Recurrent Bacterial Vaginosis

Recurrent Bacterial Vaginosis – Can It Be Prevented?

Bacterial Vaginosis is an infection most common in women in their child-bearing and reproductive years. Women who are ages 15-44 years old are at most risk of getting bv. Bacterial Vaginosis is not a sexually transmitted infection but it can occur after unprotected sexual intercourse.

Recurrent Bacterial Vaginosis is a big problem because it often occurs when there is an imbalance in the vaginal flora. The vagina normally has both good and bad bacteria. The good bacteria such as Lactobacillus keep the vaginal pH slightly acidic and prevents foreign pathogens from multiplying and proliferating in the vagina.

When there is a decrease in the number of good bacteria, the bad bacteria will start to multiply and cause a whole host of problems not least bacterial vaginosis.

What Is Recurrent Bacterial Vaginosis?

It’s basically when bv returns after you have successfully treated it. It might come back 2-3 times in a year after each successful treatment. If it is left untreated there are possible complications and risks that can affect a woman especially if she is pregnant.

It puts her unborn baby at risk for possible complications such as preterm birth and delivery, low birth weight of baby and premature rupture of membranes. Women are also prone to getting Pelvic inflammatory disease which is the infection of the reproductive system.

Other nasty things it can cause are:

  • postpartum fever
  • infection of the reproductive organs after surgery
  • It can also increase a woman’s risk of getting sexually transmitted infections such as Herpes simplex type 2, Gonorrhoea, chlamydia and trichomoniasis.

Women who are diagnosed with Bacterial Vaginosis must immediately consult their medical care provider for the treatment and since bv is a simple infection, treatment usually includes antibiotics, oral and vaginal creams. It is quite important to complete the recommended treatment to prevent the recurring of bv, even if the symptoms are already gone within a few days of treatment.

What Are The Symptoms Of Bacterial Vaginosis?

Recurrent Bacterial Vaginosis

There are around 50-75% of women who experience symptoms, the rest are asymptomatic and only find out they have BV when going for a checkup with their medical care provider:

  1. Change in the vaginal discharge – Usually thin greyish, white in colour
  2. Painful and itchy vagina
  3. Burning sensation when urinating
  4. Painful vagina after sexual intercourse
  5. Unpleasant, “fishy” odour of the vagina

How Can BV Be Diagnosed?

Bacterial Vaginosis can be properly diagnosed by doing a medical history and discussing the symptoms with the medical care provider.

Diagnosis starts with a thorough medical history and a detailed discussion of your symptoms. A pelvic exam will be conducted to evaluate the appearance of the vaginal lining and cervix. A sample of vaginal discharge will also be taken and tested to determine if you have bacterial vaginosis.

In addition, a “whiff test” may be performed in which potassium hydroxide is combined with a vaginal discharge sample to see if there is distinct fishy odour smell.

Recurrent Bacterial Vaginosis

What Are The Causes Of BV?

The vaginal ecosystem can be disrupted by different factors such as:

  1. Presence of semen in the vagina. Semen is alkaline and bacteria thrive in an alkaline environment
  2. Use of tampons
  3. Menstrual period
  4. Using antibiotics
  5. Vaginal douching
  6. Using scented feminine hygiene products.

Bacterial Vaginosis Can Be Prevented By Doing The Following:

Recurrent Bacterial Vaginosis

  1. Use mild soaps or plain water when cleaning the genital area.
  2. Use organic feminine pads and unscented feminine products.
  3. Avoid vaginal douching – Douching can affect the vaginal ecosystem. The vagina is self-cleaning. Women who use vaginal douches are removing the good bacteria in the vagina and this will allow the growth of pathogens and bad bacteria instead.
  4. Avoid unprotected sex – Always use a condom and avoid multiple sex partners.
  5. Take probiotics – Probiotics contain Lactobacillus, these bacteria produce lactic acid and help prevent the growth of bad bacteria in the vagina. It also maintains the slightly acidic vaginal pH that keeps the vagina clean and free from infections.
  6. Lifestyle changes – Changing diet can also help prevent bv. Focus on alkaline diet and avoid meats, alcohol, sugars, and foods rich in carbohydrates.

What Are The Treatments For Bacterial Vaginosis?

  1. Metronidazole 500 mg tablet – taken orally for 7 days
  2. Metronidazole 0.75% vaginal gel – one applicator 5 grams intravaginally once a day for 5 days
  3. Clindamycin 2% vaginal cream – one applicator 5 grams intravaginally taken during bedtime for 7 days

Alternative Treatments for BV

  1. Tinidazole tablet 2 grams – taken orally for 2 days
  2. Tinidazole tablet 1 gram – taken orally for 5 days
  3. Clindamycin capsule 300 mg taken orally – twice per day for 7 days
  4. Clindamycin vaginal suppository 100 mg – taken during bedtime for 3 days

Recurrent Bacterial Vaginosis

When you are taking antibiotic treatment, It can help if you take some natural home remedies such as probiotics to make the treatment for Bacterial Vaginosis more effective.

Studies have shown that taking probiotic supplements will help treat and reduce the BV symptoms. It also helps replenish the Lactobacillus in the vagina fight off the bad bacteria that cause the infection.

When searching for possible treatments for recurrent bacterial vaginosis, it is important to consult your medical care provider to make sure the treatments chosen are safe to use, especially for women who are pregnant.

What Are The Possible Complications Of Bacterial Vaginosis?

Once diagnosed, BV must be treated with a course of antibiotic treatment. A woman with untreated BV can experience possible complications such as:

  1. Sexually transmitted diseases
  2. There is an increased risk of contracting HIV and AIDS if exposed to the virus.
  3. There is a possibility for Pelvic Inflammatory disease – This is the infection of the reproductive organs which includes the fallopian tube, cervix, uterus, and ovaries. Getting PID can also predispose a woman to have infertility or difficulty in conceiving.
  4. There is an increased risk of having a post-surgical infection – Dilation and curettage, hysterectomy, etc.
  5. Pregnant women are at more risk of delivering the baby prematurely and at low birth weight.

Recurrent Bacterial Vaginosis


According to some women, they were able to fight off bv by combining medical treatment with other home remedies like probiotics and prebiotics that help the growth of good bacteria which keep the vagina at a pH of 3.8-4.5. When the vagina is slightly acidic, it helps prevent inflammation and infections from occurring.

Bacterial Vaginosis is present in 30-50% of sexually active women however because of the stigma in the society no one seems to be eager in discussing their vaginal infections with others.

The vagina has a delicate balance of flora and pH which can be disrupted by different factors which makes it important that once you see the symptoms you inform a medical care practitioner so a full course of antibiotics can be prescribed.

If prescribed with oral and vaginal antibiotics, it is critical you complete the regimen and never consider stopping the treatment just because the symptoms and signs of bv have already disappeared.

If the prescribed treatment is 7 days, it should be taken 7 days. If symptoms reappear after the initial treatment, your doctor can prescribe extended treatment accordingly.