Spotlight on Bacterial Vaginosis (BV) & Human Papillomavirus (HPV)

If there’s anything out of the ordinary going on with your vagina, bacterial vaginosis is probably your prime suspect but as with most things affecting our anatomy, we don’t talk about it enough.

The vagina is a sensitive soul. All it takes is some high-waisted jeans or some bougie bath products and bam, it starts acting up and, let’s be real for a sec, smelling very down in the face.

If there’s anything out of the ordinary going on with your vagina, bacterial vaginosis is probably your prime suspect but as with most things affecting our anatomy, we don’t talk about it enough.

The best way to counteract any shame and misinformation about your vagina is to get to know all of it, and to dismantle the idea that a vagina must be a perfectly peachy smelling thing, on its best behaviour at all times. BV happens, sometimes for no apparent reason, but it’s no biggie, and it certainly shouldn’t hold you back from living your life.

A mild vaginal infection is crazy common, as is the Human Papillomavirus (HPV), so to help you deal with these common viruses and infections, understand your intimate pH levels and do right by your vagina and your vulva, here’s the what’s what of BV and HPV.

What is Bacterial Vaginosis?

Most people have heard of thrush and cystitis, but BV? Not so much!

Bacterial Vaginosis (BV) is not an STI. Let’s just set that record straight. BV is an infection of the vagina caused by an imbalance in the naturally occurring vaginal bacteria. It’s the most common type of vaginal infection (affecting one in three vagina owners in their lifetime) and nothing to be embarrassed about, even if it is annoying af.

Good bacteria known as ‘Lactobacilli’ is vital to maintaining the health of a vagina. It’s this bacteria that keeps your vagina moderately acidic to prevent bad anaerobic bacteria from growing. The pH scale ranges from 0-14, with anything below seven considered acidic and anything above seven considered alkaline. A typical vaginal pH level should hover between 3.8 and 4.5.

Whenever there are low levels of Lactobacilli, the vagina’s acidic environment or microbiome is all out of whack and the BV-causing bacteria called Garderella has its time to shine. Hello BV. It’s the ultimate tale of good vs evil, and in this twisted fairytale, our vagina is the Disney villain.

Around 50 – 70% of people who have BP are asymptomatic, but when symptoms do appear, they can include an atypical, thin grey, white or yellow vaginal discharge with an unpleasant smell, often described as ‘fishy’. Some people also experience burning when urinating and itching around the opening of the vagina. So yeah, pretty annoying and inconvenient but we move!

Whilst anyone with a vagina can get BV, you may be more at risk if:

  • You’re pregnant
  • You have multiple sexual partners
  • You do not use condoms for protection
  • You have an intrauterine device (IUD)
  • You douche your vagina
  • You have prolonged or irregular menstrual cycles – menstrual blood has a slightly alkaline pH and can therefore disrupt the “normal” vaginal pH levels.


In some cases, BV clears up on its own however, to rule out other infections and avoid further complications you should always see a doctor. You don’t want to self-diagnose BV only to find out you’ve actually got a yeast infection or an STI with comparable symptoms.

In most cases, doctors will prescribe an antibiotic and the infection will clear up within a few days. Even if your symptoms have gone away, make sure you finish your course of antibiotics to ensure it doesn’t come back. A male partner will not need to be treated but if you have a female sex partner, she may also need treatment.

If left untreated, BV can make you more susceptible to STIs such as HIV, herpes and gonorrhoea and pelvic inflammatory disease (PIV). If you’re pregnant, it can also lead to premature birth and low-birth weight babies, so it’s important to be tested and treated at any stage in your pregnancy if you think you may have BV.

There are some measures you can take to lower your risk of getting BV:

Avoid douching – the vagina is self-cleaning, so douching can upset the natural balance of good bacteria present in your vagina. Using just warm water to clean the outside of your vagina is the best way to avoid upsetting your pH levels. Avoid scented or heavily perfumed products and limit your bubble baths. Sorry, Chandler.

Use condoms / dental dams every time you have sex

Wear breathable cotton underwear

Clean sex toys after every use

Increase intake of rich probiotic foods

Wipe from your vagina to your anus (front to back is the golden rule, people!)

Quit / cut back on smoking

What is Human Papillomavirus (HPV)

Unlike BV, Human Papillomavirus is a viral sexually transmitted infection, and a very common one too. Most women and men will be infected within months or years of being sexually active, even if they’ve had few sexual partners.

It can be spread during skin-to-skin genital contact and vaginal, anal and oral sex, even when an infected person has no signs or symptoms.

There are around 200 varieties within the HPV group and though usually harmless, there are two types of low-risk HPV that can lead to genital warts and at least a dozen high-risk HPVs (particularly types 16 and 18) that can persist and progress to cervical cancer or cancer of the vagina, anus or throat. Men are also at risk of penile cancer.


In most cases of HPV, your immune system will get rid of it on its own and you will never even know you had it. However, you can also still pass HPV to your partner(s), even if you don’t have any symptoms.

High risk HPV can usually be easily treated before it turns to cancer, which is why attending your regular Pap smears / cervical cancer screenings is important as they can detect abnormal cells on your cervix, often caused by HPV. However, they don’t detect the HPV infection itself.

There’s no treatment to cure the infection itself but the conditions caused by HPV, such as genital warts, cervical cell changes (abnormal cells) and cancer, can be treated.

You can do several things to lower your chances of getting HPV:

Get the HPV vaccine – there are currently three HPV vaccines available in the UK:

Gardasil 9.

When given in the recommended age groups, the vaccine reduces the spread of HPV and reduces the risk of diseases caused by HPV, including cervical cancer. Children who start the vaccine between the ages of 11 – 15 have two doses over a 6 – 12 month period, whilst teens and young adults who receive their first dose at age 15 – 26 need three doses over a 6 month period to be protected. If you are female and have had the HPV vaccine, you still need to attend your cervical cancer screening as the vaccine protects against 7 in 10 cases of cervical cancer. The smear test helps detect any abnormal cell changes caused by other HPV types.

The vaccine is recommended for anyone age 11 through to 26 if they’re not already vaccinated. The vaccine can be given to anyone between 26 and 45 who didn’t receive all their vaccine doses, though it is not routinely recommended because they are more likely to have been exposed to HPV already. The vaccines provide maximum benefit if a person receives them before he or she is sexually active.

Men who have sex with men (MSM) are currently offered the vaccine for free up to the age of 45 and some transgender people, depending on their individual situation, can also have the vaccine for free.

Wearing condoms can reduce the risk of HPV but they don’t offer complete protection as HPV can infect areas not covered by a condom.

If you’re concerned about HPV, have any questions or need some emotional support, call the free Jo’s Trust helpline on 0808 802 8000