Although bacterial vaginosis can often clear up without treatment, it is advised that all women with BV signs and symptoms be treated to avoid complications. Male partners do not usually require treatment. BV can spread between female sex partners.
BV treatment is especially important for pregnant women. Pregnant women who have had premature births or low weight babies should have a BV examination, even if there are no symptoms.
Some doctors say that all women undergoing a hysterectomy or abortion should be treated for BV before their procedure, regardless of symptoms.
BV can be treated with antibiotics. If used correctly they are 85% to 90% effective.
Metronidazole - the most common antibiotic for BV. It is available:
- In tablet form, to be taken orally (swallowed) twice daily for seven days. Seen as the most effective treatment. This is also the preferred treatment if the woman is breastfeeding or pregnant.
- In tablet form, to be taken orally, just once. The BV is more likely to return with this treatment, compared to the seven-day tablet course.
- In gel form, that is applied to the vagina once daily, for five days.
- Probiotics with metronidazole - researchers from the University of Lagos, Nigeria, reported in a Cochrane Systematic Review that taking lactobacillus tablets together with metronidazole increases the antibiotic's efficacy.
They added that intravaginal lactobacillus has the same effectiveness
as oral metronidazole, although they stressed that there were
unexplained drop-outs from the trials.
Lead researcher, Oyinlola Oduyebo, said "There are a range of good treatments for BV, but the high relapse rates require more attention and indicate that we need more research into other agents that can increase their effectiveness. We also need to understand why so many people dropped out of the Lactobacillus trials as this suggests there are unreported adverse effects."
Clindamycin - this is an alternative BV treating antibiotic, often used if metronidazole did not work or the BV came back. It is available:
- As a cream, which is applied to the vagina once daily for seven days.
- In capsule form, which is taken orally (swallowed) twice daily for seven days. Rarely used today because of the risk of developing pseudomembranous colitis.
Tinidazole - another antibiotic which is sometimes used to treat BV if metronidazole did not work, or the BV came back. Taken by mouth as a single dose. Alcohol must be avoided when taking this medication.
After completing the course of antibiotics - if symptoms go away the woman will not have to be tested for BV again. If the following occur, testing will need to be done again:
- Signs and symptoms of BV persist
- Signs and symptoms of BV go away, and then come back
- The patient being treated is pregnant
A GP (general practitioner, primary care physician) whose treatment was not effective may choose to refer the patient to a gynecologist - a doctor specialized in treating conditions of the female reproductive system. If a pregnant woman is having her pre-natal checks with a GP, she may be referred to an obstetrician (a doctor who specializes in pregnancies).
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Written by Christian Nordqvist
Medical News Today
