Bacterial Vaginosis
Bacterial vaginosis (BV) is a common imbalance of the bacteria naturally found in the vagina. It's not a sexually transmitted infection, but it can cause unusual discharge and odour
About bacterial vaginosis
The vagina normally contains a balance of bacteria, including protective lactobacilli. BV occurs when this balance shifts and other bacteria overgrow, raising the vaginal pH. It can occur without an obvious cause but is more common with douching, new or multiple sexual partners, and the use of scented products. It isn't harmful in itself but can increase the risk of other infections
Treatments
Symptoms
• Thin, greyish-white vaginal discharge
• A strong, fishy odour, often more noticeable after sex
• Mild itching or irritation (uncommon)
• Around half of women have no symptoms at all
Diagnosis
BV can often be recognised from typical symptoms, but a swab test checking vaginal pH and appearance under a microscope gives a definite diagnosis, particularly if symptoms are recurrent or unclear
Treatment
BV is treated with a course of antibiotics, either as tablets or a vaginal gel or cream, typically metronidazole or clindamycin. Symptoms usually settle within a few days, but the full course should be completed to reduce the chance of recurrence
Prevention and self-care
• Avoid vaginal douching
• Use water or a mild, unperfumed soap to wash the external genital area only
• Avoid scented soaps, bubble baths and vaginal deodorants
• Wipe front to back after using the toilet
• Use condoms, as this may reduce recurrence for some
• Change tampons or pads regularly
Reviewed by Hamza Iqbal Naheed, Superintendent Pharmacist, GPhC 2209194 (check the register) · Last updated 21 September 2026