Bacterial Vaginosis

Bacterial Vaginosis is a condition caused by an imbalance in the natural bacteria of the vagina. Normally, the vagina maintains a mildly acidic environment thanks to beneficial bacteria called Lactobacillus. When harmful bacteria overgrow and outnumber the good ones, the balance is disrupted — resulting in abnormal discharge, odour, and discomfort.

It's important to know that BV is not a sexually transmitted infection. Women who have never had sex can develop it too, because it's about the internal bacterial balance rather than catching something from someone else.

Every woman has vaginal discharge, and that's completely normal. The key is knowing when something has changed.

✅ Normal discharge — Clear or slightly milky white / no unpleasant odour / amount may vary with your menstrual cycle (more and clearer around ovulation) / no itching, burning, or irritation

❌ Abnormal discharge that may indicate BV — Greyish-white or dull in colour / fishy odour, especially after sex or during your period / thin and watery consistency / mild irritation possible

⚠️ Discharge that may indicate something else — Green or dark yellow + foul smell → could be Trichomonas infection / Thick white clumps like cottage cheese + intense itching → could be a yeast infection (Candida) / Blood-tinged discharge outside of your period → see a doctor for further investigation

The exact cause isn't 100% known, but several risk factors are well established.

🧼 Douching — One of the top risk factors. Douching destroys the good bacteria that maintain vaginal balance. The vagina is self-cleaning — internal washing is unnecessary.

🧴 Fragranced soaps and products — Scented soaps, feminine washes, and some intimate care products can disrupt the natural balance.

🔄 Multiple or new sexual partners — Having multiple partners or a new partner increases risk, as outside bacteria can disturb the existing balance.

🚬 Smoking — Research shows that women who smoke have a higher risk of developing BV.

💊 Antibiotics — Some antibiotics can kill beneficial vaginal bacteria along with the targeted infection, allowing harmful bacteria to take over.

BV itself isn't seriously dangerous, but leaving it untreated can lead to other problems.

😟 Risks of not treating BV — Increased susceptibility to other STIs, including HIV, due to the disrupted vaginal environment / higher risk of urinary tract infections (cystitis) / during pregnancy, BV may increase the risk of premature birth / increased risk of infection after gynaecological procedures

Even if symptoms seem mild, it's worth treating BV properly to prevent longer-term complications.

Metronidazole is the first-line antibiotic for BV treatment. It works by targeting and killing the anaerobic bacteria responsible for the condition, while largely sparing the beneficial bacteria.

At Intimo Life, we offer two Metronidazole options:

• Metronidazole — Quality generic medication at an affordable price
• Metrolex — A popular trusted brand

Typical dosage — Metronidazole 400 mg twice daily (morning and evening) for 7 days, or Metronidazole 2 g as a single dose, depending on the pharmacist's recommendation.

The most critical rule is: absolutely no alcohol while taking Metronidazole and for at least 48 hours after finishing the course. Combining the two causes a Disulfiram-like reaction — severe nausea, vomiting, headache, facial flushing, and rapid heartbeat.

Other important points — Take with or after food to reduce nausea / swallow whole with water / complete the full course even if symptoms improve — stopping early can lead to antibiotic resistance and recurrence.

Possible side effects — Nausea, metallic or bitter taste in the mouth, diarrhoea. These are usually mild.

BV is known for its high recurrence rate. Around 50% of women experience a recurrence within a year, especially within 3-6 months after treatment.

Ways to reduce recurrence — Avoid douching entirely / use mild, fragrance-free soap for the external area only / wear cotton underwear that breathes well / change underwear daily / avoid excessively tight trousers / use condoms during sex / if you're on a hormonal contraceptive pill, ask your pharmacist whether it may be contributing

If BV recurs more than 3 times per year, a doctor may recommend a different treatment approach or preventive medication.

Both are common causes of abnormal discharge, but they're caused by different organisms and require different treatments.

BV (Bacterial Vaginosis) — Caused by bacteria / greyish-white, thin, watery discharge / fishy odour / usually no itching / treated with Metronidazole antibiotic

Yeast Infection (Candidiasis) — Caused by Candida fungus / thick white clumpy discharge like cottage cheese / usually no strong odour / intense itching, burning, and redness / treated with antifungal medication

Getting the right diagnosis matters because the treatments are completely different. If you're unsure, consult a pharmacist before self-medicating.

Yes — and it's actually important to treat it. BV during pregnancy can increase the risk of premature birth and premature rupture of membranes.

Metronidazole can be used during pregnancy under medical supervision. The doctor will determine the appropriate dosage and duration. However, always inform your pharmacist if you are pregnant or planning to become pregnant.

While BV is straightforward to treat, see a doctor if you experience any of the following:

🚨 Abnormal discharge for the first time and unsure if it's BV / fever, lower abdominal pain, or pain during sex / blood-tinged discharge outside your period / symptoms don't improve after completing medication / recurrences more than 3 times per year / currently pregnant

These could indicate a different type of infection or a condition requiring further investigation.