BV Keeps Coming Back?How Often It Recurs and What Helps
Intimate HealthArticleIf bacterial vaginosis returns after antibiotics, you're in the majority. In an Australian study of 139 women treated with the standard antibiotic, 58% had BV again within a year. A past history of BV and a regular sex partner went with higher odds. An experimental vaginal probiotic cut recurrence in a trial, but you can't buy it yet. Here is what the studies show and what to ask for.
In this article
Bacterial vaginosis (BV) happens when the lactobacilli that normally keep the vagina acidic are replaced by a mix of other bacteria, often causing a fishy smell and thin grey discharge. Antibiotics clear it, but it often comes back.
How often it returns
An Australian study followed 139 women treated with a week of oral metronidazole, the standard antibiotic, checking samples at 1, 3, 6 and 12 months.1
The authors concluded that the recommended treatment wasn’t preventing recurrence for most women.1
What raised the odds
| Factor | Effect on recurrence |
|---|---|
| Past BV | Higher1 |
| A regular sex partner during the study | Higher1 |
| Female sex partners | Higher1 |
| Hormonal contraception | Lower1 |
The link with partners points to a possible role for sexual transmission.1 See partner treatment for recurrent BV.
A probiotic that helped, but isn’t on sale
In a trial of 228 women who had just finished BV treatment, a vaginal product containing one specific strain of Lactobacillus crispatus, called Lactin-V, was used for 11 weeks:2
- BV returned by week 12 in 30% with Lactin-V, against 45% with placebo.2
- Side effects were similar in both groups.2
That’s an experimental product tested in one mid-stage trial. It isn’t the same as the probiotics sold in shops; see vaginal health probiotics.
What to ask for
- A swab to confirm it’s BV before another course, since yeast, trichomoniasis and other problems can feel similar. See yeast, BV or UTI?
- A plan for repeat episodes. Ask what options exist for women whose BV keeps returning.
- Whether partner treatment fits your situation.
- Track the pattern: dates, timing in your cycle, new partners, products used.
For the basics, see what bacterial vaginosis is and over-the-counter BV gels.
Try: “This is my third bout of BV this year, each time a week or so after my period. Could we confirm it with a swab and talk about a longer treatment plan to stop it coming back?”
Down There, Decoded covers this in Chapter 7, “Here We Go Again,” in a section called “When BV Comes Back.” Its Down-There Log records each episode with dates and possible triggers, so a pattern is easy to show a clinician. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Get a swab to confirm BV before treating again, especially if symptoms differ from before. See a clinician if you're pregnant with symptoms, or have pelvic pain, fever, sores or bleeding between periods. Don't use boric acid or home remedies without advice. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- Journal of Infectious Diseases (abstract via PubMed), 2006High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence (opens in a new tab)abcdefghi
- New England Journal of Medicine (abstract via PubMed), 2020Randomized Trial of Lactin-V to Prevent Recurrence of Bacterial Vaginosis (opens in a new tab)abc
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