Preventing bacterial vaginosis (BV) comes down to protecting the natural balance of bacteria in your vagina. A healthy vaginal environment is slightly acidic, with a pH between 3.8 and 4.2, maintained by beneficial bacteria called lactobacilli. These bacteria produce lactic acid and hydrogen peroxide that keep harmful organisms from taking over. When that balance gets disrupted, BV develops. The good news: most of the factors that throw off your vaginal flora are within your control.
Why BV Keeps Coming Back
Before diving into prevention, it helps to understand the scope of the problem. Up to 66% of women experience a recurrence within a year of treatment, according to the American College of Obstetricians and Gynecologists. That staggering number makes prevention arguably more important than treatment itself. BV isn’t a one-and-done infection for most people. It’s a recurring disruption of the vaginal microbiome, and preventing it requires ongoing habits rather than a single fix.
Stop Douching
Douching is the single most avoidable risk factor for BV. Women who douche at least once a month have a 1.4 times higher risk of developing BV or disrupted vaginal flora. For women who douched within a week of being tested, the risk jumped to 2.1 times higher. The mechanism is straightforward: douching washes away the hydrogen peroxide and lactobacilli that form your vagina’s natural defense system. Once that protective layer is stripped, anaerobic bacteria (the kind that cause BV) can multiply unchecked.
Your vagina is self-cleaning. It doesn’t need internal rinsing with water, vinegar, or any marketed product. If you notice an unusual odor, that’s a reason to see a provider, not a reason to douche.
Choose the Right Soap and Products
The vulva (the external area) can be gently washed, but the products you use matter. Most regular soaps and body washes are too harsh for this skin. They can strip natural moisture, shift pH levels, and cause irritation that leaves you more vulnerable to BV. Look for products that are fragrance-free, paraben-free, and glycerin-free. Glycerin is a sugar-based ingredient found in many soaps and lubricants that can feed yeast and disrupt the vaginal environment.
The same goes for lubricants. If you use personal lubricant, check the ingredient list for glycerin and fragrances. Unscented, water-based options without glycerin are the safest bet for maintaining your natural pH.
Use Condoms Consistently
Semen is alkaline, with a pH between 7.2 and 7.8, nearly double the acidity of a healthy vagina. Every time semen enters the vaginal canal, it temporarily raises your pH, creating a window where harmful bacteria can gain a foothold. Your body does correct this on its own, but frequent exposure without protection adds up.
Research on condom use and BV prevention shows a meaningful effect, but with an important nuance. Among women who were BV-free at the start of the study, consistent condom use reduced the likelihood of developing BV by 43% over six months compared to inconsistent use. However, for women who already had BV, consistent condom use didn’t change their outcomes. In other words, condoms are effective for prevention but aren’t a treatment. If you’re prone to recurrent BV and have a male sexual partner, condoms can help break the cycle, especially after you’ve been successfully treated.
Wear Breathable Underwear
Cotton underwear wicks away the excess moisture that bacteria and yeast thrive on. Synthetic fabrics trap heat and sweat against the skin, creating a warm, damp environment that promotes bacterial overgrowth. If you prefer synthetic underwear with a cotton crotch panel, know that the small panel doesn’t fully protect you from the surrounding synthetic material and won’t breathe the way 100% cotton does.
Beyond fabric choice, changing out of sweaty workout clothes or wet swimsuits promptly makes a difference. Sleeping without underwear or in loose-fitting cotton shorts also gives the area time to air out overnight.
Pay Attention to Your Diet
Your diet plays a less obvious but real role in vaginal health. A study of 1,735 women found that diets with a higher glycemic load (meaning they caused bigger spikes in blood sugar) were associated with a higher prevalence of BV. More importantly, high glycemic load was also linked to BV persisting longer and to new cases developing over time. Diets with higher overall nutritional quality, on the other hand, were associated with lower BV rates.
This doesn’t mean you need to overhaul your eating habits overnight. But if you’re dealing with recurring BV, reducing refined carbohydrates and added sugars while increasing vegetables, whole grains, and other nutrient-dense foods may support a healthier vaginal microbiome. High-dose vitamin D supplementation, sometimes promoted as a BV remedy, has not been shown to reduce recurrence in clinical trials.
What About Probiotics?
Probiotics for vaginal health get a lot of attention, and there’s promising science behind one strain in particular. A clinical trial tested a vaginal probiotic containing Lactobacillus crispatus (the same species that dominates a healthy vaginal microbiome) in women after standard BV treatment. The probiotic was applied vaginally for five days, then twice weekly for 10 weeks, and it showed enough promise to advance to further testing.
That said, current CDC guidelines do not recommend probiotics for BV prevention. A systematic review of studies on oral and vaginal probiotics found mixed results, with no consistent evidence that they reliably prevent recurrence. Over-the-counter probiotic supplements vary widely in the strains they contain, and most haven’t been specifically tested for BV. If you want to try probiotics, look for products containing Lactobacillus crispatus or Lactobacillus rhamnosus, which have the most research behind them, but set realistic expectations.
Partner Treatment
For years, treatment guidelines did not recommend treating male sexual partners of women with BV, since earlier trials showed no benefit. That changed in late 2025, when ACOG recommended concurrent sexual partner treatment for recurrent BV for the first time. The reasoning is that BV-associated bacteria can be shared between partners, and treating only one person may allow reinfection.
If you’re in a sexual relationship and dealing with recurrent BV, this is worth discussing with your healthcare provider. A U.S. trial of oral antibiotics for male partners did not find a significant reduction in recurrence, but the shift in clinical guidance reflects growing recognition that BV has a sexually transmitted component for some couples.
Daily Habits That Add Up
Prevention works best as a collection of small, consistent choices rather than any single intervention. A practical checklist:
- Skip internal washing. Clean only the external vulva with mild, fragrance-free soap or water alone.
- Use condoms with male partners, especially if you’re BV-prone.
- Wear 100% cotton underwear during the day and go commando or wear loose cotton at night.
- Change out of damp clothing after exercise or swimming.
- Choose glycerin-free, unscented lubricants.
- Limit refined sugars and prioritize whole, nutrient-dense foods.
- Avoid scented period products, including pads, tampons, and sprays.
None of these steps guarantees you’ll never get BV. But together, they protect the acidic, lactobacillus-rich environment your body works to maintain, making it significantly harder for harmful bacteria to take hold.