Bacterial Vaginosis: Quick Guide to Symptoms, Treatment & Prevention

Noticed a thin white or gray discharge and a fishy smell after sex? That’s the most common sign of bacterial vaginosis (BV). It’s caused when the balance of bacteria in the vagina shifts away from protective lactobacilli toward anaerobic bacteria. BV is common, treatable, and often comes back—but there are clear steps you can take right now.

Treatment Options

Most doctors start with antibiotics. The usual choices are:

• Oral metronidazole 500 mg twice daily for 7 days — effective and widely used.
• Metronidazole 0.75% gel applied vaginally once daily for 5 days — fewer systemic side effects.
• Clindamycin cream 2% applied vaginally at night for 7 days — an alternative if metronidazole isn’t suitable.

If you can’t take metronidazole, tinidazole or oral clindamycin are options. Always check with your provider about pregnancy, breastfeeding, or drug interactions before starting treatment.

Thinking about home remedies or OTC options? Some topical antiseptics and home washes don’t help and can make BV worse. Boric acid suppositories are used by some people for recurrent BV, but that’s an off-label approach and not safe during pregnancy. Talk to a clinician before trying boric acid.

Prevention & When to See a Doctor

Want fewer recurrences? Try these simple habits:

• Avoid douching and scented washes — they upset the vaginal microbiome.
• Use condoms and limit new sexual partners when possible — sex can change vaginal flora.
• Quit smoking — it raises BV risk.
• Wear breathable cotton underwear and avoid tight synthetic pants for long periods.

Some people use probiotics (oral or vaginal lactobacillus) to restore balance. Research shows mixed results, but probiotics are low-risk and may reduce recurrence for some. If BV keeps coming back, ask your provider about a suppressive plan — for example, metronidazole gel twice weekly for several months has helped many people.

See a doctor if you have a strong fishy odor, heavy discharge, fever, pelvic pain, or if you’re pregnant. BV in pregnancy can raise the risk of early labor, so don’t delay care. Also get checked for STIs if symptoms are unusual or your partner has symptoms.

Quick self-care tips: keep the area clean with plain water, don’t use harsh soaps, and avoid forcing treatments without medical advice. If you take antibiotics, finish the full course even if symptoms improve.

Got questions about metronidazole alternatives, over‑the‑counter substitutes, or how to stop BV from returning? Talk to a provider or pharmacist — they can match treatment to your situation and safety needs.