Understanding Bacterial Vaginosis: A Common but Treatable Condition

What Is Bacterial Vaginosis?

Vaginal infections are a frequent occurrence for many women, with bacterial vaginosis (BV) being the most common cause of abnormal vaginal discharge in women of reproductive age. According to the World Health Organization, BV is the leading cause of vaginal discharge globally among women of reproductive age.

BV is a condition characterised by an imbalance in the natural bacterial flora of the vagina. A healthy vagina contains a variety of bacteria, predominantly lactobacilli, which maintain an acidic environment that inhibits the growth of harmful microorganisms. In BV, there is a reduction in protective lactobacilli and an overgrowth of other bacteria — particularly Gardnerella vaginalis and other anaerobic species.

This imbalance leads to a characteristic increase in vaginal discharge — often thin and grey or white, with a distinctive fishy odour, particularly noticeable after intercourse. While some women with BV may experience mild itching, it is typically far less intense than that associated with a yeast infection. Importantly, around half of all women with BV have no symptoms at all.

What Is a Yeast Infection (Thrush)?

A vaginal yeast infection — also known as thrush or vaginal candidiasis — is a fungal infection, most commonly caused by Candida albicans. This yeast is naturally present in the vagina in small amounts. Certain factors can disrupt the natural balance and trigger overgrowth, resulting in infection.

Symptoms of thrush typically include: intense itching and irritation of the vagina and vulva; a thick, white discharge with a texture sometimes described as cottage cheese-like; soreness; and redness. Thrush does not typically cause a fishy odour — this characteristic distinguishes BV from thrush.

BV vs Yeast Infection: Key Differences

What Causes BV?

The precise mechanism behind BV is not fully understood, but several factors are associated with disrupting the vaginal bacterial balance:

• Douching — washing inside the vagina disrupts protective lactobacilli
• Using perfumed soaps, scented washes, or vaginal deodorants in the vaginal area
• Having new or multiple sexual partners — alters the vaginal environment
• Smoking — associated with reduced vaginal lactobacilli
• Hormonal changes — including those related to the menstrual cycle or pregnancy

BV is not an STI — it can develop in women who are not sexually active. However, it does increase susceptibility to certain sexually transmitted infections if left untreated.

Can You Have Both BV and Thrush at the Same Time?

Yes — it is possible to have both a yeast infection and bacterial vaginosis simultaneously. This dual infection can present with overlapping symptoms, making accurate diagnosis particularly important. If you suspect you may have both conditions, a clinical assessment is recommended to ensure you receive the right treatment for each.

Treatment for Bacterial Vaginosis

The primary treatment for BV is antibiotic medication, which helps restore the healthy bacterial balance in the vagina. The most commonly prescribed antibiotics in the UK are:

• Metronidazole (oral tablets or Zidoval vaginal gel) — NICE first-line treatment. Avoid alcohol during treatment and for 48 hours after. See: Metronidazole side effects guide.
• Dalacin Cream 2% (clindamycin vaginal cream) — applied vaginally for 7 nights. Suitable for women who cannot tolerate metronidazole.

While some mild cases of BV may resolve without treatment, it is generally recommended to seek treatment to relieve symptoms, reduce the risk of complications, and prevent recurrence — particularly during pregnancy.

Accessing Help and Treatment with Access Doctor

If you think you have BV, Access Doctor offers a convenient and discreet way to access help, diagnosis, and prescription medication — without needing a GP appointment or facing a lengthy wait.

1. 1

   Request your treatment

   Visit the Access Doctor website, select your BV treatment, and provide your medical details.

2. 2

   Prescriber review

   A GPhC-registered pharmacist independent prescriber reviews your information to ensure the treatment is appropriate for you.

3. 3

   Receive your medication

   Once approved, your medication is picked, packed, and delivered discreetly to your door — often with next-day delivery available.

Access Doctor provides a streamlined, confidential service — allowing you to manage your health efficiently without the barriers of traditional GP appointments. Do not delay seeking help: many conditions worsen without timely treatment.