When to worry about vaginal discharge with bacterial vaginosis

Bacterial vaginosis is an imbalance of bacteria in the vagina. Discharge may be thinner than usual and can look white or grey, with a noticeable fish-like odour that may be stronger after sex. Some people have mild irritation, while others have no discomfort. Discharge changes can also occur with thrush, sexually transmitted infections, irritation, or hormonal changes, so appearance alone cannot confirm the cause.

Arrange a medical assessment if the discharge is new, persistent, recurrent, or different from your usual pattern. A clinician may ask about odour, itching, pain, bleeding, sexual health, pregnancy, and recent products or antibiotics, then recommend testing. Take prescribed treatment exactly as directed and avoid douching or scented washes, which can further irritate the vagina. Use gentle external washing and tell a clinician if symptoms return after treatment.

Seek prompt care for lower abdominal or pelvic pain, fever, pain when urinating, bleeding after sex or between periods, sores, marked swelling, or feeling unwell. Contact a clinician promptly if you are pregnant, recently had a new sexual partner, or symptoms persist despite treatment. Urgent assessment is needed for severe pain, fainting, heavy bleeding, or vomiting because these symptoms are not typical of uncomplicated bacterial vaginosis.

Ask whether testing is needed to distinguish bacterial vaginosis from thrush or an infection passed through sex, whether partners need advice, and when you should return if symptoms persist. Mention pregnancy, pelvic pain, bleeding, urinary symptoms, allergies, and medicines you take.