Medical professionals have outlined what to look out for when it comes to a common infection affecting millions of women worldwide.
When people think about sexually transmitted infections (STIs), conditions such as chlamydia, gonorrhoea, and syphilis often come to mind, with testing widely available through sexual health clinics.
However, some health specialists believe bacterial vaginosis (BV) should also be formally recognised as an STI. BV happens when the usual balance of bacteria in the vagina changes, leading to an overgrowth of certain bacteria.
Although men don’t develop BV themselves, they can carry bacteria linked to it and may contribute to women becoming infected. BV is most commonly seen in women who are sexually active, particularly those with multiple sexual partners.
Dr Valentina Milanova told Metro: “The traditional argument against calling bacterial vaginosis an STI is that it stems from an overgrowth of endogenous flora rather than a single external pathogen.
“But this is becoming increasingly difficult to defend.”
She added that sexual health guidance hasn’t been refreshed for years, which she says can mean clinicians “are not routinely treating partners”.
Dr Milanova also said clinics may not be “notifying contacts, or screening systematically — leaving many women stuck in a cycle of recurrence which impacts women’s holistic wellbeing”.
Research suggests around 84 percent of women with BV don’t notice any symptoms, which can make it hard to know when treatment is needed.
That said, symptoms can occur. These may include watery, thin, or greyish vaginal discharge. Some people also report a strong “fishy” smell, and discharge that becomes more noticeable during sex or around their period.
With the right prescribed medication, BV often improves within around seven days. For those who experience repeat bouts, a longer course of antibiotics may be recommended.
If left untreated, BV can sometimes linger for months. In some cases, it may resolve without antibiotics—particularly if there are no symptoms—though professional advice is still recommended if you’re concerned.
Despite growing calls to classify BV as an STI, Dr Giuseppe Aragona told the Metro that its behaviour is not the same as infections like chlamydia or gonorrhoea.
“While there’s growing evidence of sexual transmission dynamics and partner involvement in recurrence, it still doesn’t behave like a classic STI in terms of a single causative organism or straightforward transmission pattern,” he said.