Treatment and Recurrence of Bacterial Vaginosis
Bacterial Vaginosis is treatable, usually with antibiotics that restore the natural bacterial balance in the vagina. However, recurrence is common, with some women experiencing repeated episodes even after successful treatment. Learn more about the treatment and recurrence of bacterial vaginosis below.
First-line treatments typically include:
- Metronidazole (oral tablet or vaginal gel)
Patients usually take metronidazole for 5 to 7 days. They should avoid alcohol during treatment and for at least 48 hours after finishing the medication to prevent side effects - Clindamycin (cream or oral tablet)
An alternative for those who can’t tolerate metronidazole. Can weaken condoms, so additional contraception may be advised during use.
Both medications are highly effective, but symptoms may return within weeks or months in some women. If symptoms recur frequently (three or more times in 12 months), doctors may consider longer-term treatments or maintenance therapy.
To reduce the risk of recurrence:
- Avoid douching and scented vaginal products
- Use unscented soaps externally only — never internally
- Limit the number of sexual partners and use condoms
- Don’t self-treat repeatedly without professional advice
- Consider probiotics, which may help restore lactobacilli, though research is still emerging
Women with recurrent BV may benefit from lifestyle reviews with a healthcare provider to identify potential triggers.
For pregnant women, BV treatment is especially important. BV can increase the risk of premature rupture of membranes, preterm labour, and miscarriage. Doctors typically prescribe metronidazole early in pregnancy, as it is generally considered safe.
In South Africa, free treatment for BV is often available at government clinics. However, recurring infections may not always receive specialised follow-up unless symptoms are severe or complications arise.
Treatment and Recurrence of Bacterial Vaginosis
Open communication with healthcare providers can lead to better outcomes. Treating both the infection and the underlying factors helps prevent recurrence and improve vaginal health in the long term.
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