Bacterial vaginosis


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Treatments and drugs

By Mayo Clinic staff

To treat bacterial vaginosis, your doctor may prescribe one of the following medications:

  • Metronidazole (Flagyl, Metrogel-Vaginal, others). This medicine may be taken orally — as a pill that you swallow. Metronidazole is also available for use topically, as a gel that you insert into your vagina. To avoid the potential for stomach upset, abdominal pain or nausea while using this medication, avoid alcohol during treatment and for at least one day after completing treatment — check the instructions on the product.
  • Clindamycin (Cleocin, Clindesse, others). This medicine is available as a cream that you insert into your vagina. One effect of using clindamycin cream is that it may weaken latex condoms during treatment and for at least three days after you stop using the cream.
  • Tinidazole (Tindamax). This medication is taken orally. Tinidazole has the same potential for stomach upset and nausea as oral metronidazole does, so avoid alcohol during treatment and for at least one day after completing treatment.

Generally, it's not necessary to treat a woman's male sexual partner, but bacterial vaginosis can spread between female sexual partners. Female partners should seek testing and, if indicated, treatment of bacterial vaginosis. It's especially important for pregnant women with symptoms to be treated, as this may decrease the risk of premature delivery or low birth weight.

Take your medicine or use the cream or gel for as long as your doctor prescribes it — even if your symptoms go away. Stopping treatment early may increase the likelihood of recurrence.

Recurrence
Despite effective treatments for bacterial vaginosis, recurrence of symptoms within three to 12 months is common. Researchers are exploring treatment regimens for recurrent bacterial vaginosis. If your symptoms recur soon after treatment, talk with your doctor about treatment options, one of which is extended-use metronidazole therapy.

A self-help approach is lactobacillus colonization therapy — which attempts to boost the number of good bacteria in your vagina and re-establish a balanced vaginal environment — possibly accomplished by eating certain types of yogurt or other foods containing lactobacilli. However, research to determine the benefits and risks of probiotic therapy is lacking.

Prevention Tests and diagnosis
References
  1. CDC fact sheet: Bacterial vaginosis fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/bv/STDFact-Bacterial-Vaginosis.htm. Accessed March 19, 2013.
  2. Bacterial vaginosis. National Institute of Allergy and Infectious Diseases. http://www.niaid.nih.gov/topics/bacterialvaginosis/pages/default.aspx. Accessed March 19, 2013.
  3. Sexually transmitted diseases (STDs): Bacterial vaginosis (BV). Centers for Disease Control and Prevention. http://www.cdc.gov/std/bv/default.htm. Accessed March 19, 2013.
  4. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Gynecology. ACOG Practice Bulletin No. 72. Vaginitis. Obstetrics and Gynecology. 2006;107:1195. Reaffirmed 2011.
  5. Frequently asked questions. Gynecologic problems FAQ028. Vaginitis. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq028.pdf?dmc=1&ts=20130319T1944039856. Accessed March 19, 2013.
  6. STD treatment guidelines 2010. Centers for Disease Control and Prevention. http://www.cdc.gov/std/treatment/2010/default.htm. Accessed March 19, 2013.
  7. Sobel JD. Bacterial vaginosis. http://www.uptodate.com/home. Accessed March 19, 2013.
  8. Bacterial vaginosis fact sheet. Womenshealth.gov. http://womenshealth.gov/publications/our-publications/fact-sheet/bacterial-vaginosis.cfm. Accessed March 19, 2013.
  9. Flagyl (prescribing information). New York, N.Y.: Pfizer; 2010. http://labeling.pfizer.com/ShowLabeling.aspx?id=570. Accessed March 21, 2013.
  10. Cleocin (prescribing information). New York, N.Y.: Pfizer; 2005. http://labeling.pfizer.com/showlabeling.aspx?id=627. Accessed March 21, 2013.
  11. Tindamax (prescribing information). San Antonio, Texas: Mission Pharma; 2004.http://www.missionpharmacal.com/Global_Content/Package_Inserts/Tindamax.pdf. Accessed March 21, 2013.
  12. Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. March 26, 2013.
  13. Thielen JM (expert opinion). Mayo Clinic, Rochester, Minn. April 6, 2013.
DS01193 April 20, 2013

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