How can I prevent bacterial vaginosis (BV)?

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Last updated: July 1, 2025View editorial policy

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From the Guidelines

To prevent bacterial vaginosis (BV), it is essential to maintain good vaginal hygiene by avoiding douching, scented products, and tight synthetic underwear, as these practices can disrupt the natural balance of vaginal flora. Instead, wear cotton underwear, wipe from front to back after using the toilet, and practice safe sex with condoms to reduce the risk of BV 1. Limiting multiple sexual partners is also crucial, as this increases the risk of developing BV 1. Consider taking probiotics containing Lactobacillus species, either orally or vaginally, which help maintain healthy vaginal flora and can be especially beneficial after antibiotics, which can disrupt vaginal bacteria 1. Maintaining a balanced diet low in sugar and alcohol is also important, as these can promote bacterial overgrowth. If you're prone to recurrent BV, your doctor might recommend preventive measures like boric acid suppositories (600mg inserted vaginally at bedtime) or metronidazole gel used twice weekly. BV occurs when the balance of bacteria in the vagina shifts, with an overgrowth of certain bacteria and a reduction in protective Lactobacillus species, creating an environment where harmful bacteria thrive 1.

Some key points to consider in preventing BV include:

  • Avoiding douching and scented products
  • Wearing cotton underwear and practicing good hygiene
  • Limiting multiple sexual partners
  • Taking probiotics to maintain healthy vaginal flora
  • Maintaining a balanced diet low in sugar and alcohol
  • Considering preventive measures like boric acid suppositories or metronidazole gel for recurrent BV.

It is essential to note that treatment of the male sex partner has not been beneficial in preventing the recurrence of BV 1. By maintaining good hygiene and a healthy bacterial balance, you can significantly reduce your risk of developing BV.

From the Research

Prevention of Bacterial Vaginosis (BV)

To prevent BV, several strategies can be considered:

  • Avoiding vaginal douching, as it has been associated with an increased risk of disrupting vaginal flora and developing BV 2
  • Using probiotics, which have been shown to be effective in preventing and treating BV in some studies 3, 4, 5, 6

Probiotics for BV Prevention

Probiotics can be administered orally or vaginally, and some studies suggest that they can help maintain a healthy vaginal microbiota and prevent BV:

  • Orally consumed probiotics, such as Lactobacillus acidophilus, Lactobacillus rhamnosus GR-1, and Lactobacillus fermentum RC-14, at a dose of at least 10 CFU/day for 2 months, have been shown to be effective in preventing BV 3
  • Vaginally administered probiotics, such as Lactobacillus acidophilus, have also been shown to be effective in treating and preventing BV 6

Important Considerations

It is essential to note that while some studies suggest that probiotics can be effective in preventing and treating BV, the results are not always consistent, and more research is needed to fully understand their role in BV prevention 4, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Effects of probiotics on the recurrence of bacterial vaginosis: a review.

Journal of lower genital tract disease, 2014

Research

Probiotics for the treatment of women with bacterial vaginosis.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2007

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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