Bacterial vaginosis

Bacterial vaginosis isn't a sexually transmitted infection. It happens when the usual balance of bacteria in the vagina goes out of order.

Bacterial vaginosis often causes no symptoms at all. Some women do notice a change in their normal vaginal discharge.

When there is a change, the discharge is usually white or grey, thin or watery, and has a strong, unpleasant fishy smell. You may notice the smell more during and after sex, and during periods.

Bacterial vaginosis does not usually cause itching or irritation.

• Check whether your toiletries could be triggering it.
• Think about trying over-the-counter treatments from your pharmacy.
• Contact a doctor for an appointment, or book one at your local sexual health clinic.

Sometimes treatment for bacterial vaginosis is started on the basis of your symptoms alone, without any examination or test.

In some cases the doctor can make a diagnosis straightaway just from how the discharge looks. In others, a sample is sent to a lab for testing. You're more likely to need a test if you have frequent episodes of discharge.

Your nurse or doctor may do an internal examination to check your vagina for signs of bacterial vaginosis. They may also use a swab to collect a sample of the discharge. A swab looks a bit like a cotton bud, and taking the sample only takes a few minutes. It isn't painful, but it may feel a little uncomfortable for a moment.

If your nurse or doctor suspects you are at risk of an STI, they may do more tests.

Bacterial vaginosis is treated with antibiotics, and these must be prescribed by a doctor or nurse. You may be given an antibiotic cream or gel to use in your vagina, instead of antibiotic tablets taken by mouth.

When you see the doctor or nurse, make sure you tell them if you:

• are pregnant
• think you might be pregnant
• are breastfeeding

These may affect the type of treatment you're given.

You can still have sex while you're being treated for bacterial vaginosis, because it's not sexually transmitted. However, antibiotics and creams can affect condoms and other forms of contraception. Speak to your doctor or pharmacist, who can give you further information.

Partners do not usually need treatment.

Non-antibiotic treatment is also available to buy in pharmacies.

Your vagina naturally has bacteria called lactobacilli, and they stop other bacteria from growing there. Sometimes the balance of these bacteria changes, and if that happens you can develop bacterial vaginosis.

Bacterial vaginosis can't be passed on. But it's more common in sexually active people.

Some other things may raise your risk of getting it too:

• having a new sexual partner
• having multiple sexual partners
• smoking
• using scented soaps or perfumed bubble bath
• putting antiseptic liquids in the bath
• douching (washing or cleaning out the vagina with water or other fluids)
• using vaginal washes or deodorant
• using strong detergents to wash your underwear
• receiving oral sex

Doctors don't fully understand what causes bacterial vaginosis, so it may not be possible to prevent it completely. You may still be able to lower your risk of getting it by following the genital washing advice.