Uh oh. Something doesn’t feel quite right down there. You’re familiar with your own body and you know when something’s out of kilter. You’ve got more discharge than normal; it’s watery, and it smells – dare we say it – a bit fishy. Not another bout of thrush, surely?

You may not have thrush at all. You could have a health condition that’s lesser known, but actually twice as common as thrush: bacterial vaginosis (BV).  It’s a natural condition that develops when your normal vaginal flora is disrupted, and it’s easily treated.

1 in 3 women in the UK will have BV at some point, with 60% of those believing it’s thrush and perhaps trying to self-treat with over-the-counter thrush medications. These don’t work on BV, so frustratingly, the symptoms reoccur.

Don’t suffer in silence. Dr Shazia Malik, Consultant Obstetrician and Gynaecologist at The Portland Hospital in London, says: “There is still a lot of embarrassment surrounding women’s intimate health, which means women will just put up with symptoms – even if they suspect something isn’t quite right. Talking openly about conditions like BV is the first step to addressing this issue and helping women seek help to look after their vaginal health.”

So, what causes BV?

When your vagina is healthy, it has a balance of ‘good’ bacteria, including lactobacilli, that keep its natural pH balance at its normal, slightly acidic level. If the pH level increases and your vagina becomes more alkaline, the number of lactobacilli can reduce and other, more harmful bacteria may multiply. This can give you an infection such as BV.

Several things make you more susceptible to BV. First and foremost, being sexually active, especially if you have a new partner; semen is alkaline and can neutralise the vagina’s mild acidic protection. Blood is also alkaline, so your period can affect it too, along with normal monthly hormonal changes. Using an IUD as your contraceptive of choice is another factor. And because your vagina is naturally self-cleaning, it doesn’t need any help in the form of scented soaps, bubble bath, vaginal deodorant or douches – these disrupt the flora. Even washing your underwear in strong detergent can be enough to trigger BV, and it goes without saying that smoking does your vaginal health no favours.

What are BV’s symptoms?

You might not experience any symptoms – 50% of women with BV don’t. If you do, you’ll probably have an unusual vaginal discharge that’s greyish-white and watery. The giveaway that it’s probably BV is its strong, distinctive fishy smell – particularly after sex. BV doesn’t usually cause itching or soreness, though – these symptoms are more likely to indicate thrush or another infection.

“Symptoms of BV can be easily relieved – but you need to know what you’re looking for first. Once recognised, BV should be treated otherwise it’s likely to reoccur, creating a never-ending cycle of symptoms and potential embarrassment,” says Dr Malik.

Is it an STI? (and other misconceptions)

No, BV isn’t a sexually transmitted infection, although it’s more common if you’re sexually active. You might be worried about your partner catching it, but as it’s solely a vaginal condition, you can’t pass it on to a partner who has a penis, but you can pass it on if your sexual partner is female. And you can’t get it from public swimming pools, toilet seats or by sharing baths or towels.

What effects can BV have?

BV’s not usually serious, but it’s important to get it treated. Because it makes your vagina less acidic, your natural defences against infections generally may be reduced, increasing your risk of picking up an STI such as chlamydia. If you’re pregnant, always get yourself checked out to minimise the risk of pregnancy complications.

What’s the diagnosis and treatment for BV?

Instead of worrying yourself unnecessarily, get straight down to your pharmacist. Pharmacists are highly trained medical professionals, experts in medicines, and they’re very discreet. They’ve also seen and heard everything before, so there’s no need to feel embarrassed. If you’re experiencing first-time symptoms, or you’re pregnant, the pharmacist may well ask you to visit your GP. The doctor will want to confirm that you have BV, and rule out another infection by examining you, maybe taking a swab, and, if necessary, prescribing antibiotic tablets, creams or gels.

BV has a habit of recurring. But once you recognise its symptoms again, you can head back to your pharmacist for an over-the-counter remedy clinically proven to bring vaginal pH levels back to normal, rapidly helping to relieve the symptoms of BV. “Products that treat BV effectively can be picked up in a pharmacy, saving you the bother of a trip to the GP and a course of antibiotics,” says Dr Malik.

So next time something’s up down there, remember…, maybe it’s not thrush?

To self-test if you might have BV, try the Balance Activ online symptom checker. The Balance Activ product range provides a natural solution to a natural problem; it is clinically proven to effectively treat the symptoms of BV by restoring normal pH and vaginal flora.