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Female hands hold white tube of BV cream to treat BV symptoms

Bacterial vaginosis treatment

Share your symptoms with Health AI and get treatment from a provider if appropriate.

How it works

Check-in with Health AI
Complete a check-in with the help of Health AI.
Discuss with a provider
Review your health concern or treatment request with a One Medical provider via message.
Get treatment
Receive your care plan. If appropriate, prescriptions are sent to your pharmacy and, if you use Amazon Pharmacy, delivered to your door (if eligible).
Smiling One Medical provider delivers telehealth care

Common BV medications

Your Amazon One Medical provider will determine which (if any) BV treatment is medically appropriate for you based on your symptoms and health history. If you're prescribed medication, your provider will send the prescription to your preferred pharmacy. The cost of your prescribed medication is not included with the treatment cost and may be covered by health insurance.
Topical icon

Topical antibiotics

• Clindamycin cream (Cleocin)
• Metronidazole gel (Metrogel Vaginal)
Pill bottle icon

Oral antibiotics

• Metronidazole (Flagyl)
• Tinidazole (Tindamax)
Two female friends walk down urban street, chatting with shopping bags about BV symptoms

What is bacterial vaginosis (BV)?

BV is a type of vaginitis caused by an overgrowth of unwanted bacteria in the vagina. These bacteria can throw off the natural balance of the vaginal microbiome, leading to uncomfortable symptoms. If you have BV, specialized antibiotics can help restore your protective vaginal flora.

What are BV symptoms?

• Abnormal vaginal discharge
• Itchiness
• “Fishy” odor that’s worse after sex or during your period

Frequently asked questions

See all Amazon One Medical FAQs
What's the difference between bacterial vaginosis and a yeast infection?
BV and vaginal yeast infections are both types of vulvovaginitis, which is the general name for inflammation of the vagina or vulva. BV is the most common type of vaginitis, followed by vaginal yeast infections, then trichomoniasis (also known as trich).
BV and vaginal yeast infections may have some overlapping symptoms, like itchiness and discomfort. But BV is associated with a fishy odor, while yeast discharge is odorless. BV discharge also tends to be thin, grayish, or foamy, while yeast infection discharge tends to be thick, white, or like cottage cheese.
You're in the right place to get bacterial vaginosis treatment. If you're not sure what you have (BV or a vaginal yeast infection), our health intake will help narrow down your symptoms so you can get the right treatment.
If you think you have trich, a sexually transmitted infection (STI), you'll need to see a primary care provider for lab testing.
Can bacterial vaginosis go away on its own?
BV goes away on its own in about 30% of cases, but oral or vaginal antibiotics can relieve BV symptoms within days as opposed to weeks or months.
How long do I need to treat a vaginal bacterial infection?
Depending on the type of medication, you'll need to use the prescription BV treatment for 2 to 7 days.
What causes bacterial vaginosis?
Bacterial vaginosis is caused by vaginal dysbiosis, which in this case means too much bacterial diversity in the vaginal microbiome. A healthy vaginal environment contains mostly Lactobacillus bacteria—and sometimes just these bacteria.
Lactobacilli produce enough lactic acid to keep vaginal pH levels under 4.5. When more species of bacteria colonize the vagina, lactic acid production goes down and pH levels go up. The vaginal microbiome also loses some of its antimicrobial, antiviral, and anti-inflammatory properties.
Although BV isn't generally defined as a sexually transmitted infection (STI), it often spreads through sexual contact. The pathogenic bacteria that characterize BV can be introduced through a variety of sexual activities, including sex without a condom or a recent change in sexual partners.
How can I prevent another BV infection?
BV can spread through poor genital hygiene practices. To lower the risk of spreading bacteria, providers recommend the following BV prevention methods:
• Don't use vaginal douches
• Change your underwear frequently
• Urinate after having sex
Finally, smoking cigarettes, being overweight or obese, and high-fat diets have also been associated with BV risk.
Are there any natural remedies for BV?
Some research has shown that probiotics can help prevent BV from recurring after initial treatment. While antibiotics act directly on "bad" bacteria, Lactobacillus probiotics may help your body reestablish a healthy vaginal microbiome.
You can consume probiotics naturally through foods like yogurt, or you can take probiotic supplements.
What are the risks of having BV?
Vaginal bacterial infections often cause quality-of-life issues, but BV can also increase certain health risks. Less "good" bacteria in the vaginal microbiome can make a person more vulnerable to other infections of the genital tract.
For example, someone with bacterial vaginosis is more likely to contract an STI like herpes, human papillomavirus (HPV), or HIV. They may also be more vulnerable to urinary tract infections (UTIs) and pelvic inflammatory disease (PID).
BV in pregnancy can increase the risk of preterm labor and other pregnancy complications. If you're pregnant and you're experiencing BV symptoms, you're eligible for treatment through Amazon One Medical On-Demand Care.
If you're pregnant without symptoms of BV and want to lower your risk, you'll need to discuss your options with a primary care provider.
Clinical sources
1. Abou Chacra, L., Fenollar, F., & Diop, K. (2022). Bacterial Vaginosis: What Do We Currently Know?. Frontiers in cellular and infection microbiology, 11, 672429.
2. Coudray, M. S., & Madhivanan, P. (2020). Bacterial vaginosis-A brief synopsis of the literature. European journal of obstetrics, gynecology, and reproductive biology, 245, 143–148.
3. Fredricks, D. N., Fiedler, T. L., & Marrazzo, J. M. (2005). Molecular identification of bacteria associated with bacterial vaginosis. The New England journal of medicine, 353(18), 1899–1911.
4. Muñoz-Barreno, A., Cabezas-Mera, F., Tejera, E., & Machado, A. (2021). Comparative Effectiveness of Treatments for Bacterial Vaginosis: A Network Meta-Analysis. Antibiotics (Basel, Switzerland), 10(8), 978.
5. Webb L. (2021). Probiotics for preventing recurrent bacterial vaginosis. JAAPA : official journal of the American Academy of Physician Assistants, 34(2), 19–22.
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