Vagina itchy after sex: 6 causes and how to treat them
7 Best Bacterial Vaginosis (BV) Treatments, FAQs, And More
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.
BV commonly affects people with a vagina between ages 15 and 44. Typically, it develops in people who are sexually active.
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, 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 this survey is older, it 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 4–74% of women, according to research from 2022. Bacterial vaginosis is most common in parts of Africa and least common in Asia and Europe.
Here are the top causes and treatments for bacterial vaginosis plus tips for how to prevent bacterial vaginosis.
SymptomsAn excess of bad bacteria throws the vaginal environment out of balance, resulting in symptoms like:
In some cases, BV causes no symptoms. Experts don't know exactly what causes BV.
CausesAccording to the CDC, BV is more common in people who are sexually active. 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 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.
Factors that may increase your risk of BV include:
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 doing 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 they are not always accurate. These tests check for symptoms of BV, like changes in vaginal acidity and by-products 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 treatment.
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 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 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, 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.
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. 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. Also, it has been associated with other serious health complications.
ConsiderationsIf 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.
Recurring BVRecurring BV is common. Even with 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 partner, according to the CDC. But research has not yet determined the effectiveness of treating people with a vagina to prevent BV recurrence.
Other possible causes of recurrence include:
If 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.
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 2–3 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.
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 2–3 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 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.
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 2018 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 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 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. If you have recurring BV, you can work with a doctor to find long-term solutions.
Drugs For Treatment Of Vaginitis
This section is a comprehensive directory of medications for Vaginitis, listing both generic and brand names. It's a useful resource for healthcare professionals and individuals seeking medication information. Click on a medication below to view details including brand names, prices, dosages, side effects, and administration guidelines. Additionally, a FAQs section is available for each medication, addressing inquiries and providing deeper insights into its use for Vaginitis management. We recommend consulting your doctor to verify the information presented on this page or if you need any further clarifications. Brand Names and Generic Names of Drugs for Treatment of Vaginitis Amoxicillin and Clavulanic acidAmoxicillin and Clavulanic acid is a combination of β-lactam antibiotic, and a β-lactamase inhibitor (potassium clavulanate) prescribed to treat infections of the ears, lungs, sinus, skin, and urinary tract.
ButoconazoleButoconazole is an imidazole antifungal, prescribed for candidiasis (yeast infection of the vagina).
CaspofunginCaspofungin is an antifungal drug, prescribed for serious fungal infections.
Trade Names :
CefditorenCefditoren is a third-generation cephalosporin antibiotic, prescribed for certain bacterial infections.
Trade Names :
Ciprofloxacin and TinidazoleCiprofloxacin and Tinidazole contains antibacterial and antidiarrheal agents, prescribed for susceptible infections.
Trade Names :
More... ClindamycinClindamycin is an antibiotic, prescribed for certain types of bacterial infections, including infections of the lungs, skin, blood, female reproductive organs and internal organs.
Trade Names :
More... DequaliniumDequalinium is an antiseptic which helps in killing many gram-positive and gram-negative bacteria and fungi.
Trade Names :
DienestrolDienestrol is a synthetic estrogen, prescribed for atrophic vaginitis (vaginal inflammation) and kraurosis vulvae.
Trade Names :
FaropenemFaropenem is an oral carbapenem, beta-lactam antibiotic which is used for the treatment of upper and lower respiratory tract infections, urinary tract infections, skin infections, and gynecological infections.
Trade Names :
FluconazoleFluconazole is an antifungal agent, prescribed for vaginal candidiasis, pneumonia, meningitis and fungal infections of the mouth, throat, liver, kidneys, heart, urinary tract and abdomen.
Trade Names :
More... HamycinHamycin is a polyene antimycotic organic compound, prescribed for oral thrush, and vaginal infections.
Trade Names :
MetronidazoleMetronidazole is an antibacterial agent, prescribed for trichomoniasis, amebiasis and other bacterial infections.
Trade Names :
More... MicafunginMicafungin is an antifungal agent, prescribed for fungal infections.
MiconazoleMiconazole is an anti-fungal agent, prescribed for various skin infections such as athlete's foot and jock itch and also for vaginal yeast infections.
Trade Names :
More... Neomycin TopicalNeomycin Topical is an antibiotic, prescribed for fungal or viral infections.
Trade Names :
NystatinNystatin is a polyene antifungal drug, prescribed for fungal infections of the skin, mouth, vagina and intestinal tract.
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Procaine- PenicillinProcaine- Penicillin is an antibiotic, prescribed for many bacterial infections.
TerconazoleTerconazole is an antifungal agent, prescribed for fungal infections of the vagina.
Trade Names :
TinidazoleTinidazole is an anti-parasitic, prescribed for trichomoniasis, giardiasis, bacterial vaginosis, and amebiasis.
Trade Names :
More... TioconazoleTioconazole is an antifungal agent, prescribed for vaginal yeast infections.
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Triple SulfaTriple Sulfa is an antibacterial agent, prescribed for vaginal infections.
VoriconazoleVoriconazole is an azole antifungal agent, prescribed for various fungal infections.
Trade Names :
More...Related Drugs by Medical Condition
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Bacterial Vaginosis And HIV
Key pointsBacterial vaginosis (BV) is a condition which occurs when the normal balance of bacteria in the vagina becomes disrupted. This can result in an over-growth of certain bacteria, which can be accompanied by unpleasant symptoms.
It is a very common condition and can affect any woman or person with a vagina. It is not a sexually transmitted infection (STI) and is easily treated with antibiotics.
Having bacterial vaginosis increases your risk of acquiring HIV and STIs including herpes, human papillomavirus (HPV), chlamydia and gonorrhoea. For people living with HIV, having bacterial vaginosis increases the risk of passing on HIV during sex and childbirth. However, this is not the case if you are receiving HIV treatment and have an undetectable viral load.
Causes of bacterial vaginosisWhat causes the imbalance of bacteria in the vagina which leads to bacterial vaginosis is not fully understood. Since you can develop bacterial vaginosis without having ever had sex it is not classified as an STI, but sexual activity appears to increase the likelihood of developing it. For reasons that remain unclear, there are higher rates of bacterial vaginosis among lesbian, bisexual and other women who have sex with women than among heterosexual women.
These activities can increase the risk of developing bacterial vaginosis:
Bacterial vaginosis is common during pregnancy.
These activities can reduce the risk of developing bacterial vaginosis:
Studies have also shown a reduced risk of bacterial vaginosis in women whose male sexual partners are circumcised.
SymptomsBacterial vaginosis is often asymptomatic, meaning you experience no symptoms at all. When they do occur, symptoms can include changes to vaginal discharge, including turning grey or whitish, watery or developing a fishy smell. This may be worse after sex.
Bacterial vaginosis is not usually associated with itchiness, irritation, sores, blisters, or vaginal bleeding. If you have any of these symptoms, seek advice from your GP or sexual health clinic.
DiagnosisIf you think you have bacterial vaginosis, you can go to your GP or a sexual health clinic. A doctor or nurse will examine you to look for signs of bacterial vaginosis. They may be able to diagnose bacterial vaginosis straight away because of the distinctive appearance of the discharge.
If not, they will probably use a swab to collect a sample from your vagina. A swab looks like a cotton bud and collecting a sample only takes a minute or two. It shouldn't be painful, but it may feel a little uncomfortable. The sample will then be sent to a lab for testing and you should get your results within a few days.
They may also test you for sexually transmitted infections if the symptoms are similar.
Sexual health screens are freely available from NHS genitourinary medicine (GUM) and sexual health clinics. Many HIV clinics also provide sexual health screens and tests for bacterial vaginosis as part of their routine care.
TreatmentBacterial vaginosis sometimes goes away by itself as the balance of bacteria in the vagina corrects itself. If bacterial vaginosis is not bothering you, it is not always necessary to have it treated. However, it can increase the chance of acquiring HIV or passing it on if you have a detectable viral load. Treatment for bacterial vaginosis is recommended if you have a different HIV status from your partner and one of you has a detectable viral load.
Glossary bacterial vaginosisA condition caused by the overgrowth of certain species of the bacteria that are normally present in the vagina.
symptomAny perceptible, subjective change in the body or its functions that signals the presence of a disease or condition, as reported by the patient.
sexually transmitted infections (STIs)Although HIV can be sexually transmitted, the term is most often used to refer to chlamydia, gonorrhoea, syphilis, herpes, scabies, trichomonas vaginalis, etc.
detectable viral loadWhen viral load is detectable, this indicates that HIV is replicating in the body. If the person is taking HIV treatment but their viral load is detectable, the treatment is not working properly. There may still be a risk of HIV transmission to sexual partners.
It is also important to be treated if you are going to have a surgical procedure that involves going through the neck of your womb (the cervix). If bacterial vaginosis is transmitted from the cervix into the womb during a procedure, you can develop a serious condition called pelvic inflammatory disease.
If you are pregnant or thinking about becoming pregnant, you may also want to be treated. There is some evidence that bacterial vaginosis can increase the risk of premature birth, especially if you have had a miscarriage, premature baby or baby with a low birth weight before. There is also a greater risk of passing on HIV to a baby during delivery. You can safely take treatment during pregnancy.
If you have a same-sex partner, your doctor or nurse may also recommend that they are treated.
Treatment is with antibiotics, usually either metronidazole or clindamycin. It can be given as tablets (a single larger dose or doses over seven days) or a vaginal gel over five to seven days. It is important that you take all the treatment prescribed to you. You will need to avoid alcohol during treatment and for 48 hours after you have finished it, as it will make you feel very sick.
There is a lot of information online about complementary therapies to prevent or treat bacterial vaginosis, such as probiotics. However, the evidence of their effectiveness is inconclusive and therefore their use is not recommended by clinicians.
It is common for bacterial vaginosis to recur after treatment, so you may require another course of treatment at a later date. If you have frequent bouts of bacterial vaginosis, your doctor may recommend preventive treatment with antibiotics.
Using condoms can help reduce the risk of bacterial vaginosis recurring. The vaginal gel can weaken latex, so you will need to use non-latex condoms while using this treatment.
Acknowledgements
Thanks to Dr Phillip Hay for his advice.
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