Symptoms Of Bacterial Vaginosis (BV)

Dr Kathryn Basford

Medically reviewed by

Dr Kathryn Basford

Last reviewed: 23 May 2022

The usual bacterial vaginosis symptoms are a change in the colour, smell, or consistency of your vaginal discharge. BV typically causes a strong fishy smell. Many women who have BV do not get symptoms at all. BV can be mistaken for other vaginal infections, so it is best to speak to a doctor. You need antibiotics to treat BV if you have symptoms.

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What are the symptoms of BV?

The main BV symptoms are a change in the colour, smell, and consistency of your vaginal discharge. BV discharge tends to have a strong fishy smell. Your vaginal discharge may become watery, thin, or greyish. This can be more noticeable after having sex. BV does not typically cause other symptoms. 50% of women who get BV do not get any symptoms at all.

What does BV discharge look like?

BV discharge can look different for every woman. This depends on what your vaginal discharge usually looks like. BV can change the colour or consistency of your discharge or both. Usually you will get vaginal discharge that is grey or white and thin and watery in consistency. You might notice brown or pink discharge if it is around the time of your period, but otherwise this can be a sign of a different infection. Yellow or green discharge is usually caused by a different infection.

What causes BV?

Your vagina contains a natural healthy balance of bacteria. You can get BV if something upsets the balance of bacteria, leading to an overgrowth of certain bacteria which can cause symptoms. The most commonly found bacteria is Gardnerella vaginalis. Some things can increase the chance of getting BV, such as:

  • changing your sexual partner
  • using strong smelling or perfumed products around or inside your vagina
  • being sexually active, but you can still get BV without having sex
  • using an IUD, which is a contraceptive device inserted into your womb

Although BV is not an STI, sex can trigger it. Women can pass it to other women during sex.

Other conditions with similar symptoms

Some other conditions can cause symptoms like you have with BV. This means you might need to rule out other vaginal infections, including sexually transmitted infections (STIs) before getting treatment for BV. Your doctor can take a vaginal swab if they are not sure whether you have BV. Some vaginal infections also have other symptoms which can make them easier to diagnose.

Thrush

Thrush is a common vaginal infection that can cause unusual discharge like BV. The main difference between thrush and BV is that the discharge caused by thrush does not usually have a smell. Thrush vaginal discharge tends to be white and can be thick, like cottage cheese. Thrush can also cause other symptoms like pain when peeing and itching or soreness around your vagina. You can have both thrush and BV at the same time so you might need to use treatment for both.

Chlamydia or gonorrhoea

BV has similar symptoms to chlamydia and gonorrhoea, as both can cause an unusual discharge. These sexually transmitted infections (STIs) sometimes do not cause any symptoms at all. If you have changed sexual partner or had unprotected sex, it is best to take an STI test. This can rule out chlamydia and gonorrhoea.

Trichomoniasis

Trichomoniasis is an STI which is caused by a parasite. Usually, you will get symptoms within 1 month of becoming infected. Like BV, 50% of people do not get any symptoms at all. In women, trichomoniasis can cause unusual vaginal discharge. This can change the colour and consistency, as well as the smell. Trichomoniasis and BV can both cause vaginal discharge that has a strong fishy smell.

Trichomoniasis can cause other symptoms such as itching, swelling, or soreness around your vagina. Some women find it painful to pee or have sex.

How to treat BV

BV only needs treatment if you have symptoms. The symptoms of BV can go away on their own, but you might need antibiotic treatment to help to clear it up. Asda Online Doctor has a few different BV treatments available. A doctor can help you choose the right treatment if you are not sure. You can treat BV with a tablet you take by mouth, or an internal vaginal gel or cream.

Metronidazole

Metronidazole is an antibiotic, which means it can get rid of the bacteria in your vagina causing BV. You can get metronidazole in tablet form, which is taken by mouth. This can be taken in 2 ways, both are effective treatments so for most people you can choose which one suits you. One option is to take one 400mg tablet, 2 times a day for 7 days. This is better for women who have frequent BV, and it is less likely to cause side effects. The other option is to take a single dose of five 400mg tablets at once. This might be a little less effective, and the high dose can make some women feel sick or have other side effects. The single dose is not suitable for women who are breastfeeding.

Metronidazole can also be found as a branded gel called Zidoval. This contains the same active ingredient and works in the same way, except the gel is inserted into your vagina. This means it can work at the site of your infection. Your medicine packet will contain applicators to insert the gel into your vagina correctly. You should use Zidoval gel at night. The usual dose is one 5mg applicator, for 5 days.

Dalacin cream

Dalacin cream contains the active ingredient clindamycin, which is also an antibiotic. Like Zidoval, this cream should be inserted directly into your vagina to kill the bacteria causing BV. The usual dose is 5g each night, for 7 days. It also contains single use applicators in the medicine packet so you can insert the cream correctly.

Treating BV at home

You can do some things at home to treat your symptoms, and also prevent BV from coming back.

When washing your vagina, only use plain soap and water and avoid baths. You should also avoid strong detergents when washing your underwear. Do not use a vaginal douche or deodorant. Quitting smoking can also help if you get BV often.

Will BV go away on its own?

BV can go away on its own but it is harder to get rid of without antibiotic treatment. This means your symptoms can last longer. It is best to get treatment for BV, as it could keep coming back. BV can make it easier for you to get an STI, as it changes the acidity in your vagina. There is also a small chance that BV can cause complications if you are pregnant. BV can be passed on to other women if you are in a same sex relationship.

dr-kathryn-basford.png
Medically reviewed by:
Dr Kathryn Basford

Dr Kathryn Basford is a qualified GP who works as a GP in London, as well as with ZAVA. She graduated from the University of Manchester and completed her GP training through Whipps Cross Hospital in London.

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Last reviewed: 23 May 2022


Bacterial vaginosis can be treated with antibiotics and gels. Asda Online Doctor by ZAVA offers both of these options for treating infections.



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