6 tips for how to prevent bacterial vaginosis (BV)
- Bacterial vaginosis (BV) is caused by an imbalance of “good” and “bad” bacteria in the vagina. This imbalance can occur after any activity that disrupts the natural balance of bacteria, such as douching or unprotected sex.
- It’s not possible to prevent BV in all cases since researchers still aren’t sure what causes the imbalance in bacteria. However, practicing safe sex and using good hygiene practices can reduce the risk of developing BV.
- Bacterial vaginosis is treated with antibiotics. Treatment is more likely to be successful if also combined with safe sex and good hygiene.
Do you know what’s better than an effective treatment for bacterial vaginosis (BV)? Preventing BV altogether.
Bacterial vaginosis is the most common vaginal condition in people with vaginas between the ages of 15-44. And while BV is very common, it’s no fun at all.
Here’s how to prevent BV in the first place (and how to prevent BV from coming back).
What causes bacterial vaginosis?
Bacterial vaginosis is an imbalance of “good” and “bad” bacteria in the vagina. It can happen whenever something disrupts the normal flora in the vagina. It’s more common in people who have sex, but it can happen to anyone with a vagina.
When there aren’t enough “good” bacteria in the vagina, other germs have room to grow and spread. The type of bacteria that helps keep vaginas healthy is called Lactobacillus.
Bacterial vaginosis occurs when there aren’t enough Lactobacillus and too much of another type of bacteria called anaerobes. The type of bacteria that usually causes BV is called Gardnerella vaginalis.
6 tips for how to prevent bacterial vaginosis infections
BV can develop whenever something disrupts the normal balance of bacteria in the vagina. While it’s not possible to prevent BV in all cases, you can take steps to make BV less likely.
Research shows that BV is more likely in people who are sexually active. Bacterial vaginosis is also linked to:
- People who are assigned female at birth (AFAB) and have sex with other AFAB people (including women who have sex with women)
- People with multiple sex partners
- Having a new sex partner
- Douching or using irritating vaginal products
- Having unprotected sex
You can prevent BV by avoiding or limiting activities that can affect the bacteria in the vagina.
- Do not douche or use other products that could irritate the vagina, including deodorants, harsh soaps or scented tampons.
- Practice good hygiene by always wiping front to back after using the bathroom. Wash sex toys after using them.
- Limit sex partners, since BV is more common in people who have multiple sex partners.
- Practice safe sex. Latex condoms or dental dams can keep harmful bacteria out of the vagina. It can also help preserve a normal pH level since semen is alkaline and can raise the pH of the vagina. A higher pH makes it easier for some bacteria to grow.
- Choose cotton underwear. Cotton can help wick away moisture that may lead to bacterial growth.
- If you smoke, consider quitting or cutting back. Smoking affects the immune system and is linked to an increased risk of bacterial vaginosis. It also raises the risk of other infections like trichomonas, herpes simplex virus type 2 (HSV-2) and chlamydia.
BV is not a sexually transmitted infection. It does not spread in pools, hot tubs or shared bedding, or from using the same toilet seat as someone who has BV. You also can’t get BV from touching the same surface as someone who has BV.
Can probiotics prevent bacterial vaginosis?
Probiotics might help prevent and treat bacterial vaginosis, but the research is still mixed. Yogurt and other fermented foods that contain Lactobacillus might also be beneficial, although there is no clear evidence.
Some research shows that probiotics can help treat BV when combined with antibiotics, especially in people who have repeat cases of BV. However, it’s not known how much or which type of probiotics work best.
If you’re interested in probiotic supplements, be sure to talk to your medical provider before starting. They can also help you find a good brand that contains the right strains of bacteria for your health goals.
Online treatment for BV
There are many effective antibiotics that can help treat the symptoms of bacterial vaginosis. Some medications are inserted directly into the vagina while others are swallowed. People who deal with repeat cases of BV may need multiple treatments with antibiotics.
Effective treatment for BV should also be combined with safe sex and good hygiene practices. Remember, vaginas aren’t meant to be odor-free and the vagina doesn’t need any special cleansing products.
In fact, harsh soaps or douching can actually make BV more likely. The vagina keeps itself clean through normal secretions, so washing the vagina (even with plain water) can make it harder for the “good” bacteria in your vagina to protect against harmful germs.
It’s a good idea to wash the vulva (the outer part of the genital area) with plain water during normal bathing. Mild, unscented soap without added colors is also okay. But you can skip the drugstore aisle full of sprays, deodorants and special soaps – these products aren’t necessary.
If you have unusual vaginal discharge or a strong odor that is new or that bothers you, it might be a sign of bacterial vaginosis. Talk to your medical provider about your medication options, or you can talk to an online provider – discreetly and conveniently – through Dr. B.
Abou Chacra, L., Fenollar, F., & Diop, K. (2022). Bacterial Vaginosis: What Do We Currently Know?. Frontiers in Cellular and Infection Microbiology, 11, 672429. https://doi.org/10.3389/fcimb.2021.672429
Bautista, C.T., Wurapa, E., Sateren, W.B. et al. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Military Med Res 3, 4 (2016). https://doi.org/10.1186/s40779-016-0074-5
Centers for Disease Control and Prevention. (2022, January 5). Bacterial Vaginosis - CDC Basic Fact Sheet. Centers for Disease Control and Prevention. Retrieved February 6, 2023.
Chen, R., Li, R., Qing, W., Zhang, Y., Zhou, Z., Hou, Y., Shi, Y., Zhou, H., & Chen, M. (2022). Probiotics are a good choice for the treatment of bacterial vaginosis: a meta-analysis of randomized controlled trial. Reproductive health, 19(1), 137. https://doi.org/10.1186/s12978-022-01449-z
Goje, O. (2021, April 31). Bacterial vaginosis (BV) - gynecology and obstetrics. Merck Manuals Professional Edition. Retrieved February 6, 2023.
Joseph, R. J., Ser, H. L., Kuai, Y. H., Tan, L. T., Arasoo, V. J. T., Letchumanan, V., Wang, L., Pusparajah, P., Goh, B. H., Ab Mutalib, N. S., Chan, K. G., & Lee, L. H. (2021). Finding a Balance in the Vaginal Microbiome: How Do We Treat and Prevent the Occurrence of Bacterial Vaginosis?. Antibiotics (Basel, Switzerland), 10(6), 719. https://doi.org/10.3390/antibiotics10060719
Koumans EH, Sternberg M, Bruce C, McQuillan G, Kendrick J, Sutton M, Markowitz LE. The prevalence of bacterial vaginosis in the United States, 2001-2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis. 2007 Nov;34(11):864-9
Leitich, H., Bodner-Adler, B., Brunbauer, M., Kaider, A., Egarter, C., & Husslein, P. (2003). Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis00230-8/pdf). American Journal of Obstetrics and Gynecology, 189(1), 139–147. https://doi.org/10.1067/mob.2003.339
Nelson, T. M., Borgogna, J. C., Michalek, R. D., Roberts, D. W., Rath, J. M., Glover, E. D., Ravel, J., Shardell, M. D., Yeoman, C. J., & Brotman, R. M. (2018). Cigarette smoking is associated with an altered vaginal tract metabolomic profile15%20and). Scientific Reports, 8(1), 852. https://doi.org/10.1038/s41598-017-14943-3
Parenthood, P. (n.d.). What is bacterial vaginosis?: Symptoms, signs and causes. Planned Parenthood. Retrieved February 6, 2023.
Ravel, J., Moreno, I., & Simón, C. (2021). Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease31193-5/fulltext). American Journal of Obstetrics and Gynecology, 224(3), 251–257. https://doi.org/10.1016/j.ajog.2020.10.019
Surapaneni, S., Akins, R., & Sobel, J.D. Recurrent Bacterial Vaginosis: An Unmet Therapeutic Challenge. Experience With a Combination Pharmacotherapy Long-Term Suppressive Regimen. Sexually Transmitted Diseases 48(10):p 761-765, October 2021. DOI: 10.1097/OLQ.0000000000001420
Webb, Lauren DMSc, PA-C. Probiotics for preventing recurrent bacterial vaginosis. JAAPA 34(2):p 19-22, February 2021. | DOI: 10.1097/01.JAA.0000731484.81301.58