How to stop recurrent BV infections

What to do if your BV infection keeps coming back?


It is estimated that 3 out of 10 women who have been treated for BV have a recurrence of symptoms within 3 months and more than half experienced a recurrence within 12 months.

When symptoms reoccur within a short period, it is more likely that the initial treatment failed to eradicate the offending bacteria and normal vaginal flora was not restored. When provided an antibiotic for BV, it is imperative to take the medication as prescribed and complete the course. Often patients feel better during the course of treatment and stop taking the medication, but you must always complete the full course of prescrobed antibiotics.

There is no single causative agent of BV.  Contributing factorrs may include incorrect vaginal hygiene practices, sexual activity, and hormonal changes. Read further on some of the common causes of BV here.

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Sexual activity and BV

Though BV is not categorized as an STI, numerous scientific studies strongly support sexual transmission. Many BV-associated bacteria have been isolated from the male penile skin, urethra, and semen. Uncircumcised males tend to harbor more bacteria, creating a greater risk of transmitting infection to women. Using a condom during sexual intercourse can greatly reduce the risk of BV.

Things you can do to prevent BV

Douching, scented soaps, bubble baths, and vigorous washing can disturb the pH of your vagina.  This in turn can foster bacterial growth and cause irritation to your skin, leading to susceptibility to BV.

Don’t smoke. There are plenty of health risks associated with cigarette smoking; one of them being that smokers are at increased risk of getting BV.

You should avoid sexual activity or use a condom when undergoing treatment for active BV, as you may be introduced to more bacteria rendering the treatment ineffective. 

Use a condom, particularly if you are having sexual activity with multiple partners, this will help to reduce the chance of bacteria entering your vagina. A secondary alternative to this would be to have your male partner wash their genitals prior to intercourse.

Get frequent STD testing. The presence of other STIs is associated with an increased prevalence of BV. You may have another STI that could be contributing to the development or recurrence of BV. BV can also increase your risk of acquiring other STIs such as chlamydia, gonorrhea, trichomonas, and herpes simplex virus type 2.

Treatment options for recurring BV

If you are still suffering from frequent BV infections after making lifestyle modifications, consider talking to a health care provider. Currently, the only proven interventions to reduce the development and recurrence of BV are circumcision of male partners and chronic suppressive therapy consisting of antibiotics and boric acid suppositories.


Long term maintenance antibiotics are typically considered when a patient has more than three episodes of BV in less than a year.

Metronidazole gel for 7-10 days may be prescribed followed by twice-weekly dosing of gel for four to six months.

Alcohol should be avoided while taking antibiotics as it causes unwanted medication side effects.  Additionaly, alcohol cannot be combined with metronidazole, as this may lead to a severe and even dangerous reaction.

What is boric acid?

Boric acid is a weak acid that has antiseptic properties. Vaginal boric acid suppositories work against BV by helping to restore normal vaginal acidity and balancing vaginal flora.

After treatment with an antibiotic, Metronidazole, a provider may suggest the use of vaginal boric acid suppositories for the following 30 days.


LACTIN-V is another intravaginal treatment that is used for an 11 week period and is currently undergoing clinical trials.  If approved by the FDA, this will soon be another option.

If you are affected by frequent BV infections, do not despair. There is always hope. Speak with one of our doctors today to help create a treatment plan unique to you and your vaginal health. 


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