BV

Bacterial vaginosis (BV)

Real talk:

Bacterial vaginosis can happen when there’s an imbalance in the vagina’s normal bacteria. It can have a few different triggers and can be passed sexually between vaginas.

What is bacterial vaginosis?

Bacterial vaginosis (BV) is a common condition caused by an imbalance of the normal bacterial flora in the vagina. When this balance is disrupted, unfriendly bacteria can overgrow, leading to BV symptoms.

Various types of bacteria can cause BV, and multiple can be present at the same time. Although you can get BV without having sex, it can also be sexually transmitted through sexual fluids.

If contracted during pregnancy, BV can increase the chance of miscarriage or pre-term birth.

Having BV may also increase the likelihood of getting HIV or other STIs during vaginal sex.

How do you get bacterial vaginosis?

BV can happen spontaneously – no sex required! But it can also be passed sexually when fluids are exchanged between vaginas, which is why BV is more common among queer communities.

While penises cannot get BV, they can pass BV bacteria to a sexual partner (for example, during penis-in-vagina sex).

What are the symptoms of bacterial vaginosis?

BV doesn’t always have symptoms, but it’s common to present with a clear or grey watery vaginal discharge with a strong fishy smell.

It can sometimes cause vaginal itching or irritation, or a burning sensation when you pee.

How is bacterial vaginosis prevented?

BV is one of those things that can happen no matter what measures are taken. However, anything that disrupts the balance of bacteria in the vagina can cause BV.

To prevent BV:

• avoid douching or using vaginal washes – it’s important to note that the vagina is self-cleaning! Vaginal hygiene products tend to cause more harm than good. A doctor can determine the correct treatment for any symptoms.
• clean sex toys properly and change tampons regularly. Anything that disrupts the usual balance of vaginal bacteria can trigger BV. Follow the cleaning and usage directions for toys or menstrual products, and be mindful of any potential irritants (such as scents or certain lube ingredients).
• use protective barriers and measures during sex. Semen in the vagina may be a trigger for BV, so using condoms for penis-in-vagina sex may help reduce the chances of developing it. Using dams and gloves, and using a different condom when sharing toys will reduce the chance of passing BV back and forth.

Things that may increase the risk of getting BV include:

• pregnancy
• having sex without condoms, dams or other barriers
• having an intrauterine device (IUD)
• having multiple sexual partners
• having a new sex partner
• using douches
• taking antibiotics.

How do you test for bacterial vaginosis?

A routine STI screening doesn’t include a BV test. A self-collected vaginal swab can be done if symptoms are present.

How do you get treated for bacterial vaginosis?

BV is treated with antibiotics – either oral or vaginal, which you can get from a healthcare professional.

Generally, BV will go away after treatment, but it’s not uncommon for symptoms to come back. If symptoms keep returning, healthcare providers can recommend longer term treatment and prevention strategies.

It’s easy to mistake BV for vaginal thrush, but an over-the-counter thrush treatment won’t work on BV.

Check out our article on thrush for more info but always check with a doctor if you’re unsure.

When to see a healthcare professional

A healthcare professional can recommend the tests that are right for your body and your sexual practices. They can provide treatment straight away if you need it, check for any complications, and talk with you about re-testing or letting partners know. Regular checks are a simple way to look after yourself, your partners and your community.

See a healthcare provider if:

• you notice any unusual changes or symptoms listed above
• a partner has told you they have an STI
• you have had sex without a barrier (condoms, dams or gloves)
• you are starting a new sexual relationship
• it has been a while since your last sexual health check

Many STIs don’t cause symptoms, which is why routine testing is one of the best ways to stay on top of your sexual health.

Check out our STI testing guide for more on what happens during a sexual health check.