Women's Health Clinic

Bacterial vaginosis (BV) is the most common vaginal infection affecting women aged 15 to 44 and many women may suffer from recurrent episodes of infection during their lifetime.

While BV is found in sexually active individuals, it is not considered a sexually transmitted disease. The vagina contains normal flora and when the balance between ‘good’ and ‘harmful’ bacteria is disrupted, bacterial vaginosis may occur. Normal Lactobacillus (‘good’ bacteria) are replaced with a variety of ‘harmful’ bacteria – e.g. Gardnerella vaginalis, Ureaplasma and Mycoplasma.

In some women, this imbalance may persist for longer periods of time, leading to recurrence or persistence of symptoms.

None of the abovementioned symptoms is specific to BV and a high vaginal swab test is usually required to confirm the diagnosis. This swab may be done in conjunction with looking for other common vaginal infections like yeast infections, or co-existent sexually transmitted infections.

The exact reason or mechanism resulting in bacterial vaginosis is not known, however, several risk factors have been identified and avoiding these may potentially reduce the risk of infection or recurrence.

Some factors that may trigger or increase the risk of BV include:

• Having multiple sexual partners
• Exposure to a new sexual partner
• The use of over the counter feminine douches
• Lack of condom usage during intercourse

Treatment of Bacterial Vaginosis is in the form of a course of oral antibiotics or topical creams.

During treatment, one should abstain from intercourse as this may affect treatment success. The usage of feminine douches is also discouraged as it may increase the recurrence of Bacterial Vaginosis. Alcohol should also be avoided as it may interact with certain medications commonly prescribed for the treatment of BV.

Treatment is recommended for individuals with symptoms but asymptomatic individuals should seek treatment too, as BV increases the risk of one contracting other sexually transmitted infections including HIV and can also lead to issues during pregnancy including premature birth.

There is no research evidence to show that treatment of a woman’s male sexual partner will reduce the recurrence of BV.

Certain sexually transmitted infections e.g. chlamydia and gonorrhoea, if left untreated, may spread upwards to affect the uterus (womb), fallopian tubes and ovaries, resulting in a condition called pelvic inflammatory disease, which may, in turn, lead to scarring and potential infertility.

Some common recurrent vaginal infections include yeast (candida) infections and bacterial vaginosis. Sexually Transmitted Infections (STIs) may also recur if not fully treated.

The identification of triggers such as sexual intercourse and the use of over-the-counter feminine douches may be useful in reducing yeast infections and bacterial vaginosis.

For sexually transmitted infections, the correct use of condoms/barrier protection, as well as limiting the number of sexual partners reduces the risk of transmission and recurrent infections.