BACTERIAL VAGINOSIS

What is it?

Bacterial vaginosis is caused by an overgrowth of bacteria (bugs) that are normally only present in the vagina in small numbers. When these bacteria are present in large numbers they may cause symptoms such as an abnormal discharge or odour. Bacterial vaginosis is sometimes called non-specific vaginitis or Gardnerella vaginitis. It is the most common cause of abnormal discharge in people of child-bearing age.

How do you get it?

Bacterial vaginosis is not generally considered sexually transmitted or contagious. However being sexually active is a risk factor  for bacterial vaginosis. It isn’t known why some people with a vagina get it and some don’t. It can develop soon after intercourse with a new partner and can be associated with other sexually transmitted infections. It is possible that it may arise from bacteria transmitted on fingers or sex toys. Bacterial vaginosis may also occur unrelated to sexual activity


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    The following practices can increase your risk of getting bacterial vaginosis:

    • Sex with a new partner is associated with getting bacterial vaginosis.
    • Sex with an ongoing partner after treatment and not using condoms, is associated with getting bacterial vaginosis back again.
    • Having a sexual partner with a vagina.
    • Not using condoms correctly every time you have sex from start to finish.
    • Cleaning inside the vagina with water, soap or other products (douching).
    • Cigarette smoking
    • Having an intrauterine contraceptive device may increase the risk although the association is not entirely clear. 

Symptoms

Bacterial vaginosis may cause an increase in normal vaginal secretions (fluid leaking from the vagina).  This may be white/yellow/grey, thin and watery. There may be a strong odour (sour or fishy) from the vagina, and the smell may be worse after unprotected sex. 50 % of people with Bacterial vaginosis may have no symptoms.

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    Other infections may be present at the same time as bacterial vaginosis and may have similar symptoms. It is therefore important to take tests to rule out sexually transmitted infections as well.

Is it serious?

Bacterial vaginosis is easy to treat and is not likely to lead to any serious health problems. If you have no symptoms at all then there is no need to treat the infection and often the body will naturally correct the imbalance.

How do you get tested?

If you are experiencing symptoms then bacterial vaginosis can be easily diagnosed by doing a vaginal swab test at your local sexual health clinic. Results of this test will be available before you leave the appointment and you can be prescribed treatment.

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    During a medical examination, the nurse or doctor may notice a discharge or odour. The normal acidity of the vaginal fluid may have changed to become more alkaline, even though you may not have noticed any symptoms. If you are not noticing symptoms then testing and treatment is not required as the body will naturally balance itself.

Treatment

Treatment of bacterial vaginosis is not required if there are no symptoms. Treatment is offered if you have symptoms or may be offered if you are about to have a gynaecological procedure (such as a termination of pregnancy) which could allow bacteria into the uterus.

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    Treatment is usually metronidazole (Flagyl) antibiotic tablets, taken for seven days. Metronidazole may cause nausea or an upset stomach; these effects can be reduced by taking the tablets with meals. Do not drink alcohol during treatment or you may get a severe hangover.


    Some times bacterial vaginosis can come back again and again despite treatment - if this is occurring please discuss with your nurse or doctor as the management of recurrent bacterial vaginosis is based on the individuals symptoms and timing of these symptoms.

Prevention

  • Condoms used correctly every time you have sex from start to finish will provide some protection from bacterial vaginosis and offer good protection from many other sexually transmitted infections.
  • Avoid douching or bathing with bubble baths or other non-pH balanced detergents. Avoid using soap, vaginal wipes or antiseptics.
  • Wear cotton underwear

Telling your sexual partner/s

If you are diagnosed with bacterial vaginosis, partner notification is not required as this is not considered a sexually transmitted infection. Currently treatment of partners with a penis is not recommended as there's insufficient evidence to show that it would be of benefit. There may be evidence that treatment of female partners is reasonable if they test positive, however there is no evidence this will reduce recurrences.