Bacterial vaginosis treatment usually involves antibiotics like metronidazole, clindamycin, tinidazole, or secnidazole, which help restore the natural balance of vaginal bacteria. Completing the full course of medication is essential to prevent complications such as pelvic inflammatory disease or other infections.
During pregnancy, bacterial vaginosis treatment is particularly important, as untreated infection can increase the risk of premature birth and low birth weight. Preventive measures like using condoms, avoiding vaginal douching, and wearing cotton underwear can also reduce the chances of recurrence.
In addition to medications, options like probiotics and certain home remedies are being studied for their role in lowering recurrence rates. Understanding the different treatments, prevention strategies, and signs of improvement or worsening can help manage bacterial vaginosis more effectively.
Medication list
The medicines that are usually prescribed for the treatment of bacterial vaginosis are:
Bacterial vaginosis treatment should be carried out to the end, even if the symptoms have reduced or disappeared. Bacterial vaginosis that is left untreated may develop into pelvic inflammatory disease or increase the risk of acquiring other sexually transmitted infections, such as chlamydia, for example.
Treatment during pregnancy
During pregnancy, bacterial vaginosis treatment should involve antibiotics as prescribed by the OBGYN. Metronidazole is generally considered the treatment of choice, while intravaginal clindamycin cream should be avoided during the first trimester.
It is very important to take treatment as prescribed, as bacterial vaginosis in pregnancy can cause premature birth or a low birth weight in the baby. Some studies suggest that treatment before 20 weeks may help reduce the risk of preterm birth.
Prevention and recurrence
To ensure the success of treatment and to prevent bacterial vaginosis from reoccurring, it is important to consider other measures, such as:
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Use condoms in all intercourse
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Avoid douching and bubble baths
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Avoid using scented soaps
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Wash the intimate area with soap and water or intimate soap with a neutral pH
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Wear cotton underwear
Recent studies also show that treating male partners can reduce recurrence. Partner treatment has been associated with lower rates of reinfection, although it is not yet standard in all guidelines. Probiotics, taken with or after antibiotics, may also reduce recurrence rates by helping restore healthy vaginal microbiota.
Signs of improvement are typically seen with treatment and generally include the disappearance of foul-smelling yellow or green discharge and a reduction in vaginal itching.
Signs of worsening of bacterial vaginosis usually appear when treatment is not carried out until the end or if it is completed incorrectly. They include an increase in foul-smelling and green or yellow vaginal discharge, an increase in vaginal itching and pain when urinating. If these symptoms occur, a gynecologist should reassess treatment.
Home remedies
Some home remedies for bacterial vaginosis include:
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Bearberry tea, as it has antibacterial and antiseptic action which may help to eliminate the microorganisms that cause vaginosis. To make this tea, simply boil 30 grams of the leaves in 500 ml of water for 15 minutes. Then strain and drink up to 3 cups of tea a day. This treatment should not be taken by pregnant women, as bearberry is contraindicated in pregnancy.
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Tea tree oil, as it has antibacterial properties. Tea tree oil should be mixed with another oil, like almond oil to prevent skin and mucous membrane irritation. It can be used by immersing a tampon in this mixture and inserting it into the vagina for about an hour, 3-4 times a day. It should not be left in for more than an hour. Current evidence is still limited, and it is not routinely recommended in clinical guidelines.
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Probiotics, which are beneficial bacteria that prevent the growth of microorganisms responsible for vaginosis. It is therefore recommended to consume probiotic food like yogurt, kefir, kombucha or probiotic supplements. Evidence suggests probiotics can significantly lower the risk of recurrence when combined with antibiotics.
It is also important to increase intake of foods that help boost immunity, which may help to prevent another bout of vaginosis. Some foods that can be consumed are linseed, nuts and garlic, for example.
FAQs about BV treatment
Some common questions regarding BV treatment include:
1. Can BV go away without treatment?
In some cases, bacterial vaginosis may resolve spontaneously. However, treatment is recommended because untreated BV increases the risk of pelvic inflammatory disease, sexually transmitted infections, and complications during pregnancy.
2. How long does treatment take?
Most antibiotic treatments last between 5 and 7 days, depending on the medication and whether it is taken orally or as a vaginal cream or gel. Secnidazole can be effective with a single dose.
3. Can partners get BV?
Bacterial vaginosis is associated with sexual transmission, and studies have shown that treating male partners can reduce recurrence. Routine partner treatment is not yet standard but is being increasingly studied.
4. How to prevent BV from coming back?
Using condoms, avoiding vaginal douching, and maintaining good genital hygiene help reduce the risk. Taking probiotics alongside or after antibiotics can also help restore healthy bacteria and lower recurrence rates.