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Treatments and drugs
By Mayo Clinic staffTo 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 — twice a day for seven days. Metronidazole is also available for use topically, as a gel that you insert into your vagina for five to seven days. To avoid the potential for stomach upset, abdominal pain or nausea while using this medication, stay away from alcohol for the duration of the treatment.
- Tinidazole (Tindamax). This medication is taken orally once a day for two to five days, depending on the prescription's strength. Tinidazole has the same potential for stomach upset and nausea as does oral metronidazole.
- Clindamycin (Cleocin, Clindesse, others). This medicine is available as a cream that you insert into your vagina for seven days. One effect of using clindamycin cream is that it may weaken latex condoms, and that effect persists up to five days after you stop using the cream.
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 the effective treatments for bacterial vaginosis, recurrence of symptoms within three to six months is common. Researchers are exploring the treatment regimens for recurrent bacterial vaginosis, but there's no evidence to support one therapy over another. If your symptoms recur soon after treatment, make an appointment with your doctor to discuss 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.
- Bacterial vaginosis fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/bv/STDFact-Bacterial-Vaginosis.htm. Accessed July 21, 2010.
- Nyirjesy P. Vulvovaginal candidiasis and bacterial vaginosis. Infectious Disease Clinics of North America. 2008;22:637.
- ACOG Committee on Practice Bulletins — Gynecology. Vaginitis. Obstetrics and Gynecology. 2006;107:1195.
- Sexually transmitted diseases treatment guidelines 2006. Centers for Disease Control and Prevention. http://www.cdc.gov/std/treatment/2006/vaginal-discharge.htm. Accessed July 21, 2010.
- Sobel JD. Bacterial vaginosis. http://www.uptodate.com/home/index.html. Accessed July 21, 2010.
- Boyd E, et al. Vaginitis: Bacterial vaginosis. In: Hillard PA. The 5-Minute Obstetrics and Gynecology Consult. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:204.
- Boardman LA, et al. Benign vulvovaginal disorders. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:625.
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