7 Best Bacterial Vaginosis (BV) Treatments, FAQs, and More
Bacterial vaginosis is common in people with vaginas. 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 can occur.
Here are the top treatments for bacterial vaginosis, plus tips for how to prevent bacterial vaginosis.
Bacterial vaginosis (BV) is a vaginal infection caused by excess bad bacteria. This throws the vaginal environment out of balance, resulting in symptoms like:
- thin grayish-white discharge, especially after sexual intercourse
- discharge with a fishlike odor
- pain during urination
- pain during or after sexual intercourse
- vaginal itching
In some cases, BV causes no symptoms.
BV commonly affects people with vaginas between ages 15 and 44. Typically, it develops in those who are sexually active.
Experts don’t know exactly what causes BV.
According to the Centers for Disease Control and Prevention (CDC) , though, it’s more common in people who are sexually active. Things that may increase your risk of having BV include:
- douching
- not using condoms
- having multiple sex partners
- having new sex partners
Although you can’t always prevent BV, you can take the following precautions:
- avoid douching
- use a daily probiotic
- use condoms
Metronidazole
- Potential side effects: nausea, vomiting, diarrhea, metallic taste in the mouth , other gastrointestinal symptoms, appetite loss, headache, mouth or tongue irritation
One 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:
- Pill: 500 milligrams (mg) taken orally twice per day for 7 days
- Gel: 5 grams (g) inserted into the vagina once per day for 5 days
If you have BV that keeps coming back, a doctor may prescribe 500 mg of oral medication for 10 to 14 days. Another option is to use vaginal gel for 10 days, then twice per week for 3 to 6 months.
Pros
- effective treatment
- easy to take
Cons
- can be pricey
- has many potential side effects
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Clindamycin
- Potential side effects: nausea, vomiting, joint pain, heartburn, pain when swallowing, vaginal discharge, metallic taste in the mouth, itching or burning of the vagina
Clindamycin is another effective prescription treatment for BV. It’s an antibiotic that you can take as:
- a pill
- cream
- ovule suppository
An ovule suppository is a capsule that’s inserted into the vagina.
According to the CDC, the recommended dosages for clindamycin are:
- Pill: 300 mg taken orally twice per day for 7 days
- Cream: 5 g inserted into the vagina at bedtime for 7 days
- Ovule suppositories: 100 mg inserted into the vagina at bedtime for 3 days
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.
Pros
- effective prescription treatment
- available in several different forms
Cons
- higher risk of colitis than other antibiotics
- Creams and ovules may weaken certain forms of contraception.
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Tinidazole
- Potential side effects: metallic taste in the mouth, loss of appetite, vomiting, nausea, constipation, stomach pain or cramping, tiredness, dizziness, headache
It’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:
- 2 g orally once per day for 2 days
- 1 g orally once per day for 5 days
Pros
- easy to take
- short course
- lower cost than other prescription options
Cons
- potential side effects
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Secnidazole
- Potential side effects: nausea and vomiting, diarrhea, headache, metallic taste in the mouth
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 dose is one dose of 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 good option if you prefer a single-dose treatment.
Pros
- requires a single dose
- easy to mix into food
Cons
- expensive
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Probiotics
- Potential side effects: mild gastrointestinal side effects
Probiotics are good bacteria. Taking probiotic supplements may help introduce healthy bacteria into your body.
According to a 2019 review of 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 more recent 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 the:
- right dose
- strain
- length of treatment
- whether probiotics should be paired with antibiotics
If you’ve been prescribed an antibiotic for BV, bear in mind that antibiotics can kill off the good bacteria as well as the bad. Probiotic supplements and yogurt can help replace good bacteria that are 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:
- pharmacies
- health food stores
- stores that sell supplements
- online
Pros
- cost-effective
- limited side effects
- may help prevent and treat BV
- available in fermented food, pill, or liquid form
Cons
- not as effective as other methods
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Garlic
- Potential side ef f ects : burning if inserted vaginally
Garlic has strong antibacterial properties, and it’s long been used as a home remedy for BV.
For BV treatment, take garlic orally. Taking it vaginally has been known to burn vaginal tissue.
A 2020 review 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.
Pros
- natural option
- no prescription required
- inexpensive
Cons
- not as effective as prescription options
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Boric acid suppository
- Potential side effects: allergic reaction, vaginal irritation
Boric acid vaginal suppositories are commonly used to treat BV, according to a 2019 review . According to the review, 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. It’s also not safe to use if you’re pregnant. However, it’s considered safe to use boric acid in the vagina.
Pros
- safe to use as a vaginal suppository
- as effective as some medical treatments
Cons
- potential for allergic reaction or irritation
- not safe to use during pregnancy
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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:
Share on Pinterest bacterial vaginosis infographic by Maya Chastain
Although BV can clear up on its own, there are times when it can get worse without treatment. This can increase the risk of health complications, including:
- contracting HIV if exposed to the virus
- contracting sexually transmitted infections (STIs)
- experiencing complications during pregnancy
- premature delivery if you’re pregnant
- developing pelvic inflammatory disease (PID)
- developing fertility problems due to STIs and PID
- having less success with in vitro fertilization (IVF) treatment
If your symptoms haven’t resolved or started to clear up after a week of treatment, you can make an appointment with a doctor or gynecologist.
Also, contact a doctor if you have:
- recurring BV
- new or worse vaginal discharge
- new or worse itching
- vaginal sores
- fever
Consider making an appointment on a day 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 in your area using our Austra Health FindCare tool.
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 another person with a vagina, the partner may need treatment.
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 your symptoms in 2 to 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:
- clindamycin
- metronidazole
- tinidazole
Can bacterial vaginosis go away on its own?
It’s possible for BV to 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, your symptoms will likely improve within 2 to 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 that the infection has completely cleared up, which typically takes 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.
What is the difference between a yeast infection and bacterial vaginosis?
BV and vaginal yeast infections (candida) 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:
- ask about your medical history, including previous vaginal infections
- perform an examination to look for signs of infection and vaginal discharge
- take a sample of the discharge for analysis, to see whether an overgrowth of harmful bacteria or fungi is present
- test the pH of the vagina — according to a 2018 review, a pH of 4.5 or above can be an indication of BV
Can I really treat BV without antibiotics?
If you can’t use or access antibiotics, certain home remedies — namely probiotics, garlic, and boric acid suppositories — could treat BV. However, some studies indicate that these home remedies aren’t as effective as antibiotic treatment.
Although mild cases of BV may resolve on their own, 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 your symptoms might get better within a few days, be sure to take all your medication as directed. This will ensure that your infection has completely resolved. If you have recurring BV, work with a doctor to find long-term solutions.
How we reviewed this article:
Austra Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
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