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How is bacterial vaginosis (BV) treated?

BV is treated with antibiotic medicines prescribed by your doctor. Your doctor may give you either metronidazole or clindamycin. Generally, male sex partners of women with BV don't need to be treated. However, BV can be spread to female partners. If your current partner is female, talk to her about treatment. You can get BV again even after being treated.

This answer is based on source information from the National Women's Health Information Center.

Marcy Holmes, MSN, NP
Nursing Specialist

Bacterial vaginosis (BV) is an abundance of odor causing bacteria in the Vagina. It is typically initially treated with a prescription antibiotic, preferably a vaginal gel such as Metrogel/metronidazole for 5-7 days - which only targets the bad bacteria and not the good protective organisms.

If a woman also has low estrogen features to her vagina, she may also be treated with an estrogen vaginal product to rejuvenate the vaginal tissue and it's defenses against this bacteria. This is common in perimenopause and menopause.

The oral form of Metronidazole can be used for stubborn BV cases or to save money. The oral tablets are less expensive than the vaginal gel- but it has more side effects taken orally in pill form. You must avoid alcohol completely when using it orally or it can cause severe nausea and vomiting.

A woman's impulse may be to douche when she senses odor, but that is not an advisable treatment- douching disrupts your own defenses and does not appropriately treat the problem. Instead see your GYN health care provider for a proper evaluation. If a woman is allergic to the prescription antibiotics, some may find herbal products such as Tea tree oil suppositories work for them.

We find that a holistic approach is helpful in treating and preventing BV reoccurrence. Good nutrition and a healthy digestive tract is key—as well as good hygiene wiping front to back in order to keep the bacteria from the rectum away from the vagina. I do wonder if thongs are a fast track to BV sometimes, so we may advise avoiding them for a while as well. At Women to Women we usually suggest probiotics daily, a healthy high fiber diet, Omega 3 to promote healthier bowels and a better immune system overall.

Bacterial vaginosis (BV) is treated with antibiotics. The primary goal in treating BV is to relieve signs and symptoms of infection. All women with symptoms should be treated.

The most common therapies are metronidazole (Flagyl) and clindamycin (Cleocin). Both metronidazole and clindamycin are available by prescription in oral (pill) form. Metronidazole is available in a gel (MetroGel-Vaginal), and clindamycin is available in a cream (such as Clindesse) that you insert into the vagina. Generic versions of these antibiotics also are available and effective.

If your symptoms disappear with treatment, you don't have to see your healthcare professional again. One round of treatment usually works in about 70 percent of cases. However, BV frequently recurs and can be chronic in some women.

Even if all symptoms disappear, it's important that women take the full course of treatment and alert their healthcare professional of any symptoms that persist after finishing the antibiotic, because BV can recur within three to 12 months, despite treatment.

While you're being treated for BV, you may be advised not to have sex; if you do have sex, your partner should wear condoms. Treating your male partner isn't necessary, however, since studies find it doesn't help prevent another infection. Female partners may need treatment, however.

Treatment is more complicated for pregnant women. If you've previously delivered a premature infant, you may be tested for BV during your first prenatal visit. If you have the infection, you should be treated promptly.

Regardless of other risk factors for preterm delivery, all symptomatic pregnant women should be tested and treated. However, most studies show no difference in risk of preterm delivery in asymptomatic women who don't get treated versus those who get treated. Thus, pregnant women with asymptomatic BV don't require treatment.

In any case, pregnant women who are going to be screened should have this done during the first prenatal visit.

This content originally appeared on HealthyWomen.org.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.