Our 8 Picks for At-Home Bacterial Vaginosis Tests of 2023
Best Bacterial Vaginosis (BV) Medications In 2023
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Bacterial vaginosis (BV) is a vaginal infection. Antibiotic medication may help treat BV and reduce symptoms. Some antibiotics can cause side effects, and some BV drugs have warnings from the Food and Drug Administration (FDA).
The Centers for Disease Control and Prevention (CDC) reports that BV is the most common vaginal condition in people ages 15–44 years.
This article discusses the different medications available for BV, the antibiotics that doctors may prescribe, and frequently asked questions that people may have for a doctor treating BV.
Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.
Medical News Today follows a strict product selection and vetting process. Learn more here.
Antibiotic medications that doctors can prescribe for people with BV include:
People can take metronidazole tablets twice daily for 7 days or a single tablet as a one-time dose.
People taking metronidazole should not consume alcohol while taking the medication or for at least 1 day after the treatment course has ended. Consuming alcohol while taking metronidazole can cause:
The FDA has issued a black box warning indicating that metronidazole has caused cancer in studies using rats and mice. As a result, the FDA advises that healthcare professionals should only prescribe this drug if other medications have not worked, especially if a person is pregnant.
Where to get metronidazoleA person can purchase metronidazole through the online pharmacy Plushcare. The company does not state the exact cost of the product and says this varies between pharmacies and based on dosage.
However, membership to Plushcare costs $14.99 per month, plus copay for every visit with insurance. Without insurance, a person pays $129 for the first visit and $99 for visits afterward.
Doctors send Plushcare prescriptions to a person's local pharmacy.
Metronidazole vaginal gelA person may also use metronidazole as a gel, which that apply to the vagina via an applicator.
People who find swallowing tablets difficult may prefer to use this gel. However, a doctor may not recommend this gel if the person is menstruating. The drug's prescribing information also states that it may not be suitable for people with health conditions affecting the central nervous system. There have not been any studies looking at the cancer risk of metronidazole vaginal gel.
Where to get metronidazole gelPeople may receive a prescription and purchase metronidazole gel from Nurx, an online pharmacy. The cost varies depending on the local pharmacy from which a person will pick up the prescription.
A person must pay a $65 medication consultation fee, which includes one week of unlimited medical care.
Clindamycin (Cleocin)Clindamycin stops or slows the growth of bacteria.
Clindamycin is available as a cream, which doctors may prescribe if a person's symptoms keep returning or they do not improve with metronidazole.
Clindamycin comes as a single, prefilled applicator containing 5 grams (g) of the medication that a person inserts into their vagina every night for up to 7 days.
The CDC suggests that people avoid using latex and rubber condoms during treatment and for 5 days after use. This is because clindamycin cream contains mineral oil, which may weaken latex condoms or diaphragms.
Studies on the efficacy of clindamycin have shown that most people do not experience any BV symptoms 1–2 weeks after using the cream.
Where to get clindamycin creamClindamycin cream is available to purchase from Wisp, an online pharmacy. Once a doctor provides a prescription, a person can receive free delivery of their medication in 3–5 days or collect their order on the same day from a local pharmacy. The cost of clindamycin may vary between pharmacies.
People can choose whether to purchase this once or as part of a subscription. It costs $120 for a one-off treatment or $33 a month with a subscription for those who experience regular infections.
TinidazoleTinidazole is available as a single-dose tablet.
A 2019 study of tinidazole and metronidazole involving 90 females found that tinidazole is more effective than metronidazole in treating BV. Tinidazole also has fewer side effects than metronidazole.
Where to get tinidazoleTinidazole is available via Blink Health, an online pharmacy that offers discounted prices on a wide range of medications. People must search for a medication and pay online. They can choose to collect their prescription from any of Blink Health's participating pharmacies or opt for home delivery.
Blink Health will send a person a Blink Health card to show at the pharmacy so they do not pay twice. At the time of publication, tinidazole costs around $45 through Blink Health, although this may vary between pharmacies and locations.
BV occurs when there is an imbalance of the vaginal flora, which are types of bacteria that naturally live inside the vagina.
BV can occur in anyone with a vagina, but a person may be at an increased risk of developing BV if they:
Research also mentions that people with BV may have a higher chance of contracting an STI.
Recurrent BV is when a person continues to have symptoms 12 months after their initial treatment.
Up to 80% of people will experience recurrent BV. Usually, a healthcare professional will prescribe a second course of antibiotics if a person still has symptoms after the initial treatment.
A 2020 review notes that metronidazole and clindamycin are two effective antibiotics for BV. However, they may only work for short-term use. Additionally, frequent use of antibiotics can cause antibiotic resistance and thrush.
Older research suggests that home remedies, such as probiotics, salt baths, and frequent showers, have little to no effect on BV symptoms. However, a 2022 meta-analysis found that probiotics may be an effective short and long-term treatment for BV.
That said, more research is necessary.
Find out more about home remedies for BV.
A person might consider contacting a doctor if they have unusual vaginal discharge, a fever, or both.
Only 30% of BV cases resolve without medical treatment. People should speak with a healthcare professional as soon as possible after symptoms occur and if their symptoms do not improve within a few weeks.
If BV symptoms return, a healthcare professional may recommend a longer course of treatment.
A person should also consult a doctor if their symptoms worsen during BV treatment or if they experience medication side effects.
How doctors diagnose BVTo diagnose BV, a doctor or another healthcare professional may:
They will recommend a treatment approach based on the history, exam, and test results.
How to prepare for a doctor's appointmentPeople may wish to prepare a list of their symptoms, any medications, over-the-counter (OTC) treatments, or supplements they are taking, and consider a note-taking device for their appointment.
It may also be helpful if a person takes a list of questions they wish to ask the healthcare professional. Example questions include:
People can lower their risk of BV by:
Below are answers to common questions about BV medications.
What is the best medication for BV?The best medications for BV are topical or oral antibiotics. Each requires a prescription from a healthcare professional.
Can you get rid of BV without going to the doctor?BV can sometimes resolve on its own. However, up to 80% of people will get recurrent BV infections, and the CDC recommends people speak with a doctor as soon as possible.
Recent research does not suggest that home remedies are particularly effective for BV.
Is bacterial vaginosis an STI?BV is not an STI. However, the CDC states that BV is more common in sexually active individuals and that having BV increases a person's risk of developing STDs.
BV occurs when there is an imbalance of bacteria in the vagina. BV does not always cause symptoms, but if they do occur, a person can seek a doctor's advice to receive a diagnosis and start a course of treatment.
A doctor may prescribe antibiotics to treat BV. If antibiotics are not effective, a doctor may recommend another treatment plan.
Those with BV cannot purchase medication without a prescription. However, a person can consider using home remedies to help treat BV and potentially reduce the chances of BV developing.
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.
What Causes Burning In The Vagina?
1. Irritation
Certain things can irritate the skin of the vagina when they come into direct contact with it. This is known as contact dermatitis.
Irritants that can cause contact dermatitis include soaps, fabrics, and perfumes. As well as burning, other signs and symptoms include:
The main treatment for irritation is to avoid whatever is causing it. Avoiding the irritant and not itching the area allow the skin to heal. Sometimes, a person may require medication.
2. Bacterial vaginosis
Bacterial vaginosis (BV) is a condition that occurs when there is too much of a certain type of bacteria in the vagina, affecting the normal balance. According to the Centers for Disease Control and Prevention (CDC), BV is the most common vaginal infection in women ages 15–44.
One symptom of BV is a burning sensation in the vagina, which can also occur when urinating.
BV does not always cause symptoms. When it does, symptoms can include:
Having BV can increase a person's risk of contracting a sexually transmitted infection (STI). If someone develops symptoms of BV, they should be checked and treated by a doctor. Treatment for this condition will often involve a course of antibiotics.
3. Yeast infection
An infection in the vagina caused by yeast can lead to a burning sensation. The medical term for this is candidiasis, and it is also known as thrush.
Associated symptoms include:
Many women get yeast infections, but some women are more likely to develop an infection if they:
Treatment is usually an antifungal medicine, which a woman can either apply directly in the form of a cream or take orally as a capsule.
4. Urinary tract infection
Different parts of the urinary tract can become infected, including the bladder, urethra, and kidneys.
A woman with a urinary tract infection (UTI) will likely feel burning in the vagina when urinating. Other symptoms of a UTI include:
Doctors will usually prescribe antibiotics to treat urinary tract infections. In general, an infection will clear up in around 5 days after starting a course of antibiotics.
Repeat prescriptions may be required if an infection returns.
5. Trichomoniasis
Also known as trich, this is a very common STD in the United States. Trichomoniasis is caused by a parasite that is passed from one person to another during sexual intercourse.
Only around 30 percent of people with trich show any symptoms. As well as a burning sensation in the vagina, these symptoms may include:
Trichomoniasis is treated using metronidazole or tinidazole, which are pills taken by mouth.
6. Gonorrhea
Gonorrhea is an infection where bacteria called Neisseria gonorrheae infect mucous membranes, such as the cervix, uterus, and fallopian tubes. It is typically transmitted through sexual contact with someone who has the infection.
This STD is particularly common in people aged 15 to 24. Women can experience vaginal burning when urinating, as well as these symptoms:
Gonorrhea can be cured with the right medical treatment.
7. Chlamydia
Chlamydia is caused by the bacteria Chlamydia trachomatis and is typically transmitted through sexual contact with someone who has the infection.
Research suggests that at least 70 percent of people with chlamydia experience no symptoms, which is why the condition is sometimes known as a "silent" infection.
When symptoms do occur, they can include a burning sensation in the vagina, as well as:
Chlamydia is treated using antibiotics. The most commonly prescribed is doxycycline.
8. Genital herpes
Genital herpes is caused by skin-to-skin contact with a person with the herpes virus. It is estimated that around 1 in 6 people in the U.S. Aged 14 to 49 have genital herpes, and women are more prone to infection than men.
Once a person has the virus, it stays with them for life. However, they may not develop any signs or symptoms until the virus becomes active.
If the virus becomes active, they might experience a burning sensation in the vagina. Other symptoms include:
Painful sores, blisters, or ulcers may also develop after a few days.
The symptoms of genital herpes can be treated with antiviral medication but never cured.
9. Menopause
The shifting levels of hormones in a woman's body before she enters menopause can affect the vagina. Vaginal burning is one possible result of these changes, especially during sex.
Other common symptoms of menopause transition include:
Not all women entering menopause have treatment to relieve symptoms, but there are often options available that a doctor can outline, including hormone therapy.
10. Genital contact allergies
The immune systems in some women can become hypersensitive to certain substances.
These substances can cause allergic irritation when they come into contact with the vagina, including:
Treatment mainly involves avoiding the substance that is causing the irritation. Patch testing using the suspected allergen to stimulate a controlled reaction in a clinical setting can help to identify which substance is creating the burning sensation.
Below are some commonly asked questions on vaginal burning:
Why does down there feel like it's burning?Infections and STDs, such as bacterial vaginosis, candidiasis, gonorrhea, and chlamydia, can cause a burning sensation in the vagina. Irritants and the menopause may also cause this.
How can I stop the burning down there?Applying an ice pack or cold compress to the affected area can help reduce the burning sensation. Applying petroleum jelly to the skin can also help protect it. However, depending on the cause, a person may also require medical treatments.
What does BV burning feel like?Symptoms of bacterial vaginosis include pain, itching, or burning in the vagina. This burning may also occur when peeing.
Which infection causes a burning sensation?A burning sensation in the vagina can be symptomatic of bacterial vaginosis, a yeast infection, a urinary tract infection, or an STI.
What is vulvar burning?Vulvar burning refers to a burning sensation in the vulvar. This can happen due to conditions such as:
A doctor can help a person determine the cause of vulvar burning and advise on suitable treatments.
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