Many people with bacterial vaginosis display no symptoms. Signs and symptoms to watch for include:¹

• Thin, vaginal discharge that may be gray, white or green.

• Foul-smelling, "fishy" vaginal odor.

• Vaginal itching.

• Burning during urination.

BV occurs when the vaginal bacteria, called the vaginal flora, is unbalanced. There are good bacteria called lactobacilli and bad bacteria called anaerobes. When the level of anaerobes becomes too high, it causes BV.²

The true cause of BV is often unclear, but there are some risk factors that can increase the chances of BV. Risks for BV include:³

• Having a new sex partner or multiple partners. Risk of BV is higher if both sexual partners are female.

• Douching. The vagina is self-cleaning and does not need harsh chemicals or douche products. These can cause an imbalance in the vaginal flora.

• Natural lack of lactobacilli bacteria.

There are a few differences between BV and a yeast infection, including:⁴

• BV is caused by a bacterial imbalance. A yeast infection is a fungal infection.⁵

• BV causes a “fishy” smelling discharge that can be gray, white or green. Discharge from a yeast infection does not usually smell strong and resembles cottage cheese.

• BV requires a prescription antibiotic for treatment. Yeast infections can be treated with over-the-counter antifungal medications.

BV is not an STD or an STI because it can develop in people who do not have sex. However, it can be transmitted between people through sexual contact if one of them has BV or has recently come into contact with someone who has BV.⁶

With prescribed antibiotics, BV will usually resolve in about one week. Approximately 10%-15% of the population will require two rounds of antibiotics.⁷

In rare cases, BV can resolve on its own. However, BV can increase the risk of STIs and can cause complications in pregnancy, so it’s best to seek treatment as soon as possible.⁸

Pinpointing the cause of recurring BV can be tough. There have been some connections between recurring BV and certain factors, including:⁹

• Repeated sexual contact with a person who has BV, especially unprotected.¹⁰

• Copper IUDs.

• Douching.

• Scented products like perfumes, pads or tampons.

No, men and those assigned male at birth cannot contract BV. However, a man can spread BV from one partner to another.¹¹

There is no way to prevent BV. You can decrease your risk by following a few rules, including:¹²

• Avoid douching.

• Avoid vaginal contact with anything that has touched your or your partner’s anus.

• Limit your number of sex partners.

• Use latex condoms for penetrative sex or dental dams for oral sex.

• Wear cotton or cotton-lined underwear to wick away bacteria-causing moisture.

1. Mayo Clinic

2. Mayo Clinic

3. Mayo Clinic

4. Cleveland Clinic

5. Mayo Clinic

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7. Cleveland Clinic

8. Cleveland Clinic

9. Cleveland Clinic

10. National Library of Medicine

11. Cleveland Clinic

12. Cleveland Clinic

The only clinically proven way to get rid of BV is with prescription antibiotic treatment like metronidazole tablets, metronidazole 0.75% gel or clindamycin¹³ from a medical provider.

There are no proven over-the-counter treatments for BV. Occasionally, a provider may suggest boric acid suppositories for cases of recurrent BV. Boric acid is usually used in conjunction with antibiotics. Research is inconclusive on the efficacy of boric acid for BV.¹³

There are no proven over-the-counter or home remedies for BV.¹⁴ However, you can get prescription medications shipped directly to your home by telehealth providers like RedBox Rx. Start a quick online assessment for BV and one of our U.S. licensed medical providers will determine if medication is right for you.

It typically takes antibiotic treatments up to one week to treat BV.¹⁵

Antibiotics are prescribed to treat BV. Some of the most commonly prescribed include:

• Metronidazole tablets (Flagyl®)

• Metronidazole 0.75% gel

• Clindamycin (Cleocin®)

You should feel better within a few days of starting an antibiotic for BV. If you do not, please contact your provider.¹⁶

There is no evidence to support that over-the-counter options will work to cure BV.¹⁷

Around 10%-15% of the population will require a second dose of antibiotics to treat one instance of BV.¹⁸ Around 50% of women will experience a recurrence of BV within one year of diagnosis and treatment. The typical course of treatment for chronic or recurring BV is to extend antibiotic use for up to three to six months.¹⁹

You should avoid having sex while on antibiotic treatment for BV. After treatment is over, sex should be avoided until all symptoms have cleared.²⁰

Yes, RedBox Rx has prescription treatment options for BV online. Start an affordable and easy online assessment and a U.S. licensed provider will determine if medication is right for you.

13. National Library of Medicine

14. Cleveland Clinic

15. Cleveland Clinic

16. Mayo Clinic

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18. Cleveland Clinic

19. National Library of Medicine

20. Mayo Clinic

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