Bacterial vaginosis, often called BV, is one of the most common causes of unusual vaginal discharge and odour in adults. It happens when the usual balance of vaginal bacteria changes, allowing certain species to overgrow and the protective lactobacilli to fall. BV is not an STI, but it can be more common if you are sexually active or if the vaginal environment is disrupted. The good news is that BV is usually straightforward to treat with a short antibiotic course and most people improve within a few days.
BV symptoms to watch for
- Thin, grey or white vaginal discharge
- Noticeable fishy odour, often stronger after sex
- Minimal or no itch/soreness; burning when passing urine is uncommon with BV
Red flags: pelvic pain, fever, bleeding after sex, sores, or significant itch may suggest another cause (e.g. thrush or an STI). Arrange a clinical assessment instead of self‑treating if these occur.
What causes bacterial vaginosis?
BV is caused by a change in the balance of bacteria that naturally live in the vagina. Lactobacilli (which produce lactic acid and help maintain a healthy acidic pH) drop, and other bacteria increase. Triggers include:
- New sexual partner or multiple partners; sex without condoms
- Vaginal douching or deodorants; perfumed washes used internally
- Intrauterine devices (IUDs) in some people
- Recent antibiotic courses that alter normal flora
- Smoking and periods of low oestrogen (e.g. postpartum)
Many people develop BV without any obvious trigger. Recurrence is common, so prevention tips matter once symptoms settle.
Testing for BV in Ireland
BV can often be diagnosed based on history and examination alone. If symptoms keep coming back, are atypical, or you are pregnant, your clinician may perform a swab test. People with pelvic pain, fever, bleeding, or suspected PID should arrange urgent assessment.
BV treatment options in Ireland
The first‑line treatment is an antibiotic. The most used options are:
- Metronidazole tablets (typically 5–7 days). Avoid alcohol during treatment and for 48 hours after the last dose.
- Metronidazole 0.75% vaginal gel (usually once daily for 5 days) if you prefer a local option.
- Clindamycin cream if metronidazole is unsuitable.
Symptoms often improve within 2–3 days, but complete the full course. If symptoms persist or return within a few weeks, arrange review: a longer course, a switch of preparation, or a maintenance plan may be recommended.
How to get BV treatment online in Ireland
Step 1: choose an online doctor and complete a short medical questionnaire. You can use Zava for same‑day assessment.
Step 2: if BV treatment is appropriate, the doctor issues a prescription and sends it to your chosen pharmacy via Healthmail. If you choose Healthwave, your doctor can address it to healthwave.dundrum@healthmail.ie.
Step 3: the pharmacy confirms availability and explains how to use the medicine. If you choose Healthwave, we pack discreetly and deliver typically within 1–2 working days, or arrange convenient collection.
Prefer to speak directly with a doctor?
Book a video consultation with a registered doctor via Eirdoc.
Prefer to see a doctor in person?
BV in pregnancy: when to seek help
If you are pregnant and have symptoms of BV, speak with your GP or midwife for assessment and safe treatment choices. Seek urgent care if you have pelvic pain, fever, bleeding or severe symptoms, or if you feel unwell.
Self‑care and prevention tips
- Use condoms with new or multiple partners to reduce recurrence.
- Avoid vaginal douching and internal use of perfumed products.
- Wash externally only with non‑perfumed products; do not wash inside the vagina.
- Do not repeat old antibiotics without advice—recurrence may need a different plan.
- If BV recurs frequently, ask about maintenance regimens with metronidazole gel.
Is BV an STI?
No, BV is not a sexually transmitted infection. However, sexual activity can influence the vaginal microbiome and BV is more common with a new partner or multiple partners. If you are at risk of STIs, or your symptoms don’t match classic BV, consider STI testing alongside BV treatment.
What about sexual partners?
BV is not usually passed to male partners and they do not need treatment. Female partners can also develop BV; if your partner has symptoms they should be assessed. Using condoms and avoiding douching can help reduce recurrence.
Can BV go away without antibiotics?
Mild symptoms may sometimes settle, but recurrence is common and untreated BV can raise risks in pregnancy and around gynaecology procedures. Antibiotics are recommended for symptomatic cases, during pregnancy, and before certain procedures.
What if BV keeps coming back?
Recurrent BV is common. A longer course or a different preparation can be used. Some care plans use metronidazole gel on a schedule to reduce flare‑ups. Arrange review if you have repeated episodes so a tailored plan can be made.
Supports available in Ireland
FAQs
What is BV?
BV is a change in the normal balance of vaginal bacteria that causes discharge and odour. It is common, not dangerous in most cases, and usually easy to treat.
What does BV discharge look and smell like?
Typically thin, grey or white discharge with a fishy odour that may be stronger after sex. Marked itch/soreness suggests another cause,arrange assessment.
Which antibiotic treats BV fastest?
Metronidazole is most used in Ireland (tablets or gel). Most people notice improvement within 2–3 days; complete the full course.
Can I drink alcohol on metronidazole?
No, avoid alcohol during treatment and for 48 hours after the last dose to prevent unpleasant reactions.
Does my partner need treatment?
Male partners do not usually need treatment. Female partners with symptoms should be assessed.
How can I prevent BV coming back?
Use condoms with new or multiple partners, avoid douching and perfumed products inside the vagina, and complete antibiotic courses. If BV recurs, ask about maintenance plans.
