Home Treatment for Bacterial Vaginosis
Bacterial vaginosis cannot be effectively treated at home without prescription medications—you must obtain either oral metronidazole or intravaginal clindamycin cream from a healthcare provider. 1, 2
First-Line Prescription Treatment Options
The CDC recommends three equally effective first-line regimens for symptomatic BV, all requiring a prescription 2:
- Metronidazole 500 mg orally twice daily for 7 days (cure rate 78-84%) 1, 2
- Clindamycin 2% vaginal cream, one full applicator (5g) intravaginally at bedtime for 7 days (comparable cure rates) 1, 2
- Metronidazole gel 0.75%, one full applicator (5g) intravaginally twice daily for 5 days (cure rate 78-84%) 2
Critical Instructions While Taking Medication at Home
If Using Metronidazole (Oral or Gel)
- Avoid ALL alcohol during treatment and for 24 hours after completion—this includes alcohol in mouthwash, medications, and food, as even small amounts can cause severe disulfiram-like reactions (flushing, nausea, vomiting, headache) 3, 2
If Using Clindamycin Cream
- Do not rely on latex condoms or diaphragms for contraception—clindamycin cream is oil-based and weakens latex barrier methods, making them unreliable during the entire 7-day treatment course 3, 2
Sexual Activity During Treatment
- Avoid sexual intercourse until both you and your partner complete therapy and are asymptomatic 3
- This prevents reinfection and allows treatment to work effectively 3
What NOT to Do at Home
Do not attempt to self-treat BV with over-the-counter products 2:
- Over-the-counter antifungal creams (like those for yeast infections) will not treat BV and may delay proper treatment 1
- Home remedies, dietary modifications, and non-medical vaginal products lack evidence for BV treatment 4
- Douching worsens BV and should be avoided 1
Partner Treatment
Your male partner does NOT need routine treatment—multiple clinical trials show that treating male partners does not reduce your recurrence rate or improve your response to therapy 1, 2
When to Seek Follow-Up Care
- No routine follow-up visit is needed if symptoms resolve after completing treatment 1, 2
- Return for evaluation if symptoms persist or recur within 2 months—50-80% of women experience recurrence within one year, requiring extended treatment regimens 4, 5
Common Pitfalls to Avoid
- Do not stop treatment early even if symptoms improve—complete the full course to prevent recurrence 2
- Do not use single-dose metronidazole 2g as first-line treatment—it has significantly lower efficacy (84%) compared to the 7-day regimen (95%) 1, 2
- Do not assume you have BV without proper diagnosis—clinical diagnosis requires 3 of 4 Amsel criteria (homogeneous discharge, pH >4.5, fishy odor with KOH, clue cells on microscopy) 1, 6