How To Get Rid Of Bacterial Vaginosis, According To Experts

On the list of annoying health woes that go along with having a vagina: Bacterial vaginosis (BV)—the most common vaginal disorder among reproductive-aged women, affecting more than 21 million1 per year, according to the CDC.

BV occurs when there is an overabundance of harmful bacteria (compared to good bacteria) in the vagina, and it’s often accompanied by an unpleasant vaginal odor and discharge.

While BV isn’t typically as uncomfortable as a yeast infection, it does come with significantly more serious consequences if left unaddressed2 such as increased risk of certain STDs, reduced fertility, and early labor, according to the Centers For Disease Control And Prevention (CDC).

Adding to the frustration, BV often recurs after treatment with antibiotics. 

The good news: Effective home remedies for BV, along with lifestyle changes that support the vaginal microbiome, are emerging.

Bacterial vaginosis occurs when3 there is a reduction in the number of beneficial Lactobacillus bacteria in the vagina and a significant increase in anaerobic bacteria, including Gardnerella vaginalis.

While researchers don’t know the exact cause of BV2 or why some women get it and not others, several factors can increase your risk. 

“Anything that disrupts the normal ecological environment of the vagina can result in BV,” says Felice Gersh, M.D., OB/GYN, founder and director of the Integrative Medical Group of Irvine. “This large list includes having sexual intercourse, using spermicides and lubricants, douching, taking antibiotic, or using IUDs and other contraceptives," she says. "Anything that lowers one’s optimal immune status can also promote unwanted microbes to proliferate, creating imbalance within the vaginal microbiome.”

Additionally, your gut could be impacting the health of your vagina. “In my practice, I have found that recurrent BV often relates back to the health of the gut microbiome,” says says Wendie Trubow, M.D., functional medicine gynecologist.

Many women understandably confuse BV with yeast infections, but because they have different treatments, identifying what you’re dealing with is a crucial first step.

“Sometimes telling the difference between BV and a yeast infection is clearcut, and sometimes it's tricky,” says Trubow. “Yeast often causes a thick, curd-like discharge, is super itchy, and can smell a bit yeasty. While BV often has a thinner, watery discharge, can also itch, and usually has an odor reminiscent of old fish or smells foul.” 

Unlike the bacterial imbalance that occurs with BV, a yeast infection is caused by an overgrowth of yeast in the vagina called Candida albicans.

Many women get yeast infections after taking antibiotics, and some experts link the consumption of simple sugars and refined carbs to yeast overgrowth in the vagina and other areas of the body. 

While conventional treatment for BV typically includes an oral or topical antibiotic such as metronidazole or clindamycin, treatment for yeast infections involves an antifungal such as fluconazole.

Unfortunately, BV often recurs within three to 12 months, despite antibiotic treatment. And that’s where natural home remedies can help.

“BV can sometimes be treated with all natural regimes and sometimes it requires an antibiotic,” says Gersh. “But often, a combination of the two strategies is most successful.”

Probiotics contain beneficial bacteria meant to bolster your gut microbiome, and this, in turn, may positively influence your vaginal microbiome as well.* 

“To support recovery of the vaginal microbiome, I recommend women take probiotics with Lactobacillus strains,” says Trubow, noting that there are benefits to taking both oral supplements and vaginal probiotic suppositories.* 

One research review found that receiving Lactobacillus acidophilus, Lactobacillus rhamnosus GR-1, and Lactobacillus fermentum RC-14 at a dose of at least 10 billion CFU per day for two months helped treat BV and prevent its recurrence.

In addition to probiotic supplementation, your overall diet is important too. Focusing on gut-friendly foods is key, as “the microbes of the gut can impact the microbial composition of the vagina,” says Gersh.

This means incorporating probiotic foods such as kefir, yogurt, kimchi, and raw sauerkraut into your diet, along with a diverse array of fiber-rich plant foods.

Additionally, “BV and yeast infections can be flashing alerts for food sensitivities and system imbalance,” says Trubow. “Fixing the root cause almost inevitably fixes the BV.”

Boric acid has become an increasingly popular natural remedy for both BV and yeast infections, and records show it’s been used to treat BV for over 100 years5.

“I love boric acid capsules and find they work well not only for treatment, but also prevention,” says Trubow, adding that they’ve recently become widely available over the counter and online.  

Boric acid suppositories are capsules containing boric acid powder (typically 600 mg, the amount used in studies) that are inserted into the vagina (never consumed orally).

"We typically recommend 10 days of treatment (one suppository per day), but it can begin working in as little as 36 hours," says Trubow.

The exact mechanism by which boric acid helps alleviate BV is unknown, but it does have antiviral, antifungal, and bacteriostatic (i.e. able to inhibit the growth or reproduction of bacteria) activity, and some research suggests that it helps bring the vagina's pH back down to a normal level where harmful bacteria are less likely to thrive. 

Tea tree oil has natural antimicrobial properties, and research indicates that while it effectively kills a variety of BV-causing bacteria, it seems to preserve “good” Lactobacillus bacteria.

Meaning, compared to antibiotics, it appears to be more selective and less damaging to the overall vaginal microbiome.

But don’t use straight tea tree oil—instead, consider short-term use of a tea tree oil suppository specifically meant to be inserted into the vagina.

“My favorite BV remedy is tea tree oil suppositories used nightly for six nights,” says Trubow. “I like them because they work well, are cheap, are naturally derived, and are well-tolerated. Tea tree oil is a natural antibacterial agent, and I find it to be gentler to the vagina overall.”

Garlic contains potent compounds linked to everything from cardiovascular health to cancer prevention6, and preliminary research suggests it may help with BV.

A 2014 study, in which participants with BV took either a garlic supplement7 or the commonly prescribed oral antibiotic metronidazole for seven days, found that the treatments were similarly effective—yet there were fewer side effects in the garlic group.

Participants in this study took two 500-mg garlic tablets twice a day to alleviate their symptoms, but as always, consult with your doctor before trying this natural BV treatment.  

Whether you’re dealing with BV or a yeast infection, it’s typically a good idea to stick with loose fitting clothing and cotton underwear until you feel better.

Research is mixed8 on just how effective these strategies are for preventing BV or speeding your recovery, but they can at least make you feel a bit more comfortable.

Whatever treatment protocol you’re following, it can be wise to simultaneously avoid sex, or at least use condoms, until your treatment is complete, says Trubow.

While BV is an incredibly common condition triggered by an imbalance in vaginal bacteria, finding the right treatment is tricky.

Functional and integrative physicians are increasingly embracing natural treatments and you should feel encouraged to explore all of your options.

However, sometimes antibiotics truly are necessary, and you should always consult with your doctor about the right approach for you, given your personal medical history and other factors.

They may be able to recommend a combination of natural treatments, or home remedies and antibiotics, that is more beneficial than any one strategy alone.