When to worry about vaginal itching with bacterial vaginosis

Bacterial vaginosis reflects a change in the balance of bacteria in the vagina. It often causes a thin discharge or a noticeable fish-like odour, while itching may be mild or absent. Irritation can also come from thrush, an infection passed through sexual contact, soap, fragranced products, or a skin condition, so itching alone cannot identify the cause.

Wash the outer genital skin gently with lukewarm water and avoid douching, scented washes, deodorants, and bubble baths. Wear breathable underwear and change out of damp clothing. Do not insert leftover medicines or assume an anti-thrush treatment will treat bacterial vaginosis. Arrange a clinician review if symptoms are new, do not settle after treatment, or return repeatedly.

Seek prompt medical advice for lower abdominal or pelvic pain, fever, feeling faint or very unwell, bleeding that is unusual for you, sores or blisters, pain when passing urine, or discharge with a strong new odour. If you are pregnant or could be pregnant, contact a maternity or medical team about new symptoms. Urgent help is appropriate for severe pain, heavy bleeding, or collapse.

Ask whether testing is needed to distinguish bacterial vaginosis from thrush or a sexually transmitted infection, whether your current treatment is suitable, and how to reduce irritation while symptoms settle.