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.
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Bacterial vaginosis (BV) is the most common vaginal problem experienced by people assigned female at birth (AFAB) of reproductive age.  BV isn’t considered a sexually transmitted infection; however, it is still closely related to sexual and reproductive health. Let’s take a closer look at the causes and treatment options for BV.
Bacterial vaginosis is caused by an imbalance of certain kinds of bacteria within the vaginal microflora.  Similar to the gut, the vagina hosts useful bacteria that are responsible for maintaining a healthy vaginal pH and limiting the overgrowth of unwanted microorganisms or yeast.  When the balance of this bacteria is disrupted, bacterial vaginosis can occur. Some common causes of BV include sexual activity, douching, and the use of antibiotics.  Learn: How to Prevent BV
Additionally, there are some factors that may increase the risk of getting BV. These include [1,3,4]:
Fortunately, BV is a curable condition that can be treated with antibiotics and other medications. Nearly 30% of BV cases will resolve without treatment; however, a majority of people affected by BV can benefit from medical intervention. 
The first-line treatment for most people with bacterial vaginosis is a course of antibiotics. Antibiotics are medicines that kill bacteria and/or prevent bacteria from growing.  Antibiotics come in a few different forms, including :
Antimicrobials are agents that work to reduce the possibility of infection and sepsis.  While all antibiotics are a type of antimicrobial, not all antimicrobials are antibiotics. A simple way to explain the difference is that antibiotics target and kill bacteria, while antimicrobials target and kill bacteria, fungi, viruses, and other organisms. 
Metronidazole is a commonly prescribed antibiotic for various bacterial infections, including respiratory tract infections, some sexually transmitted infections, meningitis, and others.  When prescribed for BV, metronidazole often comes in the form of a vaginal suppository, meaning it is inserted inside the vagina.  Metronidazole can also be prescribed as an oral tablet  Metronidazole is FDA-approved for many different bacterial infections and is generally considered safe; however, there are some potential side effects.  Some adverse effects of metronidazole can include :
Clindamycin is another common antibiotic. It is often used to treat infections such as strep throat, lower respiratory infections, pelvic inflammatory disease, and others.  Clindamycin is also available in various forms, including a gel, foam, lotion, solution, and oral capsule. For the treatment of bacterial vaginosis, clindamycin is often prescribed as a vaginal suppository, but may also be prescribed orally.  The side effects can vary depending on the mode of administration, but some potential effects include :
While clindamycin and metronidazole are the two most frequently prescribed antibiotics for BV, alternative regimes are available.  If first-line treatments are not effective or there are allergy risks, other antimicrobial agents such as tinidazole can be used. Tinidazole is often used to treat infections caused by parasites, bacteria, and other microorganisms.  Tinidazole is often prescribed as an oral tablet, and may potentially cause side effects such as :
Secnidazole is another alternative regime used to treat bacterial vaginosis as well as some sexually transmitted infections. [4, 10] Secnidazole is an antimicrobial agent often prescribed as an oral tablet. This medication is usually well tolerated, but some side effects may occur, such as :
Some people may be interested in home remedies for bacterial vaginosis. While there are some non-prescription treatment options that have been shown to aid in the management or prevention of BV, you should always consult a healthcare provider prior to trying home treatments or remedies for any conditions.
As strange as it may sound, some studies suggest that garlic could be a suitable alternative regime for various infections, including bacterial vaginosis. [11-12] Garlic has antimicrobial properties and has actually been used as a medicinal or therapeutic remedy for hundreds of years.  There is still limited data to speak on the efficacy of garlic for BV, but some studies do show that taking garlic tablets may [12-14]:
Probiotics are live microorganisms that promote a healthy balance of bacteria in the body. The use of probiotics for treating BV is still being studied, but there are some interesting results. Multiple studies have found that the use of probiotics is thought to be safe and may have beneficial effects for BV treatment. [15-16] One study suggests that probiotics play an important role in maintaining the female reproductive tract, improving vaginal immunity, and treating various gynecological diseases.  While results are promising, more research is still needed.
Boric acid is sometimes recommended by healthcare providers if patients experience recurrent yeast infections or bacterial vaginosis.  Boric acid is a compound consisting of hydrogen, boron, and oxygen, that helps promote healthy acid balance in the vagina.  In doing so, it can relieve symptoms of some vaginal infections and potentially help prevent and treat BV and yeast infections.
Home remedy treatments are not recommended without consulting a healthcare provider first. Antibiotic treatments are considered the best option for treating BV. If you are experiencing symptoms or believe you may have an infection, speak to a healthcare provider about testing and treatment options. Learn: What Happens If BV Goes Untreated?
As previously mentioned, bacterial vaginosis is not considered a sexually transmitted infection. This means that you cannot transmit BV to someone else while having sex. While BV isn’t considered an STI, sexual activity can still increase the risk of primary or recurring BV. [1,4] The CDC recommends that anyone being treated for BV refrain from sexual activity or use protection consistently while being treated. 
BV is a common vaginal condition that shares similar symptoms with many other vaginal infections, including some STIs, yeast infections, and others. Taking control of your sexual and reproductive health can be as easy as ordering an at-home lab test online or speaking with a licensed healthcare provider through a telehealth consultation. Everlywell is proud to offer virtual women’s health visits so you can get answers, next steps, and peace of mind.