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All About Bacterial Vaginosis (BV): Treatments, FAQs, And More For 2024
Bacterial vaginosis is common in people with a vagina. Although it can clear up on its own, getting treatment can lower your risk of complications and health risks.
A healthy vagina naturally contains both "good" and "bad" bacteria. But if there's an overgrowth of bad bacteria, an infection called bacterial vaginosis (BV) can occur.
Your treatment regimen will usually begin with antibiotic bacterial vaginosis medication that your doctor will prescribe. People who cannot use antibiotics sometimes try bacterial vaginosis home remedies, such as over-the-counter BV treatments like:
BV commonly affects people with a vagina between ages 15 and 44. Typically, it develops in sexually active people.
According to the Centers for Disease Control and Prevention (CDC), BV is the most common cause of vaginal symptoms among women ages 14–49 in the United States.
In the National Health and Nutrition Examination Survey, 2001–2004, the prevalence of BV was about 29% of females ages 14–49, or about 21 million individuals. Prevalence means the number of people affected by a condition at a particular time. Although older, this survey provides the most current reliable nationwide count.
Research indicates that BV affects about 1 in 3 women worldwide. Global prevalence of BV varies greatly, ranging from 4–75% of women, according to research from 2022. Bacterial vaginosis is most common in parts of Africa and least common in Asia and Europe.
Although most prevalent among women of reproductive age, BV can also affect postmenopausal women. A 2021 research review shows that the prevalence of BV among postmenopausal women worldwide is about 17%.
Though research does not agree on what leads to BV, here are the top BV causes that research pinpoints, along with treatments for bacterial vaginosis and tips for how to prevent bacterial vaginosis.
SymptomsAn excess of bad bacteria throws the vaginal environment out of balance, resulting in bacterial vaginosis symptoms like:
In some cases, BV causes no symptoms.
CausesExperts don't totally agree on BV causes, but there are several factors that may increase your risk of BV. These include:
According to the CDC, BV is more common in sexually active people. However, researchers do not understand exactly why.
A 2023 study suggests that the bacteria causing BV may be transferrable from women to men during sex, and researchers are exploring whether men can transmit it to women.
One 2020 study shows that the bacteria causing BV can live on the penis or in a man's urinary microbiome. In the study, a significant number of women developed BV within 6–12 months after having sex with men, suggesting that bacteria associated with BV were transmitted to the women during sex.
Although BV can't always be prevented, you can take the following precautions against BV:
Diagnosing bacterial vaginosisTo diagnose BV, a healthcare professional will start by taking a medical history and performing a physical pelvic exam. They will take a sample of vaginal secretions and order lab tests analyzing your vaginal cells and checking for vaginal acidity. Sometimes, clinics do these tests in the office.
Home test kits are available in drugstores but are not always accurate. These tests check for bacterial vaginosis symptoms, like changes in vaginal acidity and byproducts of a BV infection, rather than for BV itself.
Home test kits might indicate whether you have BV. But you'll want to confirm your results with a healthcare professional. They can help you decide on the best BV treatment.
Prescriptions for BVYour doctor may prescribe several bacterial vaginosis medications as initial BV treatment. They are antibiotics available in pill, cream, or suppository form.
MetronidazoleOne of the best prescription treatments for BV is an antibiotic called metronidazole. You can take it as a pill or gel.
The CDC recommends the following dosages:
If you have BV that recurs, a doctor may prescribe 500 mg of oral medication for 10–14 days. Another option is to use vaginal gel for 10 days, then twice weekly for 3–6 months.
ClindamycinClindamycin is another effective prescription treatment for BV. It's an antibiotic that you can take as:
An ovule suppository is a medication membrane that melts inside the vagina.
According to the CDC, the recommended dosages for clindamycin are:
Clindamycin cream and ovules contain oil, which may weaken latex products like condoms and diaphragms. This effect can last 72 hours for ovules and 5 days for cream.
TinidazoleIt's possible to develop adverse side effects from metronidazole or clindamycin. In this case, the doctor may prescribe tinidazole instead.
Tinidazole is also an antibiotic that you can take as a pill. For BV, there are two recommended dosages:
Another option is secnidazole. This is an antibiotic that you can take in one dose.
Secnidazole is available as granules that you can consume orally. The recommended single dose is 2 g. You can take the granules by mixing them with unsweetened applesauce or yogurt first.
Secnidazole is significantly more expensive than other treatments. However, it may be a sound option if you prefer a single-dose treatment.
Other remedies for BV ProbioticsProbiotics are good bacteria. Taking probiotic supplements may help introduce healthy bacteria into your body.
According to a 2019 review of 10 studies, which focused on the effects of probiotics on bacterial vaginosis, there's evidence that taking probiotic supplements daily may help treat and prevent BV.
And a research review from 2021 suggests that oral and vaginal probiotics may be an effective treatment and prevention option for BV. But researchers note that more studies are needed to determine:
If you've been prescribed an antibiotic for BV, remember that antibiotics can kill off good and bad bacteria. Probiotic supplements and yogurt can help replace good bacteria destroyed by antibiotics.
If you have BV, you could try taking probiotics daily to help treat and prevent future cases of this condition. Probiotics are available in:
You can buy probiotic supplements from:
Garlic has strong antibacterial properties, and it's long been used as a home remedy for BV.
For BV treatment, you can take garlic orally. Taking it vaginally is not recommended and has been known to burn vaginal tissue.
Research from 2020 looked at alternative treatments for BV. It concluded that taking a garlic supplement tablet could be an option for treating BV, although it also noted studies that suggest antibiotic treatment is more effective.
Boric acid suppositoryBoric acid vaginal suppositories are commonly used to treat BV, according to a research from 2019. According to the research, boric acid is typically effective at treating both BV and vaginal thrush, and few side effects occur.
Please note that boric acid is not edible — it's toxic to eat. Store it away from children and animals. However, it's considered safe to use boric acid in the vagina. But it's not safe to use if you're pregnant.
According to the CDC, experts still don't fully understand how BV spreads. But in general, anything that changes the chemical balance in your vagina can increase your risk of BV.
For instance, these steps may lower your risk of BV:
Although BV can clear up on its own, there are times when it can get worse without treatment. Also, untreated bacterial vaginosis has been associated with other serious health complications.
ConsiderationsIf your bacterial vaginosis symptoms haven't resolved or started to clear up within 1 week after treatment, you can make an appointment with a doctor or gynecologist.
Also, contact a doctor if you have:
Consider making an appointment when you won't have your period. This allows the doctor to take a swab of your vaginal discharge for testing.
You can book an appointment with an OB-GYN using our Healthline FindCare tool.
Recurring BVRecurring BV is common. Despite treatment, infections recur in more than 50% of cases within 6 months to 1 year. The reasons for this high recurrence rate are not known.
Research is divided on whether recurrence can be caused by re-infection from partners during sex. The CDC says that although bacteria associated with BV can be found on male genitalia, treating male sex partners for BV has not helped prevent the recurrence of BV in women.
When both sex partners have a vagina, and one of them has BV, the infection often develops in the other partner, according to the CDC. But research has not yet determined the effectiveness of treating sexual partners with a vagina to prevent BV recurrence.
Other possible causes of recurrence include:
If bacterial vaginosis symptoms recur soon after your treatment, you may want to see a healthcare professional to consider alternative treatments. Options include different or extended drug therapies or supplementation to restore normal flora balance in the vaginal microbiome.
Is bacterial vaginosis contagious?BV is not considered to be an STI. But sex increases your risk of developing the infection.
If a person with BV has sex with a person with a vagina, their partner may need to seek treatment for BV.
BV is not considered to be an STI. But sex increases your risk of developing the infection.
If a person with BV has sex with a person with a vagina, their partner may need to seek treatment for BV.
What is the quickest way to treat bacterial vaginosis?The fastest way to treat BV is to visit a doctor and get a prescription to treat the condition.
A prescription treatment will likely clear up bacterial vaginosis symptoms in 2–3 days. If you're pregnant or undergoing any medical procedures, it's especially important to have your BV taken care of sooner rather than later.
The doctor may prescribe an oral or vaginal antibiotic, like:
The fastest way to treat BV is to visit a doctor and get a prescription to treat the condition.
A prescription treatment will likely clear up bacterial vaginosis symptoms in 2–3 days. If you're pregnant or undergoing any medical procedures, it's especially important to have your BV taken care of sooner rather than later.
The doctor may prescribe an oral or vaginal antibiotic, like:
BV might go away on its own, but it's usually not worth the wait.
If it does go away on its own, it may take around 2 weeks to resolve, and then keep coming back. During that time, you might experience unpleasant symptoms.
BV might go away on its own, but it's usually not worth the wait.
If it does go away on its own, it may take around 2 weeks to resolve, and then keep coming back. During that time, you might experience unpleasant symptoms.
How long does BV take to go away?After seeing a doctor and starting treatment with a prescribed medication, bacterial vaginosis symptoms will likely improve within 2–3 days.
However, it's important to continue taking your medication for the prescribed period of time, even if your symptoms have gone away. This will help ensure the infection has completely cleared up, typically taking about 7 days.
After seeing a doctor and starting treatment with a prescribed medication, bacterial vaginosis symptoms will likely improve within 2–3 days.
However, it's important to continue taking your medication for the prescribed period of time, even if your symptoms have gone away. This will help ensure the infection has completely cleared up, typically taking about 7 days.
Should you be treated for bacterial vaginosis if you're pregnant?If you're pregnant, it's wise to get treatment for BV as soon as possible. That's because BV can increase the risk of early delivery and other complications.
It's safe to take antibiotics for BV while you're pregnant. A vaginal suppository antibiotic is typically prescribed to avoid side effects like nausea, vomiting, metallic taste, heartburn, and others.
If you're pregnant, it's wise to get treatment for BV as soon as possible. That's because BV can increase the risk of early delivery and other complications.
It's safe to take antibiotics for BV while you're pregnant. A vaginal suppository antibiotic is typically prescribed to avoid side effects like nausea, vomiting, metallic taste, heartburn, and others.
What is the difference between a yeast infection and bacterial vaginosis?BV and vaginal yeast infections have similar symptoms but different causes and treatments. Both cause inflammation of the vagina, also known as vaginitis. Both can also cause itchiness, but yeast infections do this more.
One of the differences between BV and a yeast infection is that BV produces a foul-smelling, "fishy" odor, while a yeast infection produces a slight "yeasty" aroma to no vaginal odor at all.
Additionally, a yeast infection may cause redness and inflammation of the vulva, and white, "cottage-cheese-like" discharge, while BV doesn't produce such symptoms.
To determine whether a vaginal infection is BV or a yeast infection, a doctor may:
BV and vaginal yeast infections have similar symptoms but different causes and treatments. Both cause inflammation of the vagina, also known as vaginitis. Both can also cause itchiness, but yeast infections do this more.
One of the differences between BV and a yeast infection is that BV produces a foul-smelling, "fishy" odor, while a yeast infection produces a slight "yeasty" aroma to no vaginal odor at all.
Additionally, a yeast infection may cause redness and inflammation of the vulva, and white, "cottage-cheese-like" discharge, while BV doesn't produce such symptoms.
To determine whether a vaginal infection is BV or a yeast infection, a doctor may:
If you can't use or access antibiotics, certain bacterial vaginosis home remedies — namely probiotics, garlic (orally only), and boric acid suppositories — could treat BV. However, a 2018 research review indicates that these natural BV treatments aren't as effective as antibiotics.
The CDC reports that while some studies have evaluated supplementing Lactobacillus and other probiotics vaginally to treat BV, research does not support this to replace or add to standard BV therapy.
A 2019 study suggests other potential alternatives to antibiotic treatment, though these need to be done under a healthcare professional's care:
A 2023 study points to the development of antimicrobial resistance worldwide and calls for development of new alternative non-antimicrobial therapies for BV.
If you can't use or access antibiotics, certain bacterial vaginosis home remedies — namely probiotics, garlic (orally only), and boric acid suppositories — could treat BV. However, a 2018 research review indicates that these natural BV treatments aren't as effective as antibiotics.
The CDC reports that while some studies have evaluated supplementing Lactobacillus and other probiotics vaginally to treat BV, research does not support this to replace or add to standard BV therapy.
A 2019 study suggests other potential alternatives to antibiotic treatment, though these need to be done under a healthcare professional's care:
A 2023 study points to the development of antimicrobial resistance worldwide and calls for development of new alternative non-antimicrobial therapies for BV.
Although mild cases of BV may resolve independently, treatment can help lower the risk of complications. The most effective options are prescription antibiotics. These include metronidazole and clindamycin, which you may take as a pill or cream.
In some cases, a doctor might prescribe tinidazole or secnidazole. These medications are also antibiotics. Taking probiotics, garlic capsules, and boric acid may also help.
Though bacterial vaginosis symptoms might improve within a few days, be sure to take all your medication as directed. This will help make sure that your infection has completely resolved after treatment. If you have recurring BV, you can work with a doctor to find long-term solutions.
How To Get Rid Of Bacterial Vaginosis At Home
Probiotics and other supplements may help treat bacterial vaginosis (BV) without antibiotics. Using barrier protection and practicing proper hygiene can also reduce the risk of developing BV.
In the United States, as many as 21.2 million women aged 14–49 have bacterial vaginosis (BV). This equates to almost a third of people in this range. Many people may have no symptoms, while others may mistake their symptoms for another infection, such as a yeast infection.
The most common symptom of BV is an odor coming from the vagina. Some people also experience itching, burning, or an unusual gray discharge.
Antibiotics can treat most cases of BV. However, some people may prefer to try home remedies first.
This article explores home remedies for preventing and treating bacterial vaginosis.
The exact cause of BV is not known, but it is more common in sexually active people.
The vagina is home to a complex colony of organisms that maintain vaginal health and chemical pH. When vaginal pH or bacteria change, the vagina is more vulnerable to infections, including BV.
Sexual practices that disrupt the natural balance of bacteria in the vagina may play a role in BV development. Strategies that lower the risk include:
People who think they have BV should either abstain from sex or practice sex with barrier protection until the infection is gone.
The vagina is a self-cleaning organ that does not require douches, soaps, or perfumes. In fact, the use of these products can alter vaginal pH.
Safe hygiene practices may help reduce a person's risk of developing BV.
To reduce the risk of developing or worsening BV, the following may help:
Learn more about vaginal hygiene here.
BV rarely causes severe symptoms. However, anyone who suspects they have BV should contact a medical professional, especially if:
In most cases, a doctor can quickly diagnose BV. A short course of antibiotics should clear up the infection. These antibiotics rarely produce significant side effects.
If a person suspects they have BV, they should contact a medical professional as a first option. However, some people may wish to try alternative remedies, such as those below.
Probiotics help the body grow beneficial bacteria that can fight the bacteria associated with BV. A 2019 review concluded that probiotic therapy might have both short- and long-term benefits in treating BV.
People may wish to take probiotic supplements. However, natural probiotics can also support the bacterial colony that keeps the vagina healthy. These include:
Learn more about probiotic foods here.
Several compounds in garlic have natural antibacterial properties.
A 2014 study found that garlic supplement tablets had a similar therapeutic effect in treating BV as metronidazole, an oral antibiotic.
However, it is important to note that the above study assessed oral garlic supplements only. A person should never place garlic or garlic products in or around their vagina.
Vaginal suppositories containing boric acid may help treat BV.
A 2021 study found that using intravaginal boric acid in addition to antibiotic medications can be of benefit in treating BV. A 2019 review reported similar benefits for boric acid in treating BV and yeast infections.
However, the authors of both studies concluded that further research is necessary to assess how boric acid assists in treatment fully.
Boric acid is toxic if people take it orally. A person should only ever use this product as per instructions.
Limited anecdotal claims suggest that tea tree oil may help treat BV. However, there is no scientific evidence that tea tree oil or products containing tea tree oil can help with the condition.
Tea tree oil treatments may cause allergic reactions in some people and are not safe for use during pregnancy. People considering purchasing tea tree oil treatments should always consult a doctor first.
Some people also claim that apple cider vinegar can assist in treating BV. However, it is important to note that these claims are purely anecdotal, and there is no evidence to prove them.
Home treatments may benefit some people but should not take the place of evidence-based treatment plans. A person wishing to use home remedies should speak with a doctor before doing so.
The primary treatment course for BV is antibiotics. However, some people may wish to treat the condition at home.
Options for home treatments include practicing safe hygiene, using barrier protection during intercourse, and taking probiotic supplements.
BV is a common condition and typically is not cause for concern. However, anyone experiencing symptoms of BV should always contact a medical professional as the first course of action.
Read the article in Spanish.
Vaginal Infection Has Been Long Linked To Pregnancy Risks — And Doctors Finally Know Why
Symptoms of bacterial vaginosis include vaginal discharge or pain in the area. HENADZY – stock.Adobe.Com The researchers say further exploration of the surface of vaginal epithelial cells could make diagnosing BV easier.
"We now have a blueprint of the glycans present on epithelial cells in the vagina, and we showed that these glycans are shaped by the bacteria that live there," said Warren G. Lewis, a UCSD assistant professor.
"However, it will take more work to fully understand the functions of glycans in the vaginal epithelium and how bacterial vaginosis impacts those functions."
In the meantime, they recommend
avoiding douching or using scented products, which could disrupt the vagina's delicate balance of bacteria.BV typically occurs in women who are sexually active — it's often treated with antibiotics.
Symptoms include vaginal discharge and pain.
Lewis noted that "even when bacterial vaginosis is identified and treated with antibiotics, recurrences occur in most individuals within a year."
Not seeking treatment can lead to pre-term birth for pregnant women or
sexually transmitted diseases like chlamydia and gonorrhea.
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