Some women find the problem occurs so regularly that they need a consultation with a gynaecologist to help them overcome it. You can purchase sexual health tests and treatments from our website.