Bacterial vaginosis

If you have a vagina, you’ve probably experienced vaginal discomfort. Maybe you know enough to recognise the symptoms of thrush and cystitis. But if there’s something fishy going on down there, and you’re not sure what, it could be bacterial vaginosis. 

What is bacterial vaginosis? 

Bacterial vaginosis is when the normal balance of bacteria in the vagina gets out of whack. When too much anaerobic bacteria (which doesn’t need oxygen to grow) grows in the vagina, the environment changes, leading to some of the symptoms described below. 

How common is bacterial vaginosis? 

About 1 in 3 people with a vagina will get bacterial vaginosis at least once. It’s the most common vaginal condition among people with a vagina aged 15 to 44 years (though it can occur at any age). 

How will I know if I have bacterial vaginosis? 

About half of people with bacterial vaginosis experience no symptoms, but for others, the most common symptoms are increased vaginal discharge and grey or white discharge with a funky, fishy smell. Some people experience burning with urination. Itching is less common and more likely to be associated with conditions like thrush, cystitis and STIs. Symptoms can come and go and are often more noticeable after sexual activity. 

What causes bacterial vaginosis? 

Several factors can disrupt the delicate balance of bacteria in your vagina. Some are external, interfering factors (soap, vaginal douching, semen, and penises, for example), while others are internal (like antibiotics and even diet). Another likely culprit is prolonged and irregular bleeding, a common side effect of starting a new form of contraception. 

Being sexually active is associated with a higher risk of bacterial vaginosis - almost everyone (around 85% of people) who gets it is sexually active. Not using condoms, having new or numerous sex partners, and swapping from the anus to the vagina without cleaning up or changing barrier protection are particularly likely to increase your risk. 

How can I prevent bacterial vaginosis? 

The best way to prevent bacterial vaginosis is to minimise your risk factors. Lay off the vaginal douching, avoid using scented products down there, and keep soap and other pH-altering substances away from your vulva and vagina (which means, sadly, keeping the bubble baths to a minimum). Use condoms when you’re sexually active, and always change condoms if you’re swapping from the anus to the vagina.

Is bacterial vaginosis dangerous? 

Bacterial vaginosis comes with a few potential complications, so while there’s no need to panic, it’s best to consult your doctor if you think you might have BV. Changes to the vaginal environment trigger an immune response which reduces the effect of the vagina’s naturally protective mucus, making you more vulnerable to contracting STIs (not cool, BV). Treating bacterial vaginosis during pregnancy is important because it can increase the risk of premature birth and low birth weight. 

How do I treat bacterial vaginosis? 

The vagina is a marvellous thing. Sometimes, when its balance gets out of whack, it sorts it out all on its own. If not, don’t stress! Plenty of effective treatments for bacterial vaginosis exist, from antibiotics and probiotics to antiseptics, to medications that rebalance vaginal pH. Some are available over the counter at your local pharmacy, but others need a prescription. So, if you notice symptoms of bacterial vaginosis, your best bet is to consult your doctor.

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