Medically reviewed on June 22, 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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The treatment for bacterial vaginosis (BV) typically includes a short round of antibiotics. While some cases of BV can resolve on their own, it’s important to know the potential complications of leaving BV untreated.
BV is a condition impacting vaginal health that is caused by an imbalance or overgrowth of certain kinds of bacteria.  Various behaviors and risk factors have the ability to disrupt the natural vaginal pH and vaginal flora, leading to BV. These behaviors and risk factors include douching, sexual activity, IUD use, having partners assigned female at birth (AFAB), pregnancy, antibiotic use, and others .
A large majority of people with BV won’t have symptoms and may not be aware they have BV.  For those that do experience symptoms, they may notice the following [1-2]:
Symptoms of BV mimic many sexually transmitted infection (STI) symptoms, yeast infections, or urinary tract infection (UTI) symptoms. It’s important to speak to a healthcare provider that can confirm the cause of these symptoms. Read What Is Bacterial Vaginosis? for more information.
Bacterial vaginosis can be treated with prescribed antibiotics or antimicrobial medications. The most commonly prescribed treatments include clindamycin or metronidazole in the form of oral tablets or vaginal suppository gels.  There are also home remedies such as probiotics, boric acid, oral garlic tablets, and other supplements that have been shown to be effective in some cases. [4-6] Home remedies are not recommended unless approved by a healthcare provider.
When prescribed medications, BV is typically remedied within seven days. In some cases, infections may return or need another round of medication. [1-3]
Because BV doesn’t always cause symptoms, it can sometimes go untreated. In about 30% of cases, BV will actually resolve without treatment.  However, if left untreated for long periods of time, BV may increase the risk of various infections, complications, and health conditions. 
Bacterial vaginosis is not a sexually transmitted infection, but it is closely tied to sexual health. Research shows that having BV increases the risk of contracting STIs, including HIV.  Those living with HIV also have a higher risk of passing HIV to sexual partners if they have untreated BV. [1,7] The risk of contracting other infections such as gonorrhea and chlamydia nearly doubles when BV is left untreated. [1,3] Data also shows that BV is a risk factor for herpes simplex virus type 2, and the infection or reactivation of human papillomavirus (HPV). [1,7] Many symptoms of BV mimic those of other infections, including STIs. It’s important to speak to a healthcare provider about testing and treatment to protect yourself and your partner(s).
Pelvic inflammatory disease (PID) is the inflammation of the upper genital tract.  PID can impact the uterus, fallopian tubes, and ovaries, causing damage to pelvic tissues and organs and leading to problems with infertility, such as ectopic pregnancy, infertility, and pelvic pain.  In the majority of cases, PID is caused by untreated sexually transmitted infections that travel up the reproductive tract. Research shows that prolonged cases of BV have been associated with a higher risk of PID. 
BV can also cause complications with fertility and pregnancy. Prolonged cases of BV have been associated with ectopic pregnancies, miscarriage, low birth weight, and induction of early labor. [7,9] BV may also increase the risk of other pregnancy implications, such as rupture, postpartum endometriosis, and others. [1,7,9] Some data show an association between BV and infertility, with more infertile people AFAB having BV than fertile people AFAB. Studies have also shown that in vitro fertilization (IVF) implantation rates are lower in people with a history of BV.  Fortunately, BV can also be treated during pregnancy with antibiotics, and outcomes for those treated are usually positive. 
Getting treatment for BV early is the best way to support reproductive and sexual health. Treatment given early on during pregnancy can decrease the risk of early labor and other pregnancy complications. [1-3] Screening for BV in asymptomatic people is not generally recommended, so if you are concerned that you may have BV or another infection, be sure to speak to a healthcare provider about testing.  You can schedule a virtual women’s health visit with Everlywell today or purchase at-home lab tests to screen for other infections like STIs, HPV, and more.