Vulvitis (Vulvar Itching): Causes, Symptoms & Treatment
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:
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:
Although you can't always prevent BV, you can take the following precautions:
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:
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.
ClindamycinClindamycin is another effective prescription treatment for BV. It's an antibiotic that you can take as:
An ovule suppository is a capsule that's inserted into 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 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.
ProbioticsProbiotics 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:
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:
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.
Boric acid suppositoryBoric 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.
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. This can increase the risk of health complications, including:
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:
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 Healthline 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:
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:
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.
Ask The Expert: Can Bacterial Vaginosis Clear Up On Its Own?
Bacterial vaginosis (BV) can clear up on its own. However, if you're experiencing symptoms, see your doctor. This is especially true if you're pregnant. Having BV can increase your chance of having a preterm birth.
It's common for BV to come back. Some people may be more prone to getting BV, which is likely related to their body chemistry and vaginal environment. BV may clear up and come back, or it could be that it never completely cleared in the first place.
Talk with your doctor about some lifestyle changes you can make or if you're a candidate for medication to prevent BV.
BV is caused by an imbalance of the bacteria in the vagina. The reason for this shift is not well understood, but it's likely related to changes in the vaginal environment. For instance, you may be often more prone to getting BV if you don't change into clean clothes after a workout or if you douche. The most common bacterial overgrowth is Gardnerella vaginalis.
For some people, BV doesn't always result in symptoms. For people who do experience symptoms, they can include:
According to the Centers for Disease Control and Prevention (CDC), BV is the most common vaginal infection in women between the ages of 15 and 44.
BV is not a sexually transmitted disease. However, if you're sexually active, you might have an increased chance of developing BV. Having BV can also increase your chance of getting other sexually transmitted infections.
Aside from having some uncomfortable symptoms, BV doesn't usually cause any serious health problems for most healthy people.
Some people who get BV might need more attention. If you're pregnant, having BV can increase the chance of preterm birth or your child having a low birth weight. Or, if you're planning to undergo a gynecologic procedure, having an active episode of BV can increase your chance of infection. For these types of people, it's important to let your doctor know if you're experiencing symptoms so you can get treated.
There's a diverse population of microorganisms in the vagina. This is typical. An overgrowth causes BV, most commonly of Gardnerella vaginalis — just one kind of bacteria commonly found in the vagina.
An overabundance of yeast species causes a yeast infection. Symptoms commonly include a thick, white vaginal discharge, or itching. It's not associated with an odor.
Sometimes it can be hard to tell whether you have BV or a yeast infection based on symptoms alone. If you're not sure, make an appointment with your doctor.
If you live in the United States, BV is usually treated with antibiotics that require a prescription. The common antibiotics are metronidazole or clindamycin, although there are others that are less commonly used. In the United Kingdom, there are some non-prescription gels and creams available over-the-counter (OTC) to treat BV.
There's medication in the form of an oral pill, a gel, or a suppository to be placed in the vagina. You shouldn't consume any alcoholic beverages while taking metronidazole, and for 24 hours after the last dose. Doing so can cause you to have an adverse reaction to the medication.
Since the exact cause of BV isn't well understood, it's hard to pinpoint how to prevent it. However, using a condom or other barrier method during sexual activity can lower your chance of getting BV.
You should also avoid douching, since it can wipe out the bacteria that help keep the balance in the vagina. Along these lines, it's helpful to maintain a healthy vaginal environment.
You should call a doctor if you have:
Carolyn Kay, MD, is an obstetrics and gynecology surgeon whose special interests include reproductive health, contraception, and medical education. Dr. Kay earned her Doctor of Medicine from the State University of New York. She completed her residency at Hofstra Northwell School of Medicine in New Hyde Park.
Feminine Wash: Yea Or Nay? An OB-GYN's Verdict On Cleaning "Down There"
© Provided by Scary Mommy You can't browse your local drugstore or open up your social feeds these days without seeing some new "feminine hygiene" products in kitschy packaging designed to make your vagina smell like rainbows and butterflies or some sh*t.
If all that clever marketing has you wondering whether or not you actually do need specially scented or formulated soaps, washes, wipes, lotions, or creams to keep things feeling and smelling fresh down there, you're not alone. We asked an OB-GYN to spill the dirty truth about whether or not those products are necessary, and you'll be low-key relieved by what she had to say.
Anatomy of the VFirst, a quick anatomy refresher. Though plenty of us refer to everything down south as the vagina, it's worth being medically accurate when discussing what parts should be cleaned and which ones should never be cleaned. The vagina refers to the inner canal inside your body, and you never want to use products internally to clean your inner genitalia. More on that in a sec.
The vulva includes everything external around the vagina, including the clitoris, clitoral hood, and inner and outer labia (aka the vaginal lips). Staying on top of your vaginal health — including what it looks like, smells like, and if you notice anything abnormal or painful — is important. Unfortunately, these trendy products successfully tap into a patriarchal moral panic over the state of our vaginas and what we've been told they "should" look, smell, and feel like.
Keepin' It Squeaky: Yea or Nay?OK. Now that we've, ahem, stepped off our soapbox, do we need this sh*t, yes or no? The answer is a resounding no, as Dr. Amy Wetter, board-certified OB-GYN at Pediatrix Medical Group, tells Scary Mommy.
First, the inside scoop: "The vagina is a self-cleaning area, and if you upset the balance of normal bacteria by using scented products, you can actually change the pH and cause other issues like bacterial vaginosis (BV) to develop," says Wetter. "The vagina itself does not need to be cleaned because of the normal and physiologic bacteria and discharge that does this for you. If you clean the vagina, you will upset the balance of bacteria and discharge, which will change the pH of the vagina and can lead to depletion of Lactobacilli that keeps your vagina healthy. An acidic vagina keeps the normal bacteria in check, which helps to prevent bacterial vaginosis, yeast infections, and irritation."
What about the vulva, which can get sweaty and feel generally funky sometimes? According to Wetter, you still want to keep things super simple. "The quick answer is these products are generally safe as long as you don't have an allergic reaction, but the special scented products are typically not beneficial."
The TL;DR here, folks: "You should wash your vulva with warm water using a mild soap that is free of dyes and fragrance." That's it — nothing fancy or flower-scented. Just a gentle wash every now and again, and you're good to go.
If Something Doesn't Seem RightSo now that we've emphasized that douching, detoxing, bleaching, steaming, or any other trendy method of cleaning your vagina is unnecessary at best (and downright harmful at worst), how do you know when something doesn't look, smell, or feel right? "It is normal to have a daily discharge, and no vagina is odorless," reminds Wetter. "The smell of your vagina might change based on other factors like your menstrual cycle, diet, and sexual activity. Also, the clear and white discharge you see is the natural lubrication your vagina makes to keep it healthy."
"If you have burning, inflammation, discharge that is discolored with a 'fishy' odor, excessive discharge, pain with sex/urination, blisters/sores/warts, persistent itching, unexplained vaginal bleeding, or a significant change in your discharge, I would recommend making an appointment with your OB-GYN for evaluation," she says.
Otherwise, good old H2O (and a minimal swipe of gentle soap, if you must) is genuinely all you need to keep things happy and healthy down below.
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