How Is Bacterial Vaginosis Treated?
Medically Reviewed by Alvaro Lucioni, MD
Virginia Mason Medical Center
By Sheryl Kraft
If you have a thin, milky vaginal discharge that's white or gray, has a fishy odor and causes pain, itching or burning in the vagina, don't rush to the drugstore to buy an over-the-counter treatment for a yeast infection. These are more likely symptoms of bacterial vaginosis (BV), a common vaginal infection that needs to be diagnosed by your health care professional.
Most women will experience a vaginal infection with discharge, odor and itching at some time in their life, but the symptoms and the treatment vary, depending on the type of infection. That's why it's important to be evaluated by your health care provider as soon as symptoms appear.
Your health care provider will likely conduct a physical examination, ask questions about your personal life and medical history and may send samples to the lab for testing.
The three main causes of vaginal discharge are BV, trichomoniasis and vulvovaginal candidiasis (VVC), often referred to as a "yeast infection." Though these may produce some similar symptoms, there are differences—and they are treated differently.
For example, the discharge from VVC looks sort of like cottage cheese, while the discharge with trichomoniasis is yellowish-green. However, even a health care professional will not rely on sight alone to make a diagnosis and prescribe treatment.
Many women don't seek medical help for vaginal symptoms. They wait for them to go away or try to self-diagnose their problem. A recent online survey of 1,969 women, conducted by HealthyWomen in partnership with Symbiomix Therapeutics, shows that only four out of 10 women visited their health care professional when they experienced abnormal vaginal discharge. The others sought advice from family, friends or the Internet; used an over-the-counter, natural or home remedy; or just waited for the symptoms to subside.
While some BV infections will resolve on their own, most do not. They can be successfully treated with prescription medications, but, if left untreated, BV can worsen, spread and increase the risk of sexually transmitted infections including HIV, as well as pelvic inflammatory disease, which may lead to infertility.
That's why it's important to get evaluated by a health care professional and seek treatment if you suffer from any of the following symptoms:
A thin white or gray milky discharge
A fishy odor
Pain, itching or burning in the vagina
Itching around the vagina
BV is usually curable using prescription antibiotics. These antibiotics may be oral or topical (inserted into the vagina with an applicator). All antibiotics have potential side effects, sometimes serious, so talk to your health care provider about your prescription and read labels carefully to be aware of any potential side effects.
Be sure to take antibiotics for the fully prescribed time. The most common BV prescriptions are for either five days for the vaginal creams or seven days for the oral medications. Many of the prescription treatments advise that women not drink any alcohol while taking the medication.
Because vaginal treatments can be messy and interfere with sex and oral treatments have other restrictions and side effects, some women indicate they'd prefer a different treatment. In the recent online survey about BV, nearly 9 of 10 women (88%) said they'd be interested in an oral BV medication that they would only have to take once.
With existing options, women often don't take the full course of antibiotic treatment. Common reasons they stop include: side effects of the treatment; their symptoms disappear; or they don't want to abstain from alcohol. If a woman does not complete the full course of treatment, it increases the likelihood of the infection returning.
Studies show there is no need to treat male sexual partners for BV, but if you have a female sexual partner, she should seek treatment if you have a BV infection.
Some evidence indicates that probiotics may help prevent and treat BV, but more research is needed.
If you suspect you may have BV, see your health care provider for a diagnosis and to discuss treatment options.
This resource was developed with the support of Symbiomix Therapeutics, LLC.
- Survey results from “Do You Really Know What’s Causing Your Discharge?” (online survey conducted by HealthyWomen and Symbiomix Therapeutics, LLC, in the first quarter of 2017). Results on file with HealthyWomen and Symbiomix Therapeutics, LLC. 2017.
- Bartley JB, Ferris DG, Allmond LM, et al. Personal digital assistants used to document compliance of bacterial vaginosis treatment. 2004;31(8):488-491. https://insights.ovid.com/pubmed?pmid=15273582. Accessed July 2017.