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Bacterial Vaginosis (BV)

What is bacterial vaginosis?

Bacterial vaginosis (BV) is a vaginal infection. BV can happen when there is an overgrowth of certain bacteria in the vagina. BV is often a mild infection and can go away on its own. There are times when BV should be treated:

  • During pregnancy
  • Planning to have an IUD/IUS inserted
  • Having a surgical procedure in your pelvis (abortion, hysterectomy)

About 5% of women have recurrent BV (4 times or more a year). Having BV can increase your risk of getting other STIs.

What causes BV?

The cause of BV is not totally clear. Certain activities can upset the normal balance of vaginal bacteria and increase the risk of infection. BV can occur in women who are, and who are not currently sexually active, although it rarely affects women who have never had sex.

Some risk factors are:

  • Having a new sexual partner or multiple sexual partners
  • Having sex frequently
  • Douching
  • Having an IUD/IUS for birth control
  • Stress
  • Taking antibiotics
  • Smoking

Symptoms

Not all women with BV have symptoms – up to 50% of women are asymptomatic. Sometimes symptoms can develop with the menstrual cycle and go away after the menstrual period.

Symptoms can include:

  • White (milky) or grey vaginal discharge
  • Unpleasant vaginal odour (fishy smell)
  • Pain or burning when you pee
  • Vaginal pain or burning during sex
  • Irritation and/or itching around the outside of the vagina

How do you get tested for BV?

A cotton swab is used to collect some vaginal discharge and the sample is sent to the lab. It usually takes about 1 week to get test results.

How is BV treated?

Taking antibiotics by mouth or using a vaginal cream are the most effective treatments for BV. Symptoms often go away in 2–3 days, but it is important to finish taking all of the medication given to you.

Treatment is not necessary if you have no symptoms unless you are:

  • Pregnant
    • *Not treating BV during pregnancy can increase the risk of preterm labour and premature delivery
  • Planning to have an IUD/IUS inserted or having a surgical procedure in your pelvis such as an abortion or hysterectomy
    • *The risk of pelvic inflammatory disease (PID) increases if BV isn’t treated before a surgical pelvic procedure

Recurrent infection occurs in 15–30% of women, 1–3 months after treatment. Women should be retested to confirm BV, before retreating.