Your Complete Guide to Bacterial Vaginosis

Noticed a slightly different odour, or a change to your usual discharge lately? It could be bacterial vaginosis (BV), a common infection that many women experience. The good news is that bacterial vaginosis is very easily treated, so there is no need to panic.

Read on to learn how to identify, prevent, and care for yourself when you have bacterial vaginosis here. 

What is Bacterial Vaginosis?

BV occurs when the pH balance of the vagina becomes imbalanced, and the normally acidic conditions are disrupted. Usually, this acidic environment means that the ‘good bacteria’ (called lactobacillus) is able to thrive and the ‘bad bacteria’ is prevented from growing.

Sometimes, however, the bad bacteria can outnumber the good. When this happens, you might notice some common symptoms, including vaginal irritation, a slightly ‘fishy’ odour and a greyish watery discharge.

Treatment for BV is easily accessible from your GP or sexual health clinic, or via a pharmacy.

You should also know that BV is not a sexually transmitted infection, but it could increase your risk of getting one (NHS). So, if you think you might have it, it’s a good idea to treat it straight away. 

And, while we’re at it, let’s get another thing straight: BV is very common, especially among women of reproductive age (generally around 15-45). It’s also nothing to be ashamed of; you’re not abnormal and you haven’t done anything wrong, so let’s talk about it.

woman in underwear holding stomach

Bacterial Vaginosis vs Yeast Infection

Many women experiencing BV symptoms tend to mistake them for symptoms of a yeast infection, but the two are actually very different and require different treatment.

Yeast infections can also occur when bacterial conditions of the vagina are imbalanced, and are caused by the overgrowth of a normally harmless fungus called candida. Like bacterial infections, yeast infections are not sexually transmitted.

Women who experience a yeast infection commonly suffer with vaginal itching or soreness, which doesn’t usually occur if you have BV. Vaginal discharge is also quite different in a yeast infection too — thicker in consistency and odourless. Plus, many women also report pain when passing urine. 

And, just to add more potential confusion to the mix, the symptoms of a urinary tract infection (UTI) are also quite similar too. We recommend seeing your healthcare provider as soon as possible to clear up any confusion and suggest the right treatment for you. You should always seek separate bacterial vaginosis treatment if you have BV.

Causes of Bacterial Vaginosis 

So, what causes the bacteria in your vagina to become imbalanced, leading to BV?

pH Imbalance 

According to the NHS, doctors don’t actually know for sure why the bacteria in your vagina can sometimes become imbalanced, but there are some certain factors that are considered to be potential causes, which we will cover in this article.

Multiple Sex Partners 

If you are sexually active, you are more likely to experience BV. It is important to note that women who haven’t had sex can also get it. A change in sex partner or multiple sex partners can have an effect too.

As previously mentioned, BV is not a sexually transmitted infection, but it can be triggered by sex and a woman can pass it to another woman during sex.

It is also worth noting that when you have BV, your vagina is less acidic than usual, so your natural defences against infection are reduced, which is why your risk of contracting a sexually transmitted disease is higher.


Using perfumed products in or around your vagina can upset its delicate pH balance, which can lead to BV. Experts agree that douching inside the vagina should be avoided.


Many women find that their choice of underwear makes a huge difference. Some fabrics like silk trap heat and moisture, creating a perfect breeding ground for infections  simply because bacteria thrives in moist environments.

underwear hanging on washing line

Symptoms of Bacterial Vaginosis

It is no secret that the bacterial vaginosis symptoms are not pleasant and, while some women don’t experience any symptoms at all, others find that theirs worsen after sex. Things to look out for are:


This will be different to your usual discharge, so if you are familiar with what it usually looks like, you should spot this straight away. Milli Hill, journalist and author of the bestselling book My Period, says:

Charting your cycle can be useful in order to give you an overall sense of what is normal for you and your body. Normal vaginal fluids change throughout the month and can be an indicator of where you are in your cycle – for example, around the time of ovulation your fluids will be a similar texture to raw egg white. However, the discharge that says something isnt right, for example if you have BV, is very different, usually it will be a greyish colour, thin and watery, and often with an unpleasant, fishy odour.’


Every single vagina has a slight odour, which is completely normal. However, with BV, some women experience a stronger and more unpleasant odour, which is often described as ‘fishy’.

Treating Bacterial Vaginosis

BV rarely causes issues for most women, and can sometimes go away on its own. That said, if it does persist for more than 7 days, it is a good idea to start treatment.

Luckily, BV can be easily treated at home with an over-the-counter treatment that works quickly to relieve the symptoms. These treatments are usually very effective for most women.

woman holding glass of water and two pills

How Long Does Bacterial Vaginosis Last?

Without treatment, some women find that BV goes away after a few days, but it can return.  

For most women, BV can clear up quickly with over-the-counter treatments, and usually 1 course is enough. Most treatments come in the form of gels and are recommend to be used for 7 days. This should be long enough to restore the pH balance of your vagina, but be aware that BV can also return even after treatment too. 

Consult Your Doctor

If you have never had BV before or if you are pregnant, it is always recommended that you see a doctor or visit a sexual health clinic for advice. You might be prescribed antibiotics to treat the infection.

It is also a good idea to make an appointment if you have used an over-the-counter treatment without success too. Listen to your body; if in doubt, call the GP.

If left untreated, BV can increase your risk of contracting a sexually transmitted infection and, in some cases, it can also lead to Pelvic Inflammatory Disease (PID), a common cause of pelvic pain. 

Dr. Ghazala Aziz-Scott, specialist in integrative women's health and bioidentical hormone balancing at Marion Gluck Clinic, explains further:

‘If left untreated, then women have an increased risk of contracting a sexually transmitted infection or STI such as chlamydia or gonorrhoea. These infections can also cause pelvic inflammatory disease higher up the reproductive tract which can cause scarring of the fallopian tubes and lead to infertility.'

Dr. Aziz-Scott also advises that ‘complications for pregnant women include babies born of lower birth weight and premature deliveries, so treatment in these circumstances is very important.’

woman sat in window holding stomach

How To Prevent Vaginal Infections

It is vital to maintain good vaginal health and there are many things you can put in place to prevent infections. Your vagina is precious, so treat it that way! 

Balancing Your pH Levels

You can take steps to maintain the balance of pH levels in your vagina to prevent BV from recurring. 

Never use perfumed shower gels, soaps or deodorants. In fact, if it is heavily perfumed, keep it away! The same goes for the detergent you use for your underwear too. Use non-bio, un-perfumed to help avoid irritations. Opting for showers over baths is recommended too.

During your period, take care to change your tampon, towel or period pants regularly, but don’t be tempted to wash your vagina more than usual. It’s really not necessary and can disrupt the pH balance further.

Moisture Wicking Underwear

We cannot stress enough how important it is to always go for moisture wicking underwear whether you are experiencing BV, actively trying to prevent it, or just keen to maintain good vaginal health. 

During your period you can be more susceptible to tipping the pH balance due to the extra moisture that occurs during bleeding. We recommend ditching the sanitary pads and opting for reusable period pants instead.

Our popular WUKA Basics™ Hipster brief is a great option for heavy flow days, while our WUKA Basics™ Thong is better for lighter days. They are both breathable and moisture wicking. And, if you’re active, don’t forget we also have our activewear Perform Collection, perfect for keeping you fresh and irritation-free while you’re working out.

About The Marion Gluck Clinic:

The Marion Gluck Clinic is the UK’s leading medical clinic that pioneered the use of bioidentical hormones to treat menopause, perimenopause and other hormone related issues. Headed up by Dr. Marion Gluck herself, the clinic uses her method of bioidentical hormonal treatment to rebalance hormones to improve wellbeing, quality of life and to slow down ageing:

About Milli Hill:

Milli Hill is a writer and freelance journalist with a passion for women’s rights in childbirth and throughout their reproductive lives. Her book The Positive Birth Book is one of the UK’s bestselling pregnancy guides, and has sold nearly 100k copies since publication in 2017. Her more recent books, Give Birth like a Feminist, and My Period (for preteens), have also topped the Amazon charts:

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