Bacterial Vaginosis: Symptoms, Causes, and Treatment
Bacterial Vaginosis Is The Most Common Vaginal Infection In Women — Here's What You Need To Know
Experts explain what cause bacterial vaginosis and how to treat it. (Photo: Getty Images) (Getty Images/iStockphoto)
Bacterial vaginosis (BV) is the most common vaginal infection in women. According to the Centers for Disease Control and Prevention (CDC), the condition affects nearly 30% of women between 15 and 44 years old. However, BV disproportionately impacts Black women, who have an estimated infection rate of more than 50%.
BV occurs when there's an overgrowth of bacteria, according to the Mayo Clinic, which throws off the natural pH balance of the vagina.
What causes bacterial vaginosis?Bacterial vaginosis is most often caused by an overgrowth of a common type of bacteria called gardnerella vaginalis. Certain risk factors, such as douching, can disrupt the balance of "good" and "bad" bacteria in the vagina, leading to this overgrowth.
BV can happen to anyone with a vagina, even if you're not sexually active. However, occurrence in those who are not sexually active is rare.
You're at higher risk for getting BV if you're pregnant; have a new sex partner, a female sex partner or multiple sex partners; don't use condoms or dental dams; use douches; or have an intrauterine device (IUD).
There is no foolproof way of avoiding bacterial vaginosis. But you can reduce your risk by not douching, limiting sex partners, using latex condoms or dental dams and wearing cotton or cotton-lined underwear.
What are the symptoms?Dr. Jennifer Wider tells Yahoo Life, "Sometimes there are no symptoms, but if there are, the most common include an off-white, gray or greenish, watery vaginal discharge [and] a 'fishy' odor that can be strongest during the period or after sex. A less common symptom is itchiness or soreness."
Dr. Kecia Gaither, director of perinatal services at NYC Health + Hospitals/Lincoln in the Bronx points out to Yahoo Life that some people think bacterial vaginosis is a sexually transmitted infection, "hence the stigma," she says. "But it is not."
However, BV can increase your risk of getting a sexually transmitted infection, such as chlamydia or gonorrhea, according to the CDC. That, in turn, can lead to pelvic inflammatory disease. Having BV when you're pregnant also increases the risk of preterm birth (before 37 weeks of pregnancy).
BV is sometimes mistaken for other conditions like a non-viral STI called trichomoniasis, as well as other bacterial infections including chlamydia and gonorrhea.
According to Cleveland Clinic, the most common mix-up occurs between bacterial vaginosis and yeast infections because both are bacterial infections that cause increased discharge. However, there are notable differences between the two infections: discharge with bacterial vaginosis has a fishy smell and is watery in consistency, while discharge from a yeast infection is thick and white with a cottage cheese-like appearance and there isn't a strong odor.
Typically, BV doesn't cause irritation or itchiness, but a yeast infection will. Finally, yeast infections can be treated with over-the counter-medications or with an antifungal medication, while you will need prescription antibiotics for bacterial vaginosis.
How do you treat bacterial vaginosis?The good news is that bacterial vaginosis is curable. The infection is diagnosed through a sample of vaginal fluid taken through a gynecological exam and sent to a lab. After diagnosis, treatment usually involves a seven-day course of antibiotics. Gaither explains that "multiple therapeutic medications have been utilized for treatment like metronidazole, clindamycin and tinidazole."
However, not finishing the full course of antibiotics can trigger a relapse, according to the U.S. Department of Health and Human Services. Also, in a small percentage of cases, people may need a second treatment. Unfortunately, research shows that BV has a high rate of recurrence — a 2021 study found that BV will recur within six months in more than 50% of cases.
Bacterial vaginosis is thankfully considered a mild infection, but it can make you susceptible to more serious health conditions. If you experience any of the symptoms, don't delay seeing your medical provider.
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How To Treat Recurrent Bacterial Vaginosis, According To Ob-Gyns
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Imagine this: You're on a tropical getaway…but between the persistent vaginal itching and irritation you're feeling, you're in sweatpants instead of a bikini. Recurrent bacterial vaginosis doesn't care about your plans, whatever your life looks like at the moment. If you're dealing with symptoms like fishy odor, watery gray discharge and burning, pain, or irritation of the vulva, and this isn't the first time you've experienced these issues recently, it's likely you have a bacterial vaginosis (BV) infection that won't quit.
BV can commonly recur, especially if you never really treat the underlying cause, which is an overgrowth of the bacteria Gardnerella vaginalis. It's naturally found in the vagina and doesn't always cause problems—but sometimes, it can get too feisty.
Here, ob-gyns share everything you should know about recurrent BV and how to kick it to the curb for good.
What causes recurrent BV?If you tend to have three or more BV infections in a year, that's the threshold for recurrent bacterial vaginosis, Suzanne Bovone, MD, a board-certified ob-gyn at Pediatrix Medical Group in San Jose, California, tells SELF. For the infections to warrant an official diagnosis of recurrent BV, they all need to be confirmed by a lab or your doctor, Dr. Bovone says.
There are a few reasons BV infections can recur, but it's not unusual for BV to come back a few times. One study found that 58% of cases among the 121 participants recurred even after treatment. Stubborn cases along those lines are often not the person going through them's "fault," Kameelah Phillips, MD, a board-certified ob-gyn based in New York City, tells SELF: You can follow all the courses of treatment and take all the precautions, and BV can still come back. But why?
Whatever the cause, recurrent BV comes from a consistent imbalance of "good" and "bad" vaginal bacteria.It might make more sense to think of BV as a "state of affairs" rather than an infection, Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University School of Medicine, tells SELF. It's ideal to have a balance of "good bacteria," or lactobacilli (a common bacteria found naturally in the vagina and found in probiotics) and "bad bacteria," or Gardnerella vaginalis. (While it may seem counterintuitive, an overgrowth of lactobacilli can also lead to a yeast-infection-like condition called cytolytic vaginosis. It's a delicate dance down there!) "The good lactobacilli make acid, which tends to keep the bad bacteria away," explains Dr. Minkin. When there's not enough acidity, it can throw off your vaginal pH and cause an overgrowth of harmful bacteria, a.K.A. A BV infection. Here's what might be throwing things out of whack and contributing to your stubborn BV.
Washing your vaginaCertain products used around or inside the vagina, like douches or cleansers (and especially ones that contain fragrance), can alter your vaginal pH and contribute to BV. They tend to strip away the lactobacilli that help maintain a balanced, acidic pH in the vaginal microbiome and might allow infection-causing bacteria to flourish.
So put down the soap—you don't need anything fancy to wash with, given that your vagina is self-cleaning. One of the most important things to remember: "The vagina does have a natural odor, and many products try to make you think any odor is bad," says Dr. Bovone. Using products to mask that natural scent could give you the illusion of making the vagina "cleaner" or "healthier," but the opposite ends up being true. And if it leads to a BV infection, you might ultimately have to deal with a pungent scent that's way more pronounced—and unpleasant.
Sex (sorry!)While BV is not a sexually transmitted infection (STI), the bacteria that sometimes causes it can be passed between sexual partners. Sex can lead to BV when the natural chemistry or pH balance of a partner's genitals is different from what your vagina is used to, and so, contact between the two changes your vaginal microbiome. Annoyingly, you might encounter (and get BV from) the bacteria that causes issues every single time you have unprotected sex with even one partner whose pH isn't gelling with yours: "The BV-associated bacteria can be passed back and forth," Dr. Phillips says. "Having a consistent sexual partner can increase the risk for recurrent BV." Sex-related BV can also arise when you have a new sexual partner, or multiple partners, especially ones whom you're having unprotected sex with.
Other lifestyle factorsThere are some other less-expected habits that might have something to do with BV that won't leave you alone. For instance: Smoking cigarettes can also up your chances of getting BV more frequently, says Dr. Phillips. According to research published in Nature, smoking can alter the vaginal microbiome and contribute to deficiencies in lactobacilli bacteria. It could be that cigarettes cause a continuous bacterial imbalance that makes you vulnerable to infections, making it an even better idea to quit if you smoke.
While this is what we know so far about common BV culprits, exactly why some people have recurring cases more so than others, in terms of the root causes, isn't an open-and-shut case just yet. "We need additional research to pinpoint exactly which other lifestyle factors are most likely to contribute to recurrent BV," Dr. Phillips explains.
How to take care of yourself in a recurrent BV cycle Don't self-diagnose.A lot of the time, people with BV might not be familiar with it, and so mistake it for a yeast infection or urinary tract infection (UTI), which have similar symptoms—think itchiness and irritation. But trying to self-diagnose sometimes leads people to start taking OTC yeast infection treatments while their BV bacteria is raging, which doesn't help—and sometimes leads to a more uncomfortable infection, for a longer time, or one that just keeps coming back. This means you have to be sure of what you're actually dealing with.
It is a possibility that you can have both infections at once, but it's best to see an ob-gyn or go to a sexual health clinic to confirm what's going on. "While BV is the most common cause of abnormal vaginal discharge, it's possible that people may have a co-infection with yeast or other bacteria that can complicate diagnosis," Dr. Phillips adds.
Get evaluated by a health care provider to get the most accurate diagnosis, says Dr. Phillips—and find a new one if you're not getting good answers or helpful treatment as things stand.
Give health care providers all the info they need to make a complete diagnosis.Bacterial STIs can also be strikingly similar to BV, symptom-wise. The condition can look a lot like trichomoniasis, which usually comes with funky-smelling discharge and itchiness, or Mgen, which causes unusual or smelly discharge, burning when you pee, and vulvar pain or discomfort. To avoid a misdiagnosis, Dr. Bovone recommends that providers test for all STIs, especially those with bacteria and parasites as vectors, or which come with symptoms of vaginal itching and discharge with an off odor (like gonorrhea and chlamydia). "We see it all, and can reassure you what is normal. And if anything is off, we can help," says Dr. Bovone.
Ask a doctor to test you for BV specifically, too. Dr. Phillips starts appointments with a verbal screening to clarify her patients' symptoms, then takes a vaginal swab sample to send out to a lab for analysis. Once she knows what's actually going on, she's able to devise a treatment plan.
When a doctor prescribes you treatment, follow their instructions and stick with it for the whole time you're supposed to—even if your symptoms get better.Depending on the infection and the clinic, you might be given the option of oral or vaginal antibiotics (often, clindamycin or metronidazole) to treat BV. To target recurrent BV, Dr. Bovone explains that doctors might prescribe a longer course of treatment than they would for a one-off case, such as using an antibiotic for seven to 10 days, plus a weekly dose of a vaginal antibiotic gel for four to six months afterward to prolong the treatment. There are also newer treatments, including a clindamycin vaginal gel called Xaciato that can be applied like a tampon to deliver a strong single dose of medication.
BV can come creeping back if you veer off course with a prescribed treatment, such as not taking all of the antibiotics every day or stopping before the intended date, even if it seems like your symptoms are clearing up. "Inadequate treatment is a setup for a recurrence: BV is a disruption of the normal vaginal flora, and that flora needs to be re-established," says Dr. Bovone. It can become unclear whether the recurrence is a reinfection, or if the infection never really cleared in the first place. So, even if you're feeling better, don't stop taking medication before the set end date, or else you might risk a BV infection creeping back.
Keep things moisturized.One way to keep your vaginal pH as close to acidic (and infection-free) as possible is to make sure there's enough lubrication on a day-to-day basis. Vaginal dryness, which can happen due to lower estrogen levels during menopause or during a period of breastfeeding, among other things, can lead to a less acidic pH, according to Dr. Minkin. She recommends a vaginal moisturizing gel like Replens to help with dryness.
Get a doctor's opinion before you use OTC suppositories, like those containing boric acid.You may have heard of boric acid suppositories and other over-the-counter treatments that purportedly balance the vaginal microbiome. No matter what, you should speak with your health care provider to confirm you have BV before trying these out, Dr. Phillips says. From there, you should know that boric acid supplements are not FDA-approved, and that the jury's still out about whether boric acid on its own can help with BV. (SELF has a full rundown of how boric acid affects your vagina, including if you have a bacterial or yeast infection.)
Your ob-gyn probably won't prescribe boric acid alone to treat acute BV, since it's a homeopathic remedy and has not been proven to be more effective than prescription antibiotics. That said, there's a chance your gyno might recommend it as a maintenance treatment for acidifying the vagina and keeping recurrent BV away. Studies show it can lead to some irritation of the vagina, though, so it may not work well for everyone. And you shouldn't use boric acid supplements if you're pregnant or trying to conceive, because there's not enough research to show that it won't cause harm to a fetus.
If you decide to give boric acid a try with your ob-gyn's blessing, a typical cycle of treatment is 30 days (you shouldn't use it for longer than that, which can lead to even worse irritation). To avoid contact irritation to your partner's skin or damage to condoms or diaphragms—both of which can be caused by boric acid—it's best to hold off on having penetrative or receptive oral sex while you're using it, Dr. Bovone advises.
Err on the side of not using products in or near your vagina.Double-check with your gyno before trying any over-the-counter products that could alter your pH and send you into a BV spiral. "You don't need any vaginal wash. This will disrupt the normal bacteria and create more issues," says Dr. Bovone. The vagina is meant to be self-cleaning, thanks to vaginal discharge sweeping out any bacteria, and will regulate its own pH and natural odor, as SELF previously reported.
And, hate to say it, but…don't have sex until you get to the bottom of things, and use protection whenever possible when you do.This might seem like a given, but don't have penetrative sex or receive oral sex, even with barrier protection, during your antibiotic treatment. If you do, it can throw things off course as your pH is settling back into its normal groove. Once you finish the whole course of medication and your vagina seems calm again, you're good to go.
If your partner's pH is potentially the X factor here: Whether your partner has a penis or vagina, using condoms or dental dams might be able to decrease spread of the bacteria until you get the overall imbalance under control.
Take a breath—and don't beat yourself up about this.We know, BV is not a good time—especially when you have life events that involve bikinis! Wedding days! Beach vacations! Or simply getting laid! And it can be particularly difficult to get to the bottom of the recurrent cases. But don't be ashamed—this is SO common, and there are effective treatments available to you. It just takes a bit of trial and error—and patience. With the right help (and perhaps a thorough audit of the products you use near your vagina), you'll figure it out.
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Originally Appeared on SELF
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Bacterial Vaginosis: What To Know And How To Treat BV In 2024
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Bacterial vaginosis is common in people with a vagina. Although it can clear up on its own, getting treatment can lower your chance 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.
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. Although most prevalent among women of reproductive age, BV can also affect postmenopausal women. A 2021 research review shows that the prevalence of BV among postmenopausal women worldwide is about 17%.
A doctor will usually begin a BV treatment regimen by prescribing antibiotic bacterial vaginosis medication. People who cannot use antibiotics sometimes try bacterial vaginosis home remedies, such as over-the-counter BV treatments like:
So what's the most effective BV treatment? Let's explore below.
Prescription treatments for BVYour doctor may prescribe several bacterial vaginosis medications as initial BV treatment. They are antibiotics available in pill, cream, or suppository form.
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 sound option if you prefer a single-dose treatment.
Other remedies for BVPotential 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 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, remember that antibiotics can kill off good and bad bacteria. Probiotic supplements and yogurt can help replace good bacteria 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 everyday foods as well as supplements.
Pros & consPotential side effects: burning if inserted vaginally
Garlic has strong antibacterial properties, and it's long been used as a home remedy for BV.
For BV treatment, you can take garlic orally. Taking it vaginally is not recommended and has been known to burn vaginal tissue.
Research from 2020 looked at alternative treatments for BV. It suggests 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 & consPotential side effects: allergic reaction, vaginal irritation
Boric acid vaginal suppositories are commonly used to treat BV, according to 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. However, it's considered safe to use boric acid in the vagina. But it's not safe to use if you're pregnant.
Pros & consAn excess of bad bacteria throws the vaginal environment out of balance, resulting in bacterial vaginosis symptoms like:
In some cases, BV causes no symptoms.
CausesExperts don't totally agree on BV causes, but there are several factors that may increase your risk of BV. These include:
According to the CDC, BV is more common in sexually active people. 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 2020 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.
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 performing 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 are not always accurate. These tests check for bacterial vaginosis symptoms, like changes in vaginal acidity and byproducts 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 BV treatment.
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, untreated bacterial vaginosis has been associated with other serious health complications.
ConsiderationsIf your bacterial vaginosis symptoms haven't resolved or started to clear up within 1 week after treatment, you can make an appointment with a doctor or gynecologist.
Also, contact a doctor if you have:
Consider making an appointment 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 using our Healthline FindCare tool.
Recurring BVRecurring BV is common. Despite 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 other partner, according to the CDC. But research has not yet determined the effectiveness of treating sexual partners with a vagina to prevent BV recurrence.
Other possible causes of recurrence include:
If bacterial vaginosis 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.
What is the best treatment for BV?The most effective treatment for BV is antibiotics (metronidazole is usually the most effective), but some people still prefer to treat with home remedies. In some cases, you can use both in tandem, such as take probiotics to restore good bacteria that's killed by antibiotics.
The most effective treatment for BV is antibiotics (metronidazole is usually the most effective), but some people still prefer to treat with home remedies. In some cases, you can use both in tandem, such as take probiotics to restore good bacteria that's killed by antibiotics.
Is bacterial vaginosis contagious?BV is not considered 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.
BV is not considered 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 visiting a doctor and getting a prescription to treat the condition.
A prescription treatment will likely clear up bacterial vaginosis 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:
The fastest way to treat BV is visiting a doctor and getting a prescription to treat the condition.
A prescription treatment will likely clear up bacterial vaginosis 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:
Can bacterial vaginosis go away on its own?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 it may then keep coming back. During that time, you might experience unpleasant symptoms.
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 it may 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, bacterial vaginosis 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 the infection has completely cleared up, typically taking about 7 days.
After seeing a doctor and starting treatment with a prescribed medication, bacterial vaginosis 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 the infection has completely cleared up, typically taking 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.
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:
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 bacterial vaginosis home remedies — namely probiotics, garlic (orally only), and boric acid suppositories — could treat BV. However, a 2018 research review indicates that these natural BV treatments aren't as effective as antibiotics.
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 2019 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.
If you can't use or access antibiotics, certain bacterial vaginosis home remedies — namely probiotics, garlic (orally only), and boric acid suppositories — could treat BV. However, a 2018 research review indicates that these natural BV treatments aren't as effective as antibiotics.
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 2019 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 independently, 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 bacterial vaginosis 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 after treatment. If you have recurring BV, you can work with a doctor to find long-term solutions.
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