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Best Treatments for BV: Antibiotics, OTC and More
March 9, 2023
Read Time - 10 minutes
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The best OTC and antibiotic medicine options for BV

Bacterial vaginosis (also known as BV) is a highly common condition that affects the bacterial balance of the vagina. According to the Centers for Disease Control and Prevention (CDC)’s fact sheet, BV is “the most common vaginal condition in women ages 15-44.” Studies have shown that nearly 30% of women deal with bacterial vaginosis at some point. These infections can cause uncomfortable and painful symptoms. So, given the prevalence of the condition, what’s the best route for BV treatment?

There are currently no FDA-approved OTC medications used for the treatment of BV. That means an infection will usually require prescription medicine. In the article below, we will dig into the causes of BV as well as the prevalent treatment options available.

About BV

Bacterial vaginosis is caused by a change in bacterial levels in the vagina. The vagina contains naturally occurring bacteria that help protect the area and keep it clean. These organisms are known as “good bacteria” or “vaginal flora”. BV occurs when harmful vaginal bacteria start to overtake the amount of “good bacteria” and the pH – or acid/base balance – changes. When this vaginal balance is thrown off, due to an overgrowth and/or change in the species of bacteria growing within it, it can result in bothersome symptoms.

Common symptoms of BV include:

  • Abnormal vaginal discharge
  • A foul-smelling, fishy odor
  • Itching
  • Pain during urination

    BV infections are most common in women between the ages of 15 and 50, or women in their “reproductive years”. Nearly 1 in 3 women will experience bacterial vaginosis at some point.

There is no one cause of bacterial vaginosis. Common causes include:

  • Sex: It is rare for women to develop bacterial vaginosis if they are not sexually active. Women with multiple sexual partners, women who have unprotected sex, and women who have sex with women are at greater risk of getting BV.
  • Douching: Douching kills off good bacteria (lactobacilli) in the vagina, increasing the risk of bad bacteria (anaerobes) overgrowing and causing an infection.

While bacterial vaginosis infections are not classified as sexually-transmitted infections (STIs), they can significantly increase your risk of contracting one. Untreated BV has been linked to complications such as:

  • Sexually-transmitted infections: BV can increase one’s risk for sexually-transmitted infections (also known as sexually-transmitted diseases or STDs) such as chlamydia, gonorrhea, or human immunodeficiency virus (HIV).
  • Preterm birth: In pregnant women, BV has been shown to correlate with premature births and low birth weight babies.
  • Pelvic inflammatory disease (PID): Recurrent bacterial vaginosis may lead to the development of PID, an infection of the reproductive tract, that can cause infertility.

Prescription Bacterial Vaginosis Treatment

In some cases, BV will go away on its own. If left untreated, however, bacterial vaginosis can cause dangerous complications like those listed above. If you begin to notice some early symptoms of BV such as abnormal vaginal discharge or a fishy odor, you should talk to a health care provider right away.

Bacterial vaginosis is most commonly treated with a course of antibiotic treatment.

The FDA has approved these drugs for the treatment of BV:

  • Metronidazole: Available as an oral tablet or medicated vaginal gel. Metronidazole may cause nausea or an upset stomach. Avoid alcohol use while taking this medication.
  • Clindamycin: Clindamycin is an antibiotic medication commonly supplied as a vaginal cream or vaginal suppository–small medications that are inserted into the vagina via an applicator. Clindamycin cream may cause vaginal itching or abnormal discharge. Oral clindamycin may cause stomach pain or nausea.
  • Tinidazole: Tinidazole is available as an oral tablet. Like metronidazole, it can cause abdominal pain and an upset stomach. Talk to your doctor if you experience any adverse effects while taking this medication.
  • Secnidazole: Secnidazole is available as a fine powder that is meant to be taken with food. Simply sprinkle the powder over soft food such as applesauce or yogurt, and be careful not to bite down on the powdered crystals. Secnidazole is usually taken as a single dose.

Home remedies

There are few BV treatment options available over the counter. Antibiotic medicine is considered the primary and most effective option to completely treat BV. There are currently no FDA-approved antibiotic products available over the counter. If you are concerned about the side effects of antibiotic use, talk to your health care provider. Additionally, you should seek medical advice before you use any OTC remedies as your sole treatment for BV.


Talk to your health care provider before you begin taking probiotic supplements. These are not as effective as medication and may not completely treat a bacterial infection.

Boric Acid Suppositories

There is a role for boric acid vaginal suppositories in patients with relapsing or recurrent BV when used in combination with antimicrobial agents. However, boric acid has not been shown to effectively treat BV. Boric acid tablets are meant to play a supportive role in treatment with antibiotic medication acting as the primary therapy.

Keep boric acid tablets away from the reach of small children or pets, as boric acid is very toxic when ingested orally. In addition, boric acid suppositories are unsafe to use during pregnancy. Seek medical advice from a licensed health care provider before you begin to self-administer any OTC medications.

BV Prevention

You can decrease your risk of developing bacterial vaginosis with a few self-care practices. These include:

  • Use latex condoms. Unprotected sexual activity has been linked to BV, so use latex condoms during sex to minimize your risk of contracting an infection.
  • Limit sexual partners. BV has been linked to sex with new partners, or sex with multiple partners. Limiting sex partners may help minimize your risk of contracting BV or STIs.
  • Don’t douche. Douching eliminates good bacteria from the vagina, which can lead to an overgrowth of harmful bacteria. Avoid douching and using cleansing products (such as harsh soaps or deodorants) on the vagina.
  • Avoid irritation. Wear breathable - preferably cotton - underwear to wick moisture from the genital area and prevent irritation. Avoid scented cleaning products and tampons.

How to get a BV Prescription without seeing a doctor

BV is a very common condition that is easily treatable with a course of antibiotics. However, antibiotic use requires a prescription from a health care provider. If you’re looking to get a prescription for BV treatment without the hassle of going to a doctor’s office, book a convenient and affordable bacterial vaginosis prescription visit on Sesame today.

These convenient and affordable appointments allow you to discuss your condition with a highly-experienced health care provider from the comfort of your home. Providers can prescribe BV medication during these video visits, if appropriate. Depending on the medication, you can have your prescription delivered to your home or ready for same-day pickup at a pharmacy of your choice. Book a visit today to get started on treatment right away.

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Medical disclaimer

Sesame content is not intended to be a substitute for professional medical advice, diagnosis or treatment. If you have a medical concern, it is critical to seek the advice of your physician or another qualified health provider with any questions. If you are facing a medical emergency, call 911 or visit the nearest emergency room immediately.