Bacterial Vaginosis

Bacterial vaginosis is the most common vaginal infection, typically causing increased discharge which is usually non-irritant but has a characteristic ‘fishy’ smell. The smell may be more obvious after sexual intercourse. It can be a single infection or can co-exist along with other infections such as thrush and with sexually transmitted infections. It can also be completely symptomless. It is not classed as a sexually transmitted infection, as, like thrush (candida) it can occur in women who are not in a sexual relationship at the time. Treatment of partners does not seem to prevent relapse, which can be common, (up to 60% within 3 months of successful treatment).

It is caused by an overgrowth of anaerobic organisms (organisms that can live without oxygen), the commonest of which is gardnerella vaginalis. Other organism that can be found in sufferers are Provotella species, Mycoplasma hominis, and Mobiluncus species.

Treatment can be with an oral antibiotic - metronidazole, or with a vaginal cream - clindamycin cream. There are a variety of oral regimes, but however long you take metronidazole for, it is important to avoid alcohol for the time that you take it and for 24 hours after you stop. You can take a single high dose, or a lower dose over a week. Some people feel rather nauseous with the medication. The vaginal cream is a useful alternative, but you need to use it for 7 days.

It usually advised that you avoid bubble bath, vaginal deodorants and douches. It is thought that these can damage the sensitive lining of the vagina, change the acidity of the vagina which in turn encourages the overgrowth of these bacteria. It has to be said this is not yet proven, but sticking to these measures will do no harm, particularly if you suffer from recurrent infections.

Whilst bacterial vaginosis is predominantly a vaginal infection, there is concern that it could cause pelvic inflammatory disease under certain circumstances, eg following surgical procedures as in termination of pregnancy, and following hysterectomy. It can cause problems in pregnancy causing late miscarriage, preterm birth, premature rupture of membranes, low birth weight, and infection after delivery.

It is thought to increase the risk of contracting HIV.

Further information

This article published on
01 August 2005

Next review date 8/1/2013



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