You’ve noticed something feels… off. Maybe there’s a smell you don’t recognise. A discharge that looks unusual or uncommon. A subtle itch that appears out of nowhere for a few seconds and disappears before you know it. You Google it, only to end up spiralling into a rabbit hole of confusion.

Here’s the thing, vaginal symptoms are incredibly common, and most of the time, they’re your body signalling that you’re experiencing something different internally. It doesn’t mean you’ve done something wrong. Your vagina has its own ecosystem that works by itself, and is trying to tell you something.

Once you understand what’s normal, what’s not, and what the often-overlooked signs are, you'll gain a deeper understanding of how to care for your intimate health.

What is Bacterial Vaginosis? (BV)

Bacterial vaginosis, commonly known as BV, is one of the most common causes for vaginal discomfort amongst women aged between 15-44, and yet it’s wildly under-discussed.

So, what is Bacterial Vaginosis really about? It happens when the natural balance of vaginal bacteria is disrupted. When the protective Lactobacillus bacteria decrease, they can no longer stop other microbes, like Gardnerella vaginalis, from overgrowing. This imbalance often results in symptoms like unusual discharge, vaginal odour, irritation, and discomfort that affects quality of life (Chow et al., 2023).

Here’s what makes BV tricky: it’s often mistaken for other conditions, brushed off as something “normal”, some may even blame themselves for being “lacking in hygiene”, or even goes unnoticed. Especially when the symptoms are mild.

What Does a Healthy Vaginal Environment Look Like?

Before we dive into the “what went wrong” talk, let’s have a look at “what goes right”.

A healthy vagina naturally maintains an acidic pH, usually between 3.8 and 4.5, and is home to a community of beneficial bacteria, primarily Lactobacillus (Ravel et al., 2010). These bacteria help maintain a balanced vaginal microbiome by producing lactic acid and other protective compounds that keep harmful organisms from overgrowing.

When this balance is maintained, a vaginal discharge is typically clear to white, odourless or mildly scented. It varies in texture throughout your menstrual cycle. That’s all completely normal. Problems may arise when vaginal pH becomes imbalanced.

BV vs Yeast Infection: What’s The Difference?

	Bacterial Vaginosis	Yeast Infection
Caused by	Vaginal bacteria imbalance (Gardnerella vaginalis overgrowth) (Khedkar et al., 2022)	Fungal overgrowth (Candida albicans) (Sobel, 2007)
Discharges	Thin, grey/off-white, watery (Farr et al., 2023)	Thick, white, cottage cheese-like (Sobel, 2007)
Odour	Fishy vaginal smell, especially after sex (Khedkar et al., 2022)	Little to no odour (Sobel, 2007)
Itching	Mild or absent (Farr et al., 2023)	Often intense (Sobel, 2007)
Vaginal pH	Elevated above 4.5 (Farr et al., 2023)	Usually normal (Sobel, 2007)

 

Here Are The Common BV Symptoms That Many Look Past

Not everyone with BV experiences symptoms, but when you do, here are the signs to look out for:

Fishy vaginal smell

This is the most commonly reported symptom, and often distressing. The shift in vaginal odour tends to be more noticeable after intimacy or during menstruation. This is caused by the chemical byproducts of bacterial overgrowth during BV (Khedkar et al., 2022).

Abnormal vaginal discharge

BV-related discharges are typically thin and watery. Often greyish or off-white in colour. It’s noticeably different from the discharge associated with a yeast infection, which tends to be thick and cottage cheese-like in texture (Nyirjesy, 2008).

Vaginal discomfort or a burning sensation

Some women with BV experience mild itching, irritation, or a burning feeling in and around the vaginal area. This discomfort may extend to burning sensations during urination. This is a symptom that’s easily mistaken for a urinary tract infection (UTI) (Khedkar et al., 2022; Farr et al., 2023). If you’re experiencing recurring burning during urination without confirmed UTI, it may be worth considering BV as a possible cause.

No symptoms at all

One of the often missed signs amongst the others. Many women experience BV at first without realising they have it. Studies estimate that a significant proportion of women with BV report no symptoms at all (Khedkar et al., 2022). This is why awareness matters, because untreated BV may affect vaginal health over a period of time, and recurring cases are more common than most people think.

Common Risk Factors of BV

BV can affect any woman, regardless of their sexual activity. But certain factors are known to increase the likelihood of vaginal bacteria imbalance.

One common factor is vaginal douching, where directly washing inside the vagina causes disruption to the natural bacterial environment and is strongly associated with higher rates of BV (Wireko et al., 2024).

New or multiple sexual partners is one of the more consistently documented risk factors (Khedkar et al., 2022), where sexual activity may introduce different bacteria into the vaginal environment, further disrupting the existing microbial imbalance (Muzny et al., 2019). It doesn’t outright prove that sexual activity causes BV, however it does help explain why shifts in the vaginal microbiome are more common after changes in sexual partners.

Changes in hormones, especially oestrogen plays a key role in maintaining vaginal pH balance as it supports the growth of Lactobacillus bacteria. When oestrogen levels fluctuate (i.e during menstruation, pregnancy, hormonal contraceptives) the vaginal environment may also change in ways that makes it vulnerable to bacterial imbalance (Hong, L. et al., 2025). This is why some women notice BV symptoms appearing around their period, or after/stopping hormonal birth control.

Antibiotics are designed to eliminate harmful bacterias, but they can also deplete the protective Lactobacillus bacteria that keeps the vaginal microbiome in balance, leaving the vaginal environment vulnerable to overgrowth by other bacterial strains (Khedkar et al., 2022). This is why women sometimes develop BV after taking antibiotics for an unrelated infection, causing a downstream effect.

How Do You Keep BV Away?

While BV requires treatment, there’s a lot you can do to support a healthy vaginal environment day-to-day. Here are some practical BV prevention tips:

Avoid Frequent or Routine Internal Douching

The vagina cleans itself. Washing internally, especially with scented products causes more harm than good and has been linked to heightened risk of BV (Martino & Vermund, 2002; Wireko et al., 2024). Gentle external cleansing with water or mild pH-appropriate wash is all you need.

That said, short-term or occasional douching may help in specific situations such as supporting recovery or therapeutic irrigation, helping to remove excessive vaginal discharge during BV-related discomfort, rinsing away blood residues after menstruation, or clearing excess semen after intercourse. It’s better to douche occasionally rather than as a habitual practice. Prolonged routine of douching may cause women to have lesser chances to get pregnant as compared to those who do not (Baird et al., 1996)

Wear Breathable Undergarments

Cotton or moisture-wicking fabrics may help reduce warm, humid environments that create an environment for bacterial or fungal overgrowth (Mylonas, I. 2025). Sweaty gym clothes create conditions that disrupt vaginal pH. Opt for more functional and breathable options, or better just change out of it as soon as possible after workout.

After Intimacy Care

Rinsing the external genital area (not internally) after sexual intercourse and urinating after sex can help maintain vaginal pH balance and reduce the introduction of new bacteria.

You’re Not Alone and It’s Not Your Fault

Vaginal discomfort and BV symptoms are pretty common, but they’re often silenced due to self-blaming and misconception that they signal “poor hygiene”. But they don’t.

Millions are affected by BV worldwide. It’s a condition of microbial imbalance, not a reflection of how well you take care of yourself. The more we spread awareness and normalise conversations surrounding intimate health, the sooner women can recognise symptoms, seek professional care, and get the support that’s needed.

If something feels off, trust your body. Speak to a healthcare professional. Understanding bacterial vaginosis, recognising BV symptoms early, and maintaining healthy vaginal pH balance can help support long-term intimate wellness. If something doesn't feel right, don't ignore it. Speaking to a healthcare professional early can help you get the right care and peace of mind. Do not stop yourself from receiving the support you deserve.

References

1. Baird, D. D., Weinberg, C. R., Voigt, L. F., & Daling, J. R. (1996). Vaginal douching and reduced fertility. American Journal of Public Health, 86(6), 844–850. https://doi.org/10.2105/ajph.86.6.844
2. Chow, K., Wooten, D., Annepally, S., Burke, L., Edi, R., & Morris, S. R. (2023). Impact of (recurrent) bacterial vaginosis on quality of life and the need for accessible alternative treatments. BMC Women S Health, 23(1), 112. https://doi.org/10.1186/s12905-023-02236-z
3. Farr, A., Swidsinski, S., Surbek, D., Tirri, B. F., Willinger, B., Hoyme, U., Walter, G., Reckel-Botzem, I., & Mendling, W. (2023). Bacterial Vaginosis: Guideline of the DGGG, OEGGG and SGGG (S2K-Level, AWMF Registry No. 015/028, June 2023). Geburtshilfe Und Frauenheilkunde, 83(11), 1331–1349. https://doi.org/10.1055/a-2169-8539
4. Khedkar, R., & Pajai, S. (2022). Bacterial Vaginosis: A comprehensive narrative on the etiology, clinical features, and management approach. Cureus, 14(11), e31314. https://doi.org/10.7759/cureus.3131
5. Martino, J. L. (2002). Vaginal douching: Evidence for risks or benefits to women’s health. Epidemiologic Reviews, 24(2), 109–124. https://doi.org/10.1093/epirev/mxf00
6. Muzny, C. A., Taylor, C. M., Swords, W. E., Tamhane, A., Chattopadhyay, D., Cerca, N., & Schwebke, J. R. (2019). An updated conceptual model on the pathogenesis of bacterial vaginosis. The Journal of Infectious Diseases, 220(9), 1399–1405. https://doi.org/10.1093/infdis/jiz342
7. Mylonas, I. (2025). Bacterial vaginosis. In Sexually Transmitted Diseases (pp. 543–561). https://doi.org/10.1007/978-3-031-78204-6_35
8. Paul Nyirjesy. (2008) Vulvovaginal Candidiasis and Bacterial Vaginosis. Infectious Disease Clinics of North America. 2008; 22: 637-652.
9. Ravel, J., Gajer, P., Abdo, Z., Schneider, G. M., Koenig, S. S. K., McCulle, S. L., Karlebach, S., Gorle, R., Russell, J., Tacket, C. O., Brotman, R. M., Davis, C. C., Ault, K., Peralta, L., & Forney, L. J. (2010). Vaginal microbiome of reproductive-age women. Proceedings of the National Academy of Sciences, 108(supplement_1), 4680–4687. https://doi.org/10.1073/pnas.1002611107 
10. Sobel, J. D. (2007). Vulvovaginal candidosis. The Lancet, 369(9577), 1961–1971. https://doi.org/10.1016/s0140-6736(07)60917-9
11. Wireko, S., Ofosu, M., Agyemang, F., Dankluvi, H. E., & Cobbina, A. E. (2024). Vaginal douching and health risks among young women. Health Science Reports, 7(2), e1882. https://doi.org/10.1002/hsr2.1882