Treatment

To treat bacterial vaginosis, your doctor may prescribe one of the following medications:

  • Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine may be taken as a pill by mouth (orally). Metronidazole is also available as a topical gel that you insert into your vagina. To reduce the risk of stomach upset, abdominal pain or nausea while using this medication, avoid alcohol during treatment and for at least one day after completing treatment — check the instructions on the product.
  • Clindamycin (Cleocin, Clindesse, others). This medicine is available as a cream that you insert into your vagina. Clindamycin cream may weaken latex condoms during treatment and for at least three days after you stop using the cream.
  • Tinidazole (Tindamax). This medication is taken orally. Tinidazole has the same potential for stomach upset and nausea as oral metronidazole does, so avoid alcohol during treatment and for at least one day after completing treatment.

It's generally not necessary to treat an infected woman's male sexual partner, but bacterial vaginosis can spread between female sexual partners. Female partners should seek testing and may need treatment. It's especially important for pregnant women with symptoms to be treated to help decrease the risk of premature delivery or low birth weight.

Take your medicine or use the cream or gel for as long as your doctor prescribes it — even if your symptoms go away. Stopping treatment early may increase the risk of recurrence.

Recurrence

It's common for bacterial vaginosis to recur within three to 12 months, despite treatment. Researchers are exploring treatments for recurrent bacterial vaginosis. If your symptoms recur soon after treatment, talk with your doctor about treatments. One option may be extended-use metronidazole therapy.

A self-help approach is lactobacillus colonization therapy — which attempts to boost the number of good bacteria in your vagina and re-establish a balanced vaginal environment — possibly accomplished by eating certain types of yogurt or other foods containing lactobacilli. While current research shows there may be some benefit to probiotic therapy, more research is needed on the subject.

April 27, 2016
References
  1. CDC fact sheet: Bacterial vaginosis fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/bv/STDFact-Bacterial-Vaginosis.htm. Accessed Jan. 12, 2016.
  2. Bacterial vaginosis. National Institute of Allergy and Infectious Diseases. http://www.niaid.nih.gov/topics/bacterialvaginosis/pages/default.aspx. Accessed Jan. 12, 2016.
  3. Pruthi S (expert opinion). Mayo Clinic, Rochester, Jan. 13, 2016.
  4. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Gynecology. ACOG Practice Bulletin No. 72. Vaginitis. Obstetrics and Gynecology. 2006;107:1195. Reaffirmed 2011.
  5. Frequently asked questions. Gynecologic problems FAQ028. Vaginitis. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq028.pdf?dmc=1&ts=20130319T1944039856. Accessed Jan. 12, 2016.
  6. STD treatment guidelines 2010. Centers for Disease Control and Prevention. http://www.cdc.gov/std/treatment/2010/default.htm. Accessed Jan. 12, 2016.
  7. Sobel JD. Bacterial vaginosis. http://www.uptodate.com/home. Accessed Jan. 12, 2016.
  8. Bacterial vaginosis fact sheet. Womenshealth.gov. http://womenshealth.gov/publications/our-publications/fact-sheet/bacterial-vaginosis.cfm. Accessed Jan. 12, 2016.
  9. Flagyl (prescribing information). New York, N.Y.: Pfizer; 2010. http://labeling.pfizer.com/ShowLabeling.aspx?id=570. Accessed Jan. 12, 2016.
  10. Cleocin (prescribing information). New York, N.Y.: Pfizer; 2005. http://labeling.pfizer.com/showlabeling.aspx?id=627. Accessed Jan. 12, 2016.
  11. Tindamax (prescribing information). San Antonio, Texas: Mission Pharma; 2004. http://www.missionpharmacal.com/Global_Content/Package_Inserts/Tindamax.pdf. Accessed Jan. 12, 2016.