A guide to bacterial vaginosis

Everything you need to know about BV

Bacterial vaginosis (BV) is a common bacterial infection that women experience. Common symptoms of this infection include a grey or white coloured smelly vaginal discharge and a burning sensation during urination.

Cause of Bacterial Vaginosis

Bacterial vaginosis is caused when there is an imbalance in the vaginal bacteria that occurs naturally within the area. Naturally occurring bacteria ensure effective vaginal health and an imbalance in their levels can cause bacterial infections. This infection is often confused with a trichomonas infection or yeast infection. It commonly affects women who are reproductively active. Antibiotics and probiotics are used as primary treatment options.

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Healthy bacteria, termed as lactobacillus, maintains a symbiotic relationship in the vaginal region. When other bacteria such as Gardnerella Vaginalis infect the vaginal region, the number of lactobacilli decreases, promoting the growth of other bacteria. The risk of developing this infection is highest for women who indulge in douching or self-pleasure. For this reason, a risk for BV can increase by six-fold in women who have female partners. Vaginosis itself acts as a risk factor for reproductive disorders, sexually transmitted infections, HIV and pelvic inflammatory disease.

Signs and Symptoms

While occasionally no symptoms may be reported, the most common symptom of vaginosis is the increase in vaginal discharge. The discharge also contains a fishy odour, and may be grey in colour. Few women also experience a burning sensation during urination. Normally, the vaginal discharge varies in consistency and colour throughout the menstrual cycle. It is clearest and most frequent during the ovulation period. Bacterial vaginosis discharge, on the other hand, is consistent.

Bacterial Vaginosis Complications

While the infection is harmless and most often goes away on its own, it can cause serious complications for women who are exposed to other sexually transmitted diseases, are undergoing gynaecological surgery or are pregnant. Bacterial Vaginosis can cause pregnant women to undergo premature delivery, suffer from uterine infection and become susceptible to a greater risk of miscarriage. Women who undergo gynaecological surgeries become more prone to inflammation, and pelvic diseases.

Diagnosis of Bacterial Vaginosis

In order to check if you have bacterial vaginosis, you should obtain a swab from inside the vagina. This swab is then used to check the smell of the odour. Pathological laboratories add a little bit of potassium hydroxide on the swab with the vaginal discharge to check the odour. Another characteristic used for the diagnosis of vaginosis is through pH level detection.

A normal vagina has an acidic pH ranging between 3.8 and 4.2. If the pH is more than 4.5, then bacterial vaginosis may be present. Third exam checks for the presence of clue cells, which are cells coated with bacteria. These cells are visible under a normal microscope after being treated with sodium chloride.

Preventing Vaginosis

The best way to prevent bacterial vaginosis is by avoiding unhealthy sexual activities such as multiple partners and douching. Another good way to prevent vaginosis is by intake of healthy probiotics such as yoghurt and kefir. For minimizing the occurrence of bacterial vaginosis, it is important to:

Practice Safe and Healthy Sex

In order to avoid any sexually transmitted infections, it is necessary to practice safe and healthy sex. By limiting the number of sex partners, and using safe protection such as latex condoms, one can reduce the risk of acquiring sexually transmitted infection greatly.

Avoid Douching

Douching is the act of spraying water inside the vaginal area. There is a lot of controversial debate on the issue, yet researchers and physicians all over the world agree that douching is an unhealthy act. The female vaginal area already knows how to clean itself, and there is no point in spraying water in hopes of cleaning it extra. Tap water contains unhealthy bacteria, which invade the vaginal region and make it worse. Female partners often indulge in douching as an act of stimulation, which should be avoided.

Maintain Good Hygiene

As stated previously, the vaginal region has been naturally designed to clean itself. All the extra marketed products such as scented pads and tampons only increase the risk of an unwanted infection. All vaginal area needs for clean hygiene maintenance is the use of unscented feminine products and mild, non-deodorant soaps.

Treatment with Antibiotics

Commonly antibiotics such as Clindamycin and Metronidazole 400mg are used for the treatment of bacterial infection. They can either be taken in the form of tablets or topically applied inside the vagina. These topical medicines may include Clindamycin or Dalacin cream, Metronidazole based Zidoval gel and Metronidazole gel.


Marketed as Tindamax, it is an oral medication, which is also used for the treatment of nausea and upset stomach. It works by replacing the natural balance of probiotic bacteria within the vaginal area. It is necessary to avoid alcohol during the treatment due to medicine’s nature.


Commercially marketed as either Clindesse, Dalacin or Cleocin, Clindamycin is available as either a gel or a cream, which can be applied topically on the vaginal area. Sexual activity should be avoided during the cream application as Clindamycin weakens latex-based condoms. Alternative sexual protection should be sought out during the treatment, and should also be continued for three days after stopping Clindamycin.


Metronidazole is available as an oral medication as well as a topical gel. Normally, this antibiotic is used in the treatment of stomach-related problems as it helps control the invading bacteria in the gut and promotes the growth of healthy bacteria instead. Its feature is the same for vaginal bacteria, where it promotes the growth of lactobacillus while discouraging the growth of vaginosis-causing bacteria. Metronidazole is marketed commercially as Metrogel-Vaginal, Zidoval, Flagyl and others. It is strictly recommended to avoid alcohol at least 24 hours before and after the treatment and to abstain altogether during the treatment course.

Probiotic Therapy

Probiotic therapy is a common approach taken by women who do not want to rely too much on antibiotics. Also known as the lactobacillus colonising therapy, women increase their number of probiotic ingredients in the diet. These probiotics include yoghurt and other food containing lactobacillus. Once consumed, these probiotics encourage a healthy growth environment for the lactobacilli in the area. While this therapy is not supported equally by the researchers, users have reported improvements, some even claiming it as a full cure for their BV infections.

Is Bacterial Vaginosis Contagious?

If in case the woman is infected with bacterial vaginosis and has a male partner, there is a very low risk that the male partner will be infected. The male reproductive system has an environment that does not encourage the growth of BV causing bacteria. On the other hand, if the infected woman has a female partner, then both women will need to be checked for the disease and go under BV treatment.

Will the Disease Occur Again?

It is very common for BV infection to recur again between three to twelve months even after treatment. Therefore, even if you have been treated for your infection once successfully, you will still need to be careful and watch out for the symptoms that might appear again. If the symptoms appear again, you will need to consult with your doctor and consult your treatment options.

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