BV treatment, how to get rid of BV and what keeps it from coming back

What BV is.

Bacterial vaginosis is an imbalance, not a classic infection with one germ. A healthy vagina is dominated by Lactobacilli, which make lactic acid and keep the pH low. In BV, those protective bacteria drop and a mix of other bacteria, such as Gardnerella, overgrow. Cleveland Clinic estimates about 35 percent of people with a vagina will have it, making it the most common vaginal infection in people aged 15 to 44.

The classic sign is a thin gray or white discharge with a fishy smell that is often stronger after sex or during a period. Itching is less common than with yeast. Many people have no symptoms at all. Our vaginal odor guide goes smell by smell if you are not sure what you are dealing with.

Why it needs a prescription.

BV is treated with antibiotics that target the overgrowing bacteria. The CDC's recommended regimens use metronidazole, as pills or a vaginal gel, or clindamycin as a vaginal cream. Secnidazole, tinidazole and other clindamycin forms are alternatives. Your clinician picks the drug and the schedule; we do not give dosing.

Treatment matters for more than the smell. Cleveland Clinic lists a higher risk of STIs such as chlamydia and gonorrhea, pelvic inflammatory disease, and, in pregnancy, premature birth as possible results of untreated BV. The CDC recommends treatment for anyone with symptoms, including in pregnancy, where metronidazole and clindamycin are the usual options.

A test is part of the treatment. Trichomoniasis, a common STI, can cause a very similar smell and needs a different drug, and a yeast infection needs an antifungal. Guessing wrong costs you days.

What over the counter products can and cannot do.

Product type	Examples	What it can do	What it cannot do
Feminine washes and wipes	Summer's Eve, Vagisil, The Honey Pot	Clean the outer vulva	Treat BV, and scented ones can irritate
Odor gels	pH gels sold in the BV aisle	Mask odor briefly	Treat the overgrowth
Douches	Any vaginal rinse	Nothing useful	The CDC says douching may raise relapse risk
Boric acid	pH-D, AZO, Love Wellness	Part of a clinician's plan for repeated recurrences	Replace the antibiotic
Oral probiotics	RepHresh Pro-B, Jarrow Fem-Dophilus	Add Lactobacillus strains	Treat BV, per the CDC
Homeopathic BV kits	Various	Nothing proven	Treat anything
Whole body deodorant	Lume, Dove	Control skin odor on the outside	Reach the vagina or treat BV

The CDC is blunt on two of these. Douching might increase the risk of relapse, and no data support it for treatment or symptom relief. And no studies support probiotic products as an add on or replacement for BV therapy. The Office on Women's Health adds that women who douche weekly are about five times more likely to develop BV. Our Lume deodorant review explains why a deodorant cannot fix a smell that starts inside.

Boric acid for recurrence.

Boric acid is the one over the counter product with a real place in BV guidance, and it is a narrow one. For people with multiple recurrences, the CDC describes a plan that starts with a course of a prescription antibiotic, then vaginal boric acid, then suppressive prescription treatment. It is a piece of a clinician's plan, not a stand alone fix.

Boric acid is not FDA approved, is toxic if swallowed, must be kept from children and pets, and is not for use in pregnancy. Skip oral sex during a course. Our boric acid suppositories guide has the full rules.

Recurrence prevention evidence.

Recurrence is the hard part of BV. Cleveland Clinic says up to 80 percent of people get BV again in their lifetime. Here is what the evidence says about stopping it.

Partner treatment. For years, guidelines said treating male partners did not help, and the CDC's guidance reflects older trials with that result. Then a 2025 trial in the New England Journal of Medicine treated men with both oral and topical antibiotics alongside their female partners. Recurrence within 12 weeks fell to 35 percent, versus 63 percent when only the woman was treated, and the trial was stopped early because partner treatment was clearly better. A 2026 meta analysis found older partner treatment approaches did not help, so the combined oral and topical method appears to be what made the difference. If you have a regular male partner and BV keeps coming back, ask your clinician about it.

Vaginal probiotics. In a 2020 NEJM trial, women who used Lactin-V, a vaginal L. crispatus strain, after metronidazole gel had BV return in 30 percent of cases by 12 weeks, versus 45 percent on placebo. That is promising, but the CDC notes Lactin-V is not yet FDA cleared or commercially available. Over the counter probiotics are different strains taken a different way. We cover what is known in the best vaginal probiotics.

Suppressive treatment. For frequent recurrences, the CDC describes longer suppressive courses of prescription treatment. Which one, and for how long, is a conversation with your clinician.

Everyday habits. None of these has trial proof on its own, but each lowers known risks.

• Do not douche, and skip scented washes, sprays and wipes inside the folds. Plain water on the vulva is enough; see the best feminine wash.
• Use condoms, especially with new partners. Cleveland Clinic lists not using condoms among BV risk factors.
• Keep back to front contact out of the vagina, including toys and fingers moving from anal to vaginal play without washing.
• Clean toys between uses and between partners.
• Choose a gentle lube. Some glycerin heavy, high osmolality lubes irritate vaginal tissue. A glycerin free lube near the vagina's pH is a cheap variable to remove; see pH balanced lube.

BV and sex.

BV is not classed as a sexually transmitted infection, but it is linked to sex, especially new or multiple partners. Many clinicians suggest pausing sex until treatment is done, and the fishy smell is often more noticeable after sex because semen is alkaline. If sex itself burns, see burning after sex.

pH-D Boric Acid Suppositories.

For repeated recurrences, as part of a clinician's plan that begins with an antibiotic. Never by mouth, never in pregnancy. See pH-D on Amazon.

RepHresh Pro-B.

An oral probiotic with L. rhamnosus GR-1 and L. reuteri RC-14. Some people take it after treatment; the CDC does not recommend probiotics for BV, so treat it as optional.

When to see a clinician.

See a clinician for any new fishy smell, gray discharge or change from your normal, before using boric acid for the first time, and whenever BV comes back. Get care promptly if you are pregnant with symptoms, or if you have fever, pelvic pain or sores. Ask about suppressive treatment and partner treatment if you have had BV three or more times. More guides are in the health hub. This page is general information, not medical advice.