Doctors Explain The Symptoms Of A 'Fishy' Infection That Affects Millions Of Women

Doctors have highlighted the warning signs people should know when it comes to an infection that affects millions of women around the world. Even though it is common, many people still know far less about it than they do about other sexual health conditions.

Sexually transmitted infections, including chlamydia, gonorrhea, and syphilis, are widely discussed, and testing for them is available through sexual health clinics across the country. Because of that, they are often easier for people to recognize and understand.

But some health specialists now want another condition to be viewed more seriously in the same space. It develops when the normal bacterial balance inside the vagina shifts out of place.

Men do not develop the condition themselves, but they can still carry the bacteria, Gardnerella vaginalis, that may play a role in infections in women. It is most often linked to women who are sexually active or who have multiple sexual partners, though women who are abstinent can still develop it too.

Research has suggested that up to 84 percent of people with the condition, bacterial vaginosis, do not notice any symptoms at all. That means it can easily go undetected for long periods and may only be picked up once symptoms appear or the problem keeps coming back.

A lot of women with the infection don't experience any symptoms Getty Stock Image

Dr. Valentina Milanova told Metro: "The traditional argument against calling bacterial vaginosis an STI is that it stems from an overgrowth of endogenous flora rather than a single external pathogen."

"But this is becoming increasingly difficult to defend."

The gynecologist, who is also the founder of women's healthcare brand Daye, went on to argue that sexual health guidance has not kept up with newer evidence. In her view, that has meant clinicians are still not routinely treating partners, which may leave some women dealing with repeat cases instead of lasting improvement.

Dr. Milanova also said clinics are not 'notifying contacts, or screening systematically — leaving many women stuck in a cycle of recurrence which impacts women's holistic wellbeing'. Her point was that the condition may be more disruptive than it is often treated as, especially for women who keep getting it back after treatment.

That argument is part of a wider debate about whether bacterial vaginosis should stay outside the STI label or whether the way it behaves in relationships means current guidance is too limited. The discussion has become more active as doctors look more closely at recurrence and partner involvement.

What are the symptoms of bacterial vaginosis?

There are several symptoms that can show up, including a thin, watery, or grayish vaginal discharge. For some women, that may be the first noticeable sign that something is off.

People with BV may also notice a strong 'fishy' smell coming from the discharge. That smell can become more obvious during sex or while they are on their period, which is one reason many people first start to suspect something is wrong at those times.

In many cases, BV clears within about seven days when the right prescribed treatment is used. But for people who get it again and again, a longer course of antibiotics may be needed to help bring it under control.

Symptoms are apparently more noticeable during sex Getty Stock Photo

Without treatment, the infection may last for months before it settles down. In some cases, it can also go away on its own without antibiotics, especially when the person has no symptoms and only finds out about it by chance.

That makes the condition a little harder to judge than some people might expect. Some women may never know they have had it, while others may deal with repeated symptoms that disrupt daily comfort, sex, and overall wellbeing.

Preventing bacterial vaginosis

Although there is no guaranteed way to prevent BV completely, the Cleveland Clinic lists several steps that may help lower the risk. These measures focus on protecting the vaginal area and reducing situations that may disturb its natural balance.

• Avoid douching
• Do not let anything that has touched your anus come into contact with your vaginal area
• Limit your number of sexual partners
• Use latex condoms or dental dams
• Wear cotton underwear

Even with those prevention tips, not every doctor agrees that BV should be classed in the same way as infections like chlamydia or gonorrhea. Some believe its pattern is still too different to fit neatly into that category.

"While there's growing evidence of sexual transmission dynamics and partner involvement in recurrence, it still doesn't behave like a classic STI in terms of a single causative organism or straightforward transmission pattern," he said.

That view reflects the other side of the medical debate. While some doctors think the role of sex and partner transmission is strong enough to change the way BV is classified and treated, others believe it still does not behave like a standard STI with one clear germ and one simple path of transmission.

For now, the discussion continues, but doctors agree on one practical point: women should know the symptoms, seek advice if something feels unusual, and get proper treatment when BV becomes persistent or keeps returning.