Bacterial vaginosis is the most common vaginal infection, and treating it usually requires antibiotics prescribed by a healthcare provider. The standard course lasts five to seven days, and most people notice improvement within the first few days. But BV is notoriously stubborn: 50% to 80% of women experience a recurrence within 6 to 12 months of finishing treatment, which means managing BV is often about more than just one round of medication.
What BV Actually Is
Your vagina naturally maintains an acidic environment, kept in check by beneficial bacteria. BV happens when that balance tips, and harmful bacteria overgrow. The hallmark symptoms are a thin grayish-white discharge and a fishy odor, often stronger after sex. Some people also notice mild itching or burning during urination, though many have no symptoms at all.
BV is not a sexually transmitted infection, but sexual activity is a significant risk factor. It can also develop after anything that disrupts vaginal pH, including new hygiene products, hormonal shifts, or douching.
Getting the Right Treatment
BV requires a confirmed diagnosis and a prescription. Over-the-counter products marketed for vaginal odor or pH balance won’t clear an active infection. The CDC recommends three first-line options: an oral antibiotic taken twice daily for seven days, an antibiotic vaginal gel applied once daily for five days, or an antibiotic vaginal cream used at bedtime for seven days. Your provider will recommend one based on your preferences and history.
If you prefer a simpler option, a single-dose oral treatment also exists. Clinical data shows it works just as well as the standard seven-day course, which can be helpful if sticking to a multi-day regimen is difficult.
Whichever option you use, finish the full course even if symptoms clear up early. Stopping treatment prematurely is one of the most common reasons BV comes back quickly.
Why BV Keeps Coming Back
Recurrence is the single most frustrating thing about BV. Up to 66% of women experience it again within a year. This isn’t because the antibiotics failed or because you did something wrong. The bacteria that cause BV can persist in biofilms, thin protective layers that antibiotics have trouble fully penetrating. Once the medication stops, those bacteria can re-establish themselves.
Sexual activity plays a bigger role in recurrence than researchers previously understood. In 2025, the American College of Obstetricians and Gynecologists recommended for the first time that male sexual partners be treated in some cases of recurrent BV. This was a notable shift. Previously, partner treatment wasn’t considered useful because the data wasn’t strong enough. Newer research changed that, showing that bacteria associated with BV can be harbored by male partners and passed back during sex. If you’re dealing with recurring BV and have a regular male partner, ask your provider whether concurrent partner treatment makes sense for your situation.
Lifestyle Changes That Lower Your Risk
Several everyday habits directly affect your vaginal environment and your chances of developing or re-developing BV.
Stop douching. Women who douche weekly are five times more likely to develop BV than women who don’t. Douching strips away the protective bacteria and disrupts the natural acidity that keeps harmful organisms in check. Your vagina is self-cleaning. Warm water on the external area during a shower is all you need.
Avoid scented products near the vagina. Scented tampons, pads, powders, sprays, and body washes can irritate vaginal tissue and shift pH. Switch to fragrance-free versions of anything that contacts that area.
Use condoms consistently. Since sexual transmission contributes to BV, barrier methods reduce the exchange of bacteria between partners. This is especially relevant if you’re prone to recurrence.
Wear breathable underwear. Cotton underwear and loose-fitting clothing help keep the area dry, which discourages bacterial overgrowth. Change out of wet swimsuits or sweaty workout clothes promptly.
What About Probiotics?
Probiotics are one of the most commonly searched home remedies for BV, and the reality is mixed. The theory is sound: replenishing beneficial bacteria should help restore balance. But clinical trials haven’t consistently shown that probiotic supplements improve cure rates when added to standard antibiotic treatment.
In one randomized controlled trial, women who took a well-studied oral probiotic strain alongside their antibiotic had a 30-day cure rate of about 58%, compared to 60% for women who took the antibiotic alone. By 90 days, the probiotic group actually had a lower cure rate (37% vs. 49%), though the difference wasn’t statistically significant. The takeaway: probiotics don’t appear to hurt, but they’re not a reliable substitute for antibiotics and may not meaningfully boost their effectiveness.
If you want to try probiotics anyway, look for strains specifically studied for vaginal health rather than general gut-health formulas. Just don’t rely on them as your primary treatment.
Managing Symptoms While You Treat It
While waiting for antibiotics to take full effect, a few things can help you feel more comfortable. Avoid sex during treatment, as it can introduce new bacteria and reduce the effectiveness of vaginal creams or gels. If you’re using the oral antibiotic, avoid alcohol entirely during treatment and for at least 24 hours afterward, since the combination causes nausea and vomiting.
Don’t try to mask the odor with scented products. This will only compound the irritation. A gentle rinse with plain water is the safest approach. Wearing a thin, unscented panty liner can help manage discharge while you wait for the medication to work.
When BV Keeps Recurring Despite Treatment
If you’ve had three or more episodes in a year, you’re dealing with recurrent BV, and the approach changes. Providers may recommend a longer initial course of antibiotics followed by a maintenance regimen, where you use a vaginal gel periodically for several months to suppress regrowth. This extended strategy helps break the cycle for many people, though it requires patience and consistency.
Recurrent BV is also worth investigating more thoroughly. Conditions like a retained foreign body (such as a forgotten tampon), a concurrent sexually transmitted infection, or hormonal changes from menopause can all mimic or worsen BV. Getting a full evaluation helps rule out anything that might be complicating the picture.