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Bacterial Vaginosis · Women's Health · Akoka

The Smell I Was Too Ashamed to Mention
Bacterial Vaginosis — Diagnosed and Treated

Toyin had noticed an unusual vaginal odour for three months. Shame had kept her from mentioning it to anyone. At Mascot Healthcare, a swab confirmed bacterial vaginosis — a common, treatable imbalance that is not an STI.

Composite patient journey Names changed for privacy Mascot Healthcare, Akoka
📝 Note: This is a composite clinical narrative — constructed from multiple similar presentations at Mascot Healthcare. It accurately reflects the typical diagnostic experience. Patient details have been generalised for privacy.
The Patient
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Toyin, 27

Primary school teacher, Bariga. Presented after 3 months of recurrent symptoms.

Bacterial Vaginosis
How It Started

Three Months of Silence

Toyin first noticed the odour in January. She assumed she needed to improve her hygiene and began douching with a commercial vaginal wash — twice daily. The odour persisted. The douching, she would later learn, was making it worse.

By March the discharge had increased and she had started wearing panty liners daily. She had searched online but found the descriptions alarming — she was convinced she had an STI, though she had been in a monogamous relationship for 2 years. The shame of attending a clinic with a vaginal complaint kept her at home.

A friend who had recently attended Mascot Healthcare for an unrelated matter mentioned that the clinic handles 'those kinds of complaints' without fuss. Toyin walked in on a Tuesday morning, the receptionist took her through with no waiting, and she spoke to a female doctor.

Symptoms

The Symptoms Toyin Had Been Carrying Alone

Each symptom individually manageable — together, three months of unnecessary discomfort.

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Fishy odour — stronger after sex

The hallmark symptom of bacterial vaginosis; caused by anaerobic bacterial metabolism.

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Thin, grey-white discharge

Increased in volume compared to normal; homogeneous, not clumpy.

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Mild vulval irritation

Not the intense itch of candidiasis — a lower-grade persistent discomfort.

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Odour worsening after menstruation

Menstrual blood raises vaginal pH, creating a more permissive environment for BV bacteria.

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No abdominal pain or fever

BV is a vaginal condition; ascending infection (PID) was not present.

Before the Clinic

Douching — The Thing That Made It Worse

Toyin had been douching with a fragrant vaginal wash twice daily for three months. She had also tried changing her washing powder and wearing looser underwear. Nothing had worked.

Vaginal douching is one of the most common self-treatment errors for BV. The vaginal environment maintains a delicate acidic pH that suppresses pathogenic bacteria. Douching disrupts this, raises the pH, and actively worsens BV by removing the protective lactobacillus species.

⚠️ Why this matters: Vaginal douching does not treat bacterial vaginosis — it causes it. The healthy vagina maintains its own bacterial balance. Washing inside the vagina removes protective lactobacilli and creates the pH environment in which BV bacteria thrive.
At Mascot Healthcare

A Straightforward Diagnosis

A high vaginal swab was taken. Whiff test (amine test) was positive — characteristic of BV. Microscopy showed clue cells (vaginal epithelial cells coated with bacteria) — the definitive microscopic finding. Candida was not present. STI screen (trichomonas, gonorrhoea, chlamydia) was offered and returned negative.

Toyin was told, clearly and without drama: 'This is not an STI. It is not related to hygiene. It is a change in the balance of bacteria that naturally live in the vagina. It is very common, very treatable, and nothing to be ashamed of.'

Diagnosis & Treatment

What Was Found — and What Happened Next

1

Diagnosis

High vaginal swab: positive whiff test, clue cells on microscopy. Candida not detected. STI screen negative. Diagnosis: bacterial vaginosis.

2

Treatment

A short course of prescribed medication. Advised to stop vaginal douching completely. Advised to avoid fragranced soaps inside the vagina. Probiotic vaginal capsules discussed for recurrence prevention.

3

Follow-up

Review if symptoms persisted beyond completing treatment. Counselled on recurrence — BV recurs in approximately 50% of women within 12 months. Options for recurrence prevention were discussed.

Outcome

Symptoms resolved completely within a few days of starting treatment. Toyin stopped douching and has had no recurrence in the 5 months since. 'I wish I had come sooner,' she said at follow-up. 'Three months of worry for a week of antibiotics.'

What This Story Teaches Us

BV Is Not an STI — and It Is Not Caused by Lack of Hygiene

Bacterial vaginosis is the most common vaginal condition in women of reproductive age. It is caused by an overgrowth of anaerobic bacteria that displace the normal protective lactobacillus species — often triggered by pH changes from menstruation, semen, or (ironically) excessive vaginal washing.

It is not sexually transmitted — though it is more common in sexually active women and can be influenced by sexual activity. It is not a sign of poor hygiene — in fact, the most common cause of recurrence is over-washing. And it is not dangerous in most cases, though it does increase susceptibility to STIs and, in pregnancy, carries a small risk of preterm labour.

Key takeaway

An unusual vaginal odour or discharge that persists beyond a menstrual cycle should be assessed with a swab — not treated with douching or over-the-counter products. BV is common, not shameful, and responds well to a short antibiotic course.

Unusual vaginal discharge or odour?

Book an appointment at Mascot Healthcare, Akoka — same-day slots often available, 4.9★ rated.

Service
Vaginal Swab + STI Screen
Opening Hours
Mon–Sat 9AM–5PM
Location
Akoka, Lagos
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