Bacterial Vaginosis (BV)

Bacterial vaginosis is a vaginal infection caused by an imbalance in the natural bacteria of the vagina. It’s not a sexually transmitted infection, but sexual activity can increase the risk of developing it.

You may be more likely to develop BV if you:

• Use vaginal douches or scented soaps
• Have a new sexual partner
• Use a IUD (intrauterine device) for contraception
• Are a smoker
• Have a history of BV

We offer several effective treatment options from tablets to gel and cream in order to relieve symptoms and also restore vaginal health. We advise first line treatment in the form of metronidazole tablets, before then considering any topical treatment. However, if you would prefer a treatment applied directly intravaginally due to inability to take oral medication, this can be considered.

Before you can access BV treatment, confirmation is required. You’ll need to have either:

• Previously been diagnosed with BV by a GP or sexual health clinic,

• Experienced BV before and recognise your symptoms, or

• Used a BV home testing kit that confirms the infection*.

If you haven’t confirmed that BV is the cause of your symptoms, you’ll need to complete a test or see a healthcare professional before treatment can be supplied.

*We offer the sale of Vaginal Infection Testing Kits on our website.

Treatment for bacterial vaginosis can depend upon personal preference, prior medical conditions, or allergies. If you’re uncertain about which treatment you should be using, we would advise metronidazole tablets as a first line treatment before considering gel or cream if the tablets prove ineffective.

No. You must not drink alcohol while taking or using metronidazole in any form (tablets or gel). Combining alcohol with metronidazole can cause unpleasant side effects such as nausea, vomiting, flushing, or headaches. Avoid alcohol during treatment and for at least 48 hours after finishing metronidazole.

No. Metronidazole gel and clindamycin cream should not be used during menstruation, as bleeding can make the treatment less effective. It’s best to start or continue treatment after your period ends.

You should avoid sexual intercourse during treatment with both vaginal gel and cream. These medications may not work effectively if disturbed or washed away, and they may reduce the effectiveness of condoms or diaphragms, therefore increasing risk of unplanned pregnancy. Sex may also increase the risk of passing infection or irritation to your partner.

If your symptoms don’t clear up after a completed course of treatment, or if they return within a few weeks, you should:

• Try another home test to confirm if it is BV again
• Contact your GP or local sexual health clinic for further testing and advice. Especially if you have other symptoms such as pain, itching, or unusual discharge
• Avoid self-treating repeatedly without medical guidance, as persistent BV may need further investigation or intervention.

Bacterial vaginosis – NHS

Bacterial vaginosis | NHS inform

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