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Bacterial vaginosis

Bacterial vaginosis (BV) in women

 What is bacterial vaginosis (BV)?

  • BV is the most common cause of an abnormal vaginal discharge.
  • It is caused by an upset in the delicate balance of bacteria in the vagina.
  • The ‘good’ bacteria (lactobacilli) are replaced with an overgrowth of anaerobic bacteria.
  • It is not sexually transmitted

How common is BV?

  • BV is very common in women particularly sexually active women.
  • It occurs more frequently in black women, smokers and women with an IUD (coil).

How do you catch BV?

  • Women don’t catch BV – it is an overgrowth of anaerobic bacteria naturally present in the vagina.
  • Factors that make the vagina alkaline (the healthy vagina is mildly acidic) may trigger BV in some women:
    • Douching
    • Use of irritant skin products such as bubble baths, shower gels, perfumed soap, Dettol or other antiseptics and feminine cleaning products.
    • Sexual intercourse and semen
    • Heavy or prolonged periods.

What would I notice if I had BV?

  • Many women (up to 50%) with BV will not notice anything wrong.
  • Others may notice an unpleasant fishy smelling discharge, which, is worse after sex. 

How do I get tested for BV?

  • A vaginal swab – this is looked at directly under the microscope at the Wolverton Centre to give an immediate result. 

How is BV treated?

  • In women with symptoms treatment is:
    • METRONIDAZOLE 400mg tablets twice daily for 5 days


  • METRONIDAZOLE  2g single dose


  • CLINDAMYCIN 2% vaginal cream once daily for 7 days
  •  Avoid alcohol whilst taking metronidazole and for 48 hours following completion.
  • Treatment is safe during pregnancy.
  • Clindamycin vaginal cream can weaken rubber condoms – if necessary avoid sex during treatment to prevent pregnancy.
  • Avoid douching and all soaps, shower gels and bubble baths – use aqueous cream to wash with instead.

What about my partner?

  • BV is not a sexually transmitted infection.
  • BV does not affect men.

What problems can untreated BV lead to?

  • BV will get better without treatment.
  • There is evidence to indicate that treating BV prior to termination of pregnancy will reduce the risk of developing pelvic or uterine infection post operatively. 

BV in pregnancy

  • BV may be associated with late miscarriage and premature delivery – but the evidence is not clear cut.
  • Women with symptomatic BV in pregnancy should be treated in the usual way with antibiotics.

Will BV come back again after treatment?

  • BV frequently recurs often for no apparent reason.
  • If this is troublesome ask the clinic doctor or nurse for a referral to the specialist clinic at the Wolverton Centre.

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