What are the treatments for bacterial vaginosis (BV)?

Currently, the only effective treatments for BV are prescribed antibiotics, including metronidazole and clindamycin.1,2,3,4 These are prescribed as oral medications, which are taken by mouth, or as a gel or cream, both of which are inserted into the vagina with an applicator.

Even if symptoms start to disappear, it is important to complete the entire course of a prescription for BV because of the likelihood of recurrence.

Over-the-counter medications for treating vaginal problems are not effective for treating BV.

Should BV be treated in pregnant women?

According to the Centers for Disease Control and Prevention (CDC), pregnant women with BV should be treated because of the possible risks of BV to the fetus.

Risks of BV during pregnancy include delivering an infant preterm (before 37 weeks of pregnancy) and delivering an infant with a low birth weight (generally, 5.5 pounds or less).

The CDC recommends that pregnant women be tested—and treated if necessary—if they have symptoms of BV.

In addition, the CDC recommends that all pregnant women who have ever had a preterm delivery or delivered an infant with a low birth weight be considered for BV examination regardless of whether they have symptoms.

Some research shows that treating BV in pregnant women does not reduce the risk of preterm birth. Further study is needed to better understand these outcomes.5


  1. Department of Health and Human Services, Office on Women's Health. (2008). Bacterial vaginosis fact sheet. Retrieved May 10, 2012, from http://womenshealth.gov/publications/our-publications/fact-sheet/bacterial-vaginosis.html
  2. American College of Obstetricians and Gynecologists. (n.d.). FAQ: Gynecologic problems. Retrieved May 10, 2012, from http://www.acog.org/~/media/For%20Patients/faq028.pdf?dmc=1&ts=20120510T1238147389 external link (PDF 285 KB)
  3. American Pregnancy Association. (2005). Bacterial vaginosis during pregnancy. Retrieved May 11, 2012, from https://americanpregnancy.org/pregnancy-complications/bacterial-vaginosis-during-pregnancy/ external link
  4. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR 2006: 55 (No. RR-11), 1–94.
  5. Brocklehurst, P., Gordon, A., Heatley, E., & Milan, S. J. (2013). Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev. 2013 Jan 31;1:CD000262. doi: 10.1002/14651858.CD000262.pub4.
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