Frequently Asked Questions About Bacterial Vaginosis

By Dr Jireh Serfontein.

What is Bacterial Vaginosis (BV)?

Bacterial Vaginosis (BV) is the name of a condition in women where the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain bacteria. It is sometimes accompanied by discharge, odour, pain, itching, or burning. BV is the most common vaginal infection in women of childbearing age.

What causes Bacterial Vaginosis?

Any woman can get Bacterial Vaginosis. But there are certain things that can upset the normal balance of bacteria in the vagina, increasing your risk of developing Bacterial Vaginosis:

  • Having a new sex partner or multiple sex partners
  • Douching
  • Not using a condom
  • Although sexual activity can increase the risk of developing Bacterial Vaginosis, it can occur in women who have never had vaginal intercourse.

Bacterial Vaginosis is not thought of as a sexually transmitted infection.

What are the signs of Bacterial Vaginosis?

Women with Bacterial Vaginosis may have an abnormal vaginal discharge with an unpleasant odour. Some women report a strong fish-like odour, especially after sex. The discharge can be white (milky) or grey. It may also be foamy or watery. Other symptoms may include burning when urinating, itching around the outside of the vagina, and irritation. These symptoms may also be caused by another type of infection, so it is important to see a doctor. Some women with Bacterial Vaginosis have no symptoms at all.

How is Bacterial Vaginosis diagnosed?

The diagnosis of BV is based upon a physical examination and laboratory testing. The physical examination usually includes a pelvic examination, which allows your doctor to observe and test vaginal secretions. Your doctor may take a sample of fluid from your vagina and test it.

What are the complications of Bacterial Vaginosis?

In most cases, Bacterial Vaginosis doesn’t cause any problems. But some problems can arise if Bacterial Vaginosis is left untreated:

  • Having Bacterial Vaginosis can increase a woman’s susceptibility to HIV infection if she is exposed to the HIV virus.
  • Having Bacterial Vaginosis increases the chances that an HIV-infected woman can pass HIV to her sex partner.
  • Having Bacterial Vaginosis has been associated with an increase in the development of an infection following surgical procedures such as a hysterectomy or an abortion.
  • Having Bacterial Vaginosis while pregnant may put a woman at increased risk for some complications of pregnancy, such as preterm delivery.
  • Bacterial Vaginosis can increase a woman’s susceptibility to other STIs, such as the herpes simplex virus, chlamydia, and gonorrhea.

All pregnant women with symptoms of Bacterial Vaginosis should be tested and treated if they have it. This is especially important for pregnant women who have had a premature delivery or low birth weight baby in the past. There are treatments available at any stage of your pregnancy. Be sure to talk to your doctor about what is right for you.

How can I lower my risk of getting Bacterial Vaginosis?

The best way to prevent Bacterial Vaginosis is not known. However, a few basic recommendations can be made:

  • Do not douche. Douching is the use of a solution to rinse the inside of the vagina. Some women douche to feel “clean”, although there is no proven benefit of douching. The vagina is normally able to maintain a healthy balance of bacteria; douching can upset this balance and potentially flush harmful bacteria into the upper genital tracts (uterus, fallopian tubes).
  • Limit the number of sexual partners. Women with multiple sexual partners are at higher risk of developing bacterial vaginosis and sexually transmitted infections.
  • Finish the entire course of treatment for Bacterial Vaginosis, even if the symptoms resolve after a few doses.

How is Bacterial Vaginosis treated?

Bacterial Vaginosis is treated with antibiotic medicines prescribed by your doctor. In our clinic we usually use four tablets of Fasigyn (Tinidazole) that should all be taken at the same time, to treat Bacterial Vaginosis. It does not have the same severe effect when taken with alcohol as with the traditional treatment, Flagyl (metronidazole), but it can still give you a headache or nausea when alcohol is consumed within a few days of taking it. If the Fasigyn is not effective, we use Metrogel (metronidazole gel) that should be inserted into the vagina for 5 consecutive nights.
Generally, male sexual partners of women with Bacterial Vaginosis don’t need to be treated. However, Bacterial Vaginosis can be spread to female partners. If your current partner is female, talk to her about treatment. You can get Bacterial Vaginosis again even after being treated.

Please let us know if you feel that your symptoms did not resolve from the treatment that you have received.