Bacterial Vaginosis


Bacterial Vaginosis (BV) is an infection that happens when there is an abnormal growth of the bacteria that live naturally in the vagina. This leads to an imbalance in the vagina’s delicate balance. BV is almost as common as yeast infections in women.


Bacterial vaginosis is caused by a combination of bacteria, including Gardnerella, Mycoplasma, and anaerobic bacteria. It is not considered a sexually transmitted infection, but it is more common in women who are sexually active with male partners. Sometimes BV is the result of fecal bacteria entering the vagina. This may happen if someone wipes back to front after urination (upwards direction), instead of front to back (downwards direction). It may also happen if there is anal play followed by vaginal play without proper precautions taken in between (e.g. touching a partner’s anus and then her vagina without washing hands or changing gloves in between).


Common symptoms of bacterial vaginosis include mild itching or burning in the genital area; increased grey, green, or yellow vaginal discharge; and/or an unpleasant ‘fishy’ odour (which is often worse just after intercourse).

A doctor can usually diagnose BV through a physical exam. The doctor may choose to send a sample (vaginal smear) to the lab to confirm the diagnosis.


Treatment is usually only recommended if a woman is bothered by her symptoms. If this is the case, it is best to first try a natural remedy, and if that doesn’t work, she can try prescription medication.

As a natural remedy, we usually recommend that a woman insert 1 or 2 capsules of lactobacillus acidophilus (the “good” bacteria that is found in yoghurt) into her vagina at bedtime for 5-7 days. These capsules are available at the Halifax Sexual Health Centre, in health food stores, and in some drug stores. Lactobacillus acidophilus is typically sold to be taken orally. They come in bottles of 50 or 100 and should be stored in the refrigerator. Do not pay more for special “vaginal” preparations.

If these treatments do not reduce the symptoms enough, a woman can see a doctor for a prescription. There are a number of choices available. Some treatments involve vaginal creams containing antibiotics such as inetronidazole (Nidagel) or clindamycin (Dalacin). These creams are inserted vaginally for 5-7 days and can clear up symptoms without the side effects of a medication taken orally.

Most often metronidazole (Flagyl) would be the oral antibiotic prescribed. This drug often clears symptoms quickly, but it is possible that they will return at some time. Flagyl should not be taken if a woman is pregnant or breastfeeding. It has several side effects, including nausea and vomiting (especially in combination with alcohol). You should avoid alcohol while taking this medication. Flagyl cannot be taken if you have taken either Seldane or Hismanal in the past month. There are also some concerns about the safety of long or repeated use of this drug, so it should be considered as a last resort.

Sometimes BV will simply improve on its own with no treatment.