If You’re Itchy & Uncomfortable It Might Be Bacterial Vaginosis

If you've ever experienced bacterial vaginosis, otherwise referred to as BV, you'll know how uncomfortable it is. But you'll also know, it's very common and can be easily treated with an antibiotic.

Our collective understanding of BV isn't so clear though. While currently it's not classed as a STI by official health bodies, it is linked to sex and research from March this year argues that it fits the definition of being a STI. So in the months or years to come, we might see how we categorise BV change.

Prof Catriona Bradshaw, who led on this groundbreaking trial, said: "Our trial has shown that reinfection from partners is causing a lot of the BV recurrence women experience, and provides evidence that BV is in fact an STI. Part of the difficulty in establishing whether BV is sexually transmitted has been that we still don't know precisely which bacteria are the cause, but advances in genomic sequencing are helping us close in on that mystery."

For now, the best thing to do is understand how BV presents in the body, and what you can do about it.

BV is the most common vaginal infection among women and people with vaginas, according to Dr. Kate McLean, chief medical officer at Evvy. "It’s not caused by a single 'bad' bacteria, but rather by a disruption in the vaginal microbiome. This imbalance can lead to a variety of symptoms, but sometimes BV presents without any noticeable signs." McLean says that although BV is often treated like a "single diagnosis", it actually is a broad umbrella term covering a range of issues, which is why BV looks different person to person.

Common symptoms include a thin, greyish-white vaginal discharge, a strong "fishy" odor, vaginal itching or irritation, and a burning sensation in the vagina or sometimes during urination. However, up to 84% of people with BV may experience no symptoms at all, McLean adds.

BV can have broader health risks for women, including infertility, IVF failure, premature birth (if pregnant), and STI contraction. So if you think you have signs of it, or something just doesn't feel right down there, it's important to go to a doctor.

BV is usually treated with antibiotics. However, recurrence can be common. More than 50% of patients experience BV again within six months, McLean adds. This is why it's important to see your GP.

Sometimes, especially in those who are asymptomatic, it can go away on its own. Dr. Christine Curry, Clinical Director for Women’s Health at ŌURA, says how long this will take a "quite individualised". She says it's worth considering if it's even wise to wait it out if you are experiencing symptoms. "If the discharge, pain, itching or odor are making it hard to work, exercise or have sex, it may be worth talking to your doctor about a course of antibiotics. A lot of people don't realise that having BV means that the vagina is overall pretty inflamed. All of that inflammation makes getting or giving sexually transmitted infections (STI) more likely." There is a higher chance of getting an infection with chlamydia or gonorrhoea.

Sexual activity is a huge trigger for BV, including unprotected sex, sex with a new partner, or sex with multiple partners. "This is due to the bacteria in semen (and its higher pH) as well as the bacteria in/on the penis, vagina, or mouth of your partner," McLean says. But it isn't just sex. Smoking, douching, and hormonal changes also play a role in a person's susceptibility of getting it.

McLean says to avoid using scented products down there, avoid using period products for longer than advised, to wash sex toys and cover them with a condom during partnered sex, and use condoms and dental dams during sex.

"While both can cause discomfort, BV and yeast infections have different causes and require different treatments," McLean says. "BV is an overgrowth of bacteria and often causes a fishy-smelling discharge. Yeast infections are caused by an overgrowth of Candida fungi and typically result in thick, white discharge itching and irritation." Confusing the two is common, but treating one as the other can worsen symptoms.

That remains to be seen. One thing preventing this, according to Curry, is that people who aren't sexually active can still get BV. Although, sexual contact is highly linked with BV.