Treatment for Bacterial Vaginosis

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 04 Jul 2022

Bacterial vaginosis (BV) is one of the most common causes of unusual vaginal discharge and is triggered by the overgrowth of bacteria naturally found in the vagina. The cause isn’t completely understood, but certain activities can increase your chances of developing it. BV is not a sexually transmitted infection (STI). However, it can increase your risk of catching an STI like chlamydia.

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While there are symptoms associated with the condition, half of women don’t show any symptoms. You can relieve symptoms without seeing a doctor. Relief comes in the form of creams and gels from regular and online pharmacies. While BV isn’t usually serious, it can be uncomfortable. If you have symptoms, you should treat the condition with prescribed antibiotics. It’s important to seek treatment if you’re pregnant as it can cause complications.

What are the symptoms of bacterial vaginosis?

While there are symptoms associated with bacterial vaginosis, 50% of women won’t experience any. However, if you do show signs of the condition, the most common symptoms of BV include:

  • change in the colour of your discharge which may become greyish white
  • change in consistency of your discharge which may become thin and watery
  • a strong fishy odour, particularly after sexual intercourse
  • burning during urination

BV doesn’t usually cause any itching or soreness but it can be a symptom if you also have thrush.

How do I know if I have bacterial vaginosis?

In most cases, bacterial vaginosis can be verified through a clinical diagnosis. The process of identifying the condition will be based on the signs and symptoms you’re having, as well as your health history. This makes it easy to get the treatment you need, as you don’t need a physical exam unless you really want one.

If you’re unsure about any changes in your vaginal discharge, then you can see your GP or go to a sexual health clinic to get checked. At your appointment, you’ll be asked about your symptoms and your vagina may be checked over by a nurse or doctor. A cotton bud is sometimes used to collect samples of your vaginal discharge to help doctors rule out an STI.

How to reduce your chances of getting bacterial vaginosis

BV is a result of an overgrowth of bacteria naturally found in your vagina. To reduce your chances of developing bacterial vaginosis, you should try your best to avoid triggers. Risk factors associated with BV include:

  • having new or multiple sexual partners
  • overcleaning your vagina which can disturb the natural balance
  • natural lack of lactobacilli bacteria - the good bacteria in your vagina

To help prevent BV, you should:

  • minimise vaginal irritation - wear cotton underwear, and use mild scentless soaps and unscented pads and tampons
  • don’t overclean or douche your vagina - you don’t need to cleanse your vagina, normal bathing is enough and overcleaning doesn’t get rid of infections
  • avoid catching an STI
  • take precautions when having sexual intercourse with new or existing partners by using condoms

While it’s advised to follow the recommendations above, doctors don’t fully understand the reason why some women develop BV. So while it can work for some, it may not work for others.

Treatment for bacterial vaginosis

Fortunately, BV can be treated with prescribed medication, like a short course of antibiotics. Symptoms can also be relieved with over-the-counter products.

At ZAVA, you can get your BV antibiotics online. All you need to do is fill in a brief questionnaire which will be reviewed by one of our doctors. They will then prescribe you a suitable treatment based on your answers, which will be delivered straight to your door.

Please note that you should take the prescribed treatment for as long as your doctor says to. Even if your symptoms disappear, stopping your treatment early could lead to recurring BV.

Antibiotic tablets

Metronidazole is an antibiotic that is commonly used to treat bacterial vaginosis. However, metronidazole is a prescription-only medication and isn’t available over the counter. This means that a doctor will need to evaluate your condition and issue you a prescription for it.

Creams and gels

Dalacin cream and Zidoval gel are often used to treat and ease the symptoms of bacterial vaginosis. Dalacin cream is applied to your vagina and contains the antibiotic clindamycin phosphate. Each gram of cream contains 20mg of the active ingredient clindamycin.

The active ingredient of Zidoval is metronidazole (mentioned above). Each gram of Zidoval gel contains 7.5mg of metronidazole. Within each pack, you can find a 40g tube of Zidoval gel and 5 disposable applicators. Each applicator will deliver 5g of gel into your vagina.

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What happens if bacterial vaginosis is left untreated?

In most cases, BV won’t cause other problems with your health. However, if you do leave it untreated, you could increase your risk of:

  • catching an STI such as herpes, chlamydia, gonorrhoea or HIV
  • experiencing pelvic inflammatory disease due to the BV bacteria infecting the uterus or fallopian tubes
  • an infection after a medical procedure such as a C-section, abortion, or surgery on the uterus or cervix
  • a low birth weight or premature delivery if you’re pregnant

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Can bacterial vaginosis go away on its own?

In a third of cases, bacterial vaginosis will resolve itself without the use of any medication. However, if you are showing symptoms, it’s highly advised to seek medical help. Having BV will increase your risk of developing an STI and it can have a negative effect on pregnancies.

Can I pass BV to my partner?

It’s not usually necessary to treat male sexual partners of women with bacterial vaginosis. However, BV can be passed on to female sexual partners, so female partners should seek testing and treatment. It’s especially important for pregnant women showing symptoms of BV to get treated, as this condition can lead to a low birth weight or premature delivery.

What causes bacterial vaginosis?

Bacterial vaginosis is the result of a bacterial imbalance in the vagina, where the ‘good’ bacteria is outnumbered by the harmful or ‘bad’ bacteria. This can alter the pH level and lead to bacterial overgrowth. There is little knowledge of the exact causes of BV and why certain activities, such as sexual intercourse, can cause it. But it can be treated and prevented.

Recurring bacterial vaginosis

Whether it has been treated or not, it’s common for BV to come back within 3 to 12 months. Researchers are looking into treatment to help women with recurring bacterial vaginosis. If your symptoms come back soon after you finish your treatment, you should speak to your doctor who will help you with the next steps. One option may be to extend the use of metronidazole therapy.

One of the ways some women deal with recurring bacterial vaginosis is by taking a self-help approach called lactobacillus colonisation therapy. This is when you attempt to boost good bacteria in the vagina and re-establish the natural balance. This can be accomplished by eating yoghurts and other foods containing lactobacilli, but more research is needed to confirm the benefits of probiotic therapy.

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Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 04 Jul 2022


Bacterial vaginosis can be treated with antibiotics and gels. ZAVA offers both of these options for treating infections.




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