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How to Prevent BV: Methods for Preventing Bacterial Vaginosis

Medically reviewed on June 27, 2023 by Morgan Spicer, Medical Communications Manager. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


Table of contents


An Overview of Bacterial Vaginosis

Bacterial vaginosis, also known as BV, is the most common vaginal problem for people assigned female at birth (AFAB) of reproductive age. [1] BV is a condition that occurs when there’s an imbalance or overgrowth of the natural bacteria found in the vagina. These bacteria are known as the vaginal flora and play an important role in vaginal health. [2] The vaginal flora is vital for maintaining a healthy pH and preventing the overgrowth of unwanted organisms and yeast. [2] When the natural balance of bacteria or pH is disrupted, BV may occur. This may occur as a result of sexual activity, douching, antibiotic use, or other reasons. [1,3] Want to know more? Read this overview of BV.

Symptoms of BV

BV symptoms can be very similar to symptoms of other vaginal infections or STDs. It’s important to note that a majority of people with BV do not experience symptoms. [1,3] If someone does have symptoms, they may notice the following [1,3]:

  • Pain when having sex
  • Pain when urinating
  • Abnormal vaginal discharge that is off-white, gray, or slightly green
  • Foul-smelling, often fishy, vaginal discharge
  • Vaginal irritation or itching

Because these symptoms are commonly experienced with other infections, it’s important to speak to a healthcare provider to rule out other causes and get appropriate treatment. [1,3]

How to Prevent BV

It may not be possible to completely prevent bacterial vaginosis from occurring, but there are steps you can take to potentially limit your chances. [1,3] To recap, BV is caused by an overgrowth or imbalance of naturally occurring vaginal bacteria. These steps may be helpful for maintaining a balanced vaginal flora.

Safe Sex Practices

BV is not considered an STD as there are no outside bacteria or organisms causing the infection. [1] However, being sexually active has been associated with an increased risk of BV. [1] It’s important to practice safe sex and try to avoid high-risk behaviors. This includes limiting your number of sex partners, using barrier methods such as latex condoms or dental dams, and sanitizing sex toys between uses. [1,4]

Everlywell STD Tests

Healthy Vulvar Care

Practicing healthy vulvar care is an important part of reproductive health. The vulva includes the area of female sex organs that lies outside of the vagina. This includes the labia, public bone, clitoris, and urethra. [5] The goal of vulvar care is to keep the vulva dry and free from irritants. Maintaining healthy vulvar and vaginal care can decrease the risk of irritation and infections such as BV. [5] Some general tips for healthy vulvar care include [5]:

  • Avoid scratching
  • Use tampons or menstrual cups instead of sanitary pads
  • Avoid scented oils, bubble baths, talc, or powder around the vulva
  • Use soft toilet tissue
  • Use gentle soaps or detergents on underwear
  • Avoid wearing tight underwear or clothing
  • Avoid wearing thongs

Avoid Douching and Vaginal Products

Douching has been shown to increase the risk of BV. [1] Douching refers to using a stream of water to clean or rinse out the vagina. Many experts recommend that douching be avoided as it may actually rinse away or disrupt the beneficial bacteria found in the vagina. [5] Douching can throw off pH, introduce new bacteria, or strip away healthy vaginal flora. [6] Vaginal washes, soaps, or other products can increase your risk of BV and other infections. [5] The vagina is self-cleaning and doesn’t require the use of any soaps or powders unless you are told otherwise by a healthcare provider. [5] If you are experiencing an unusual odor or have concerns about your hygiene, seek a medical professional’s opinion.

Wear Cotton Underwear

Wearing cotton underwear may also be helpful for preventing BV. Bacteria tend to thrive in moist environments, but cotton helps absorb moisture, reducing the amount of excess moisture in the vagina and reducing the risk of yeast infections, BV, and other infections. [5,7] It’s best to avoid wearing tight clothing or garments when possible, as this can negate the benefits of cotton underwear. [7]

Use Vaginal Friendly Lube

Some lubricants can potentially throw off vaginal pH or disrupt the vaginal flora. [8] The natural vaginal pH is slightly acidic and is typically a pH of 4.5. [1] Many lubricants are more basic and may cause a pH imbalance. [8] Not only can pH imbalances be harmful, but some lubricants contain ingredients that may cause irritation to the vagina or vulva. [9] A study found that some vaginal lubricants may encourage the growth of various bacteria or weaken the vaginal barrier. [9] Some specific ingredients that may lead to irritation, increased risk of infection, or hormone disruption include [10-12]:

  • Synthetic fragrances (perfume, fragrance oil, parfum)
  • Parabens and preservatives (methylparaben, ethylparaben, propylparaben)
  • Glycerin

Treating BV

About 30% of BV cases can resolve without medical treatment, however, it’s always best to consult a healthcare provider if you are concerned about BV or other infections. [1] Treating BV is typically a fast and easy process and requires the use of a prescribed antibiotic such as clindamycin or metronidazole. [1] Antibiotics may be tablets meant for oral use, or come in the form of vaginal creams. Most rounds of antibiotics will last for seven days and should eliminate the infection completely, however, some people may require another round of treatment. [1]

Can You Get BV More Than Once?

It is possible and fairly common for bacterial vaginosis to occur, even after treatment with antibiotics. [1,13] Another round of medicine can be prescribed if someone does have a recurring infection. Recurrent BV is defined as three or more confirmed symptomatic episodes in one year. [13] There are many reasons someone may have recurrent BV, including [13]:

  • Inadequate treatment: Misuse or early discontinuation of medication
  • Reinfection: Sexual contact from either a male or female partner may potentially cause recurrent BV. While people without vulvas cannot have BV, they may be able to pass it on to an AFAB partner. All partners of BV patients should speak to a healthcare provider about being tested and treated.
  • Infection relapse: Even with the appropriate medical treatment and safe sex habits, relapse is possible if the vaginal flora becomes dominated by specific bacteria.

There are other potential causes for recurring BV, such as genetics, antimicrobial resistance, and more. Speak to a healthcare provider if you’re concerned about recurring infections.

Supporting Your Sexual Health

Whether you’re concerned about bacterial vaginosis, sexually transmitted infections, yeast infections, or other conditions, it’s important to feel knowledgeable and protected. Everlywell is here to support your health and wellness, including sexual health. Book a women’s health visit online to discuss any concerns or questions with a licensed healthcare provider, or shop for at-home testing kits to get peace of mind. Want to learn more? Check out the Everlywell Blog.

How to Treat Bacterial Vaginosis (BV): Medications and Home Remedies

What Happens If BV Goes Untreated?

What is Bacterial Vaginosis? Causes and Symptoms of BV


References

  1. Kairys N, Garg M. Bacterial Vaginosis. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459216/
  2. Miller EA, Beasley DE, Dunn RR and Archie EA (2016) Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique? Front. Microbiol. 7:1936. doi: 10.3389/fmicb.2016.01936
  3. Bacterial Vaginosis. Cleveland Clinic. February 6 2023. URL. Accessed June 2023.
  4. Sexually Transmitted Infections. Cleveland Clinic. February 3 2023. URL. Accessed June 2023.
  5. Vulvar Care. Cleveland Clinic. March 23 2018. URL. Accessed June 2023.
  6. Martino JL, Vermund SH. Vaginal douching: evidence for risks or benefits to women's health. Epidemiol Rev. 2002;24(2):109-124. doi:10.1093/epirev/mxf004
  7. Felix TC, de Araújo LB, Röder DVDB, Pedroso RDS. Evaluation of Vulvovaginitis and Hygiene Habits of Women Attended in Primary Health Care Units of the Family. Int J Womens Health. 2020;12:49-57. Published 2020 Jan 30. doi:10.2147/IJWH.S229366
  8. Fashemi B, Delaney ML, Onderdonk AB, Fichorova RN. Effects of feminine hygiene products on the vaginal mucosal biome. Microb Ecol Health Dis. 2013;24:10.3402/mehd.v24i0.19703. Published 2013 Feb 25. doi:10.3402/mehd.v24i0.19703
  9. Wilkinson EM, Łaniewski P, Herbst-Kralovetz MM, Brotman RM. Personal and Clinical Vaginal Lubricants: Impact on Local Vaginal Microenvironment and Implications for Epithelial Cell Host Response and Barrier Function. J Infect Dis. 2019;220(12):2009-2018. doi:10.1093/infdis/jiz412
  10. Nicole W. A question for women's health: chemicals in feminine hygiene products and personal lubricants. Environ Health Perspect. 2014;122(3):A70-A75. doi:10.1289/ehp.122-A70
  11. Parabens Fact Sheet. Centers for Disease Control and Prevention. April 2017. URL. Accessed June 2023.
  12. Vulvovaginal Health. American College of Obstetrics and Gynecology. Reviewed January 2022. URL. Accessed June 2023.
  13. Sobel, J. Bacterial vaginosis: Recurrent infection. UpToDate. November 7 2022. URL.
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