What Is Bacterial Vaginosis? Symptoms, Causes, Diagnosis, Treatment, and Prevention - Everyday Health

Women with symptoms of BV should be treated for the infection, not only to relieve symptoms but also to prevent complications.

Medication Options

Recommended medication treatment options include:

  • Metronidazole, 500 milligrams (mg), orally twice a day for seven days, or
  • Metronidazole gel, 0.75 percent, one full applicator inserted vaginally, once a day for five days, or
  • Clindamycin cream, 2 percent, one full applicator inserted vaginally at bedtime for seven days.

Other medical treatments include:

  • Tinidazole, 2 grams (g), orally once a day for two days, or
  • Tinidazole, 1 g, orally once a day for five days, or
  • Clindamycin, 300 mg, orally twice a day for seven days, or
  • Clindamycin ovules, 100 mg, inserted vaginally at bedtime for three days

Alternative and Complementary Therapies

During treatment and for 24 hours after completion of treatment, alcohol should be avoided while taking metronidazole or tinidazole. Women should refrain from sexual activity or use condoms during treatment; but clindamycin cream, which is oil-based, may weaken latex condoms and diaphragms for five days after use.

While some studies have evaluated the use of vaginal suppositories containing lactobacillus or other probiotic formulations to treat BV, there's no evidence supporting these as a replacement therapy in women with BV.

Even after treatment, it's not uncommon for BV to persist or recur for reasons that aren't entirely understood. Research published in the Journal of Infectious Diseases found that 58 percent of women who were treated for symptomatic BV had a recurrence within a year.

To effectively treat recurrent BV, your doctor may prescribe an extended course of antibiotics.

Prevention of Bacterial Vaginosis

Researchers don't understand exactly how BV spreads, but there are some measures that may lower your risk. First, take steps to keep the bacterial populations in your vagina balanced by using only warm water to wash, avoiding soap, wiping only from front to back when you're using the toilet, and wearing cotton or cotton-lined underpants. Avoid vaginal deodorants and douching, which upset the balance of good to harmful bacteria in ways that may increase your risk of developing BV. It also may help to limit your number of sex partners and to use condoms, because experts think your risk of getting BV increases with the number of partners you have.

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