DEVA Study

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Frequently Asked Questions about BV


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What causes bacterial vaginosis?

Bacterial vaginosis (BV) occurs when there is an imbalance between the ‘good’ protective  bacteria and other bacteria which are normally present in low numbers in your vagina.  The good bacteria are replaced by an overgrowth of the other bacteria. The main bacterium causing BV is Gardnerella vaginalis.




What are the symptoms of BV?

The main symptom of BV is an increase in vaginal discharge that has an unpleasant fishy smell. The discharge may be grey or white. The fishy smell is often more noticeable after vaginal sex and during a period. It is the smell of BV that women report as being particularly distressing for them. There usually isn’t any vaginal soreness or itching.




Why do I keep getting BV?
Gardnerella vaginalis is able to form a biofilm where the bacteria bind together and produce thick layers on top of each other. This makes it more difficult to treat BV as treatments cannot reach and kill the bacteria on the inside of the biofilm. There may be a temporary improvement in symptoms during, and immediately after, treatment but these may recur within a few months after the treatment.
Other factors that can make it more difficult to clear BV are:
Having vaginal sex without a condom 
Using a coil (IUD)
Vaginal douching or inserting other things that have not been manufactured and licensed for use in the vagina
Experiencing hormonal changes with the  menopause



How to prevent bacterial vaginosis?
Whilst not all infections can be prevented, you may be able to lower your chances of getting BV again by using condoms during sex, and avoiding douching.



Can BV go away on its own?
Occasionally BV can go away without treatment but not treating BV can increase the health risks associated with BV. These include the increased risk of getting STIs that can cause pelvic inflammatory disease (PID), catching and transmitting HIV, or going into early labour or having a low birth weight baby if you have BV when pregnant. 



How to restore vaginal pH balance quickly?
The vagina is self-cleansing and the ‘normal’ vaginal discharge is the result of the vaginal cells and fluid that are routinely shed from the vagina.
Avoid inserting soaps and other things that have not been manufactured and licensed for use into the vagina. All of these may kill off the good vaginal bacteria and so predispose to BV.
However, the vulva can be cleaned with warm water and a gentle cleanser/soap as long as it is rinsed off afterwards.



Can you have thrush and BV at the same time?
Yes but it is unusual to have them both together. BV and thrush are not the same, BV is caused by an imbalance of the vaginal bacteria and thrush is caused by an overgrowth of yeasts. Thrush is the main cause of vulval itching or burning.




Frequently Asked Questions about the DEVA study


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What should I do if I need medical attention whilst taking treatment or if after the treatment my symptoms return or do not resolve completely?

We advise you to seek additional medical care and advice from your local healthcare provider e.g. GP or local GUM clinic.


You can find your local sexual health clinic using the form on the NHS website available here: 




Can I join the trial if I am using anti-fungal treatment?
If it is taken intravaginally then no you can't, but if it is taken orally or cream not intravaginally then yes you can. 



Do I still need to complete the questionnaires if I receive standard of care antibiotics?
Yes you do, completing the questionnaires is very important to find out which treatment is more effective at treating BV.



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