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Bacterial Vaginosis

Symptoms and causes of BV and effective treatment available in the UK

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Dr Hilary Jones discusses bacterial vaginosis and the treatments available at HealthExpress

Bacterial vaginosis - also known as BV or gardnerella vaginalis - is somewhat under the radar, especially in comparison to other infections such as thrush. In fact, it is the most common type of vaginal infection in the UK. It is more common in sexually active women, and has the same symptoms as certain STIs, however it's important to note that it isn't classed as a sexually transmitted infection.

If left untreated, it may increase a woman's risk of developing a uterus infection or pelvic inflammatory disease (PID) and may increase the risk of contracting other STIs, however it is easily be cured with a dose of antibiotics. For further information on BV, you can read below, or buy clinically proven treatment metronidazole by completing a free consultation.

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What is bacterial vaginosis?

The vagina has a delicate balance of bacteria that is harmless the vast majority of time - in fact, sometimes this good bacteria helps keep that area at ease – however when this is disrupted, this can lead to uncomfortable symptoms. Vaguely similar to thrush and certain sexually transmitted infections, bacterial vaginosis is an infection in the vagina that is extremely common, yet unlike other yeast infection and STIs, exposure and understanding of it is vastly unknown. Here, we look to dispel the myths and reiterate the facts surrounding BV; the UK's most common yet inadequately understood condition.

Bacterial vaginosis (BV) is the most common infection that produces discharge in the UK with 100,000 fresh cases each year at GUM clinics alone. Whilst the exact causes are still unknown, there are certain triggers you can avoid, and effective treatment you can use.

The condition is not serious for the vast majority of women, however if you haven't experienced it before it can be uncomfortable, especially as the main symptom is an unusual discharge. There is also evidence to suggest that BV can affect your baby if you are pregnant, or make you more susceptible to STIs, so many women get themselves treated with antibiotics.

Is bacterial vaginosis an STI?

Most credible sources such as the NHS or webmd do not class BV as a sexually transmitted infection. Although rates of BV in sexually active women and those with multiple partners are higher, this could be linked to age. It is also possible to transfer the condition to your female partner if you're in a same sex relationship. Whilst these factors are linked to sex, lending itself to the term "STI", there are other points to consider. For example, there is no male alternative, and if you are a female with BV, offering treatment to your male partner will not stop yourself getting recurrent bouts in the future, suggesting than it is simply gender based rather than sex based. This means you will not pass the infection onto men. There are also cases of women who aren't sexually active getting bacterial vaginosis. Finally, studies have linked the infection to certain ethnic groups (detailed under causes below) being more likely to get BV. All in all, the causes of bacterial vaginosis lean away from the term 'STI'.

What causes bacterial vaginosis?

The medical cause of bacterial vaginosis is the natural balance of bacteria in your vagina altering. The vagina is always slightly acidic to keep it clean and healthy, this is because of the bacteria - lactobacilli. When lactobacillus is lagging, this allows other more harmful bacteria to flourish, causing the unpleasant symptoms of BV.

Triggers of causes of bacterial vaginosis

There is no precise cause of bacterial vaginosis and these signs can differ from one woman to the next so it is advised to keep a note when the infection exposes itself and what factors have differed to prompt a change. Whilst it is not 100% confirmed, there is research to show that the following could be linked to BV[1]:

Sexual activity – Women having regular sex find themselves more susceptible to BV. Having multiple sex partners increases the risk furthermore. Forums and medical research suggests this is the most common cause.

Intrauterine device (IUD) – This contraceptive device is inserted into the womb and the hormones are released, which could be triggering symptoms of BV, according to a study comparing women with IUD contraception and women without.[2]

Smoking – Studies have shown that smoking cigarettes alters the bacteria living in the vagina, which could be promoting bouts of BV.

Over-cleaning – Otherwise known as 'douching', using household products to clean your vagina could be causing the infection. Water, and maybe a little soap, should be used only as the vagina is perfectly capable of cleaning itself.

Foreign objects – Like the IUD, there is a possibility tampons, and other foreign objects, can be interrupting the natural bacteria in the vagina.

Personal hygiene – Not wiping after the toilet, wiping incorrectly, wearing synthetic fabrics and not changing your underwear often, can all be triggering BV.

Whilst BV can be instigated through sexual activity, in particular penetrative sex, it is still not strictly classed as a sexually transmitted infection as there are other causes and research surrounding its link to intercourse is limited. If you are experiencing unusual discharge, then check the symptoms of bacterial vaginosis below. If they don't fit, it could be linked to an STI.

Symptoms of bacterial vaginosis

About half of women with BV don't have any symptoms at all. Unlike other vaginal infections, itching and soreness don't usually accompany BV so it is unlikely you will need a cream to soothe any discomfort. However if you are experiencing anything unusual, the main sign of an infection is an unusual vagina discharge. This can be unclear, as most of a woman's discharge is completely normal, however there are some signs it could be something else. In this case, BV infections will have the following symptoms:

  • White or grey in colour
  • Thin and watery in texture
  • An unusual smell (strong fishy odor)

These symptoms may coincide with other factors, such as itching, burning sensation when urinating and irregular bleeding.[3] These signs are more closely linked to STIs and require a check-up at the sexual health clinic.

Benefits of treating bacterial vaginosis

Although bacterial vaginosis isn't harmful for the vast majority of women, the smell in particular can be disheartening. By treating BV with appropriate antibiotics, you clear up this and any other issues quickly allowing you to continue with your life feeling 100% yourself.

Whilst eliminating the symptoms will increase your confidence, if you are pregnant, there are links between BV and certain complications detailed below meaning pregnant women must treat bacterial vaginosis at their earliest convenience.

Other complications include a risk of sexually transmitted infections (in particular, chlamydia, gonorrhoea and HIV) and pelvic inflammatory disease.

How to treat bacterial vaginosis

Metronidazole is the most recognisable form of treatment for bacterial vaginosis according to the NHS, and a medication we offer here at HealthExpress. The antibiotic is available in different forms, most commonly as a tablet to be taken twice a day. As with all antibiotic, you must take the full course regardless of whether you are feeling better part, half or mostly the way through. It is also available as one singular tablet of a higher dosage or as a gel applied once a day. A course of antibiotics are generally preferred as side effects are increased with the higher dose tablet and gels are more difficult to apply correctly.

Bacterial vaginosis in pregnancy can still be treated with metronidazole tablets, however when breastfeeding, the active ingredients can affect breast milk so the gel will most likely be recommended in this instance. There are currently no proven natural cures or home remedies for bacterial vaginosis.

How to prevent bacterial vaginosis

BV prevention is very similar to avoiding thrush, and is linked to the possible causes. For example, practising personal hygiene (detailed below) and quitting smoking could help. Once you have had bacterial vaginosis once, recurrent bouts are not surprising so making a mental or physical note of what changes have incited symptoms and minimising these risk factors can help:

Wearing natural clothing – Loose cotton underwear may help not only prevent BV but speed up recovery during an outbreak

Natural products – Only use gentle products to clean your genitalia. Many vaginal specific brands still include ingredients that can aggravate the vagina. This includes any washing detergent you may use on your laundry

Limited cleaning - Remember, the vagina cleans itself so you shouldn't have a specific vagina-cleaning regime at all. When you have BV, it may be easy to think that cleaning will help the smell, however in reality it could be making it worse. Cleaning just once a day, tops, is all your vagina needs

No douching - Steer clear of douching completely. You shouldn't be cleaning inside your vagina, especially pushing water

Quit smoking – It's easier said than done, but once you quit smoking, your BV may go completely, as well as you reaping may other benefits

Practice safe sex – Some research has shown that using condoms can reduce the number of bouts, as well as keeping sexual activity to one partner

Good hygiene – As well as limited cleaning and no douching, wiping from front to back after using the toilet can help

The above bullet points designed like the below:

What options do we offer to treat bacterial vaginosis?

The only antibiotics available for BV is what we have on offer at HealthExpress. We offer a course of 21 tablets at 400mg dosage of metronidazole to be taken over a period of 7 days (one tablet three times a day). You can order metronidazole online with us and we will deliver discreetly to any location you need. For the UK, if you order before 4pm, you will receive your package the next day, or if you are within a London postcode, you can get your medication the very same day.

To order metronidazole, you can start a consultation below. If you are a repeat customer, you can take advantage of our super quick reordering service to have the treatment delivered the same day in London or next day to other parts of the UK.


Dr Hilary Jones, HealthExpress Medical Advisor

What should I do if I experience bacterial vaginosis?

Bacterial vaginosis is a common vaginal infection that can develop as a result of sexual intercourse. It mainly affects women and doesn't always cause symptoms.

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