Understanding BV: The Most Common Vaginal Condition
Bacterial vaginosis affects 1 in 3 women at some point. It's not an STI, but it can increase your risk of getting one. Get accurate diagnosis and effective treatment.
Bacterial vaginosis (BV) is a common vaginal condition caused by an imbalance in the natural bacteria that live in the vagina. While not technically a sexually transmitted infection, BV is associated with sexual activity and can increase susceptibility to STIs including HIV. It's the most common cause of abnormal vaginal discharge in women of reproductive age.
BV is diagnosed through clinical examination and laboratory testing. We assess vaginal pH (elevated in BV), examine discharge characteristics, and can perform microscopy to identify 'clue cells' - vaginal cells coated with bacteria. The 'whiff test' may detect the characteristic fishy odour when discharge is mixed with potassium hydroxide.
BV is treated with antibiotics, typically metronidazole (oral tablets or vaginal gel) or clindamycin (vaginal cream). Treatment usually lasts 5-7 days. It's important to complete the full course even if symptoms improve. Alcohol should be avoided during metronidazole treatment. Recurrent BV may require longer or repeated treatment courses.
BV is not classified as an STI, but it is associated with sexual activity. Women who have never had sex rarely get BV. Having a new partner or multiple partners increases risk. Male partners don't need treatment, but female partners should be assessed.
Sometimes BV resolves without treatment, but this is unpredictable. Treatment is recommended to relieve symptoms, prevent complications, and reduce the risk of acquiring STIs. Untreated BV during pregnancy can cause serious complications.
Recurrent BV affects about 50% of women within 12 months of treatment. This may be due to persistent disruption of vaginal flora, reinfection, or incomplete treatment. Strategies include extended antibiotic courses, vaginal probiotics, and addressing risk factors.
It's best to avoid sex until you've completed treatment and symptoms have resolved. If you do have sex, use condoms. This helps prevent irritation and ensures treatment effectiveness.
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