Bacterial Vaginosis (BV) & Vaginal Health Explained
Understanding BV, Why Vaginal Health Matters, and When to Seek Further Advice
Vaginal health is an important part of overall wellbeing, yet it's something many people feel embarrassed to talk about.
If you've experienced bacterial vaginosis (BV), recurrent infections, unusual discharge or persistent vaginal symptoms, you may be wondering whether they're connected to your fertility or if they're simply something you have to live with.
In many cases, BV can be treated successfully. However, if symptoms keep returning or don't improve with treatment, it's important to speak to your healthcare professional for further assessment.
This guide explains what BV is, how to support good vaginal health, and when ongoing symptoms deserve a closer look.
What is Bacterial Vaginosis?
Bacterial vaginosis (BV) is one of the most common causes of unusual vaginal discharge.
It occurs when the natural balance of bacteria in the vagina changes. Instead of the usual protective bacteria being dominant, other bacteria multiply, leading to an imbalance.
BV is not classified as a sexually transmitted infection (STI), although sexual activity may influence the balance of vaginal bacteria in some people.
What Are the Symptoms?
Some people have no symptoms at all.
Others may notice:
thin grey or white vaginal discharge
a strong fishy smell, particularly after sex
an increase in vaginal discharge
mild irritation
Unlike thrush, BV does not usually cause significant itching or soreness.
What Causes BV?
The exact cause isn't always clear, but factors that may increase the chance of developing BV include:
changes in the natural vaginal bacteria
douching or using vaginal washes
a new sexual partner
multiple sexual partners
smoking
hormonal changes
Sometimes BV develops without any obvious reason.
Why Does Vaginal Health Matter?
A healthy vagina naturally contains bacteria—especially Lactobacillus species—that help maintain an acidic environment.
This acidity helps protect against harmful bacteria.
When that balance is disrupted, infections such as BV become more likely.
Supporting vaginal health isn't about being "cleaner." In fact, the vagina is self-cleaning, and using scented products or internal cleansing (douching) can upset its natural balance.
Can BV Affect Fertility?
Most people with BV will not experience fertility problems because of BV alone.
However, research has suggested that BV may be associated with certain reproductive health complications in some circumstances, and untreated pelvic infections can, in some cases, contribute to damage of the Fallopian tubes.
Scientists are still studying the relationship between the vaginal microbiome, fertility, pregnancy outcomes and assisted reproduction.
If you're experiencing persistent or recurrent BV, especially alongside pelvic pain, infertility or other ongoing symptoms, it's important to discuss this with your healthcare professional so that other possible causes can also be considered.
What If BV Keeps Coming Back?
Some people experience recurrent BV despite repeated treatment.
If this happens, it's worth returning to your GP or sexual health clinic rather than repeatedly self-treating.
Your clinician may wish to:
confirm the diagnosis
exclude other infections
discuss different treatment approaches
review whether any further investigations are appropriate based on your symptoms and medical history
Persistent symptoms should always be assessed rather than simply accepted as "normal."
Looking After Your Vaginal Health
Simple steps that may help maintain a healthy vaginal environment include:
avoid douching
avoid scented soaps, washes and deodorants in the genital area
wash the vulval area gently with water or an unperfumed cleanser if advised
wear breathable cotton underwear if comfortable for you
change out of wet swimwear promptly
complete any prescribed treatment as directed
attend follow-up appointments if symptoms persist
Not every suggestion works for everyone, so discuss ongoing concerns with your healthcare professional.
When Should I Seek Medical Advice?
Arrange an appointment if you have:
recurrent BV
persistent unusual discharge
an unpleasant odour that keeps returning
pelvic pain
bleeding between periods or after sex
difficulty becoming pregnant
symptoms that don't improve after treatment
any new or unexplained vaginal symptoms
These symptoms don't necessarily indicate a serious condition, but they do deserve proper assessment.
Questions You May Wish to Ask Your Doctor
Has my diagnosis been confirmed?
Why might my BV keep coming back?
Could another condition be causing my symptoms?
Should I have any further investigations?
Could my symptoms be related to pelvic inflammatory disease or another infection?
If I'm trying to conceive, is there anything else I should consider?
When should I come back if my symptoms return?
Key Points
✔ BV is caused by an imbalance in the natural bacteria found in the vagina.
✔ It is common and usually treatable.
✔ The vagina is self-cleaning, and douching or scented products may do more harm than good.
✔ Most people with BV will not experience fertility problems because of BV alone.
✔ Recurrent or persistent symptoms should always be discussed with a healthcare professional to make sure nothing else is being missed.
Related Guides
Fertility Investigations Explained
Endometriosis Explained
Hydrosalpinx Explained
Ultrasound Explained
HSG Explained
Questions to Ask Your Doctor
Waiting for Results
A Personal Note
For many years, I experienced recurrent bacterial vaginosis. Looking back, I often wonder whether those persistent symptoms should have prompted a more detailed investigation into my reproductive health.
Every person's story is different, and recurrent BV does not mean you have endometriosis, hydrosalpinx or another fertility condition. However, if something doesn't feel right, or your symptoms keep returning despite treatment, it's reasonable to ask questions and discuss them with your healthcare professional.
My hope is that this guide encourages you to trust your instincts, seek appropriate medical advice, and remember that persistent symptoms deserve to be listened to.