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Do's and don'ts: Preventing BV

An incredibly helpful piece of literature relating to Bacterial Vaginosis is the 2018 European (IUSTI/WHO) Guideline on the Management of Vaginal Discharge. Listed below are the top methods contained in this document for preventing the onset and spread of BV.


Limit Sexual Partners

Limiting the number of partners you engage in unprotected sex with will reduce the different strains of new bacteria being introduced to the vagina, allowing lactobacilli levels to stabilise and the ‘good’ bacteria to replenish.

Use Condoms

Studies have shown that consistent us of condoms reduces BV incidence by up to 50%, compared to going unprotected. This is, once again, because new bacterial strains are prevented from entering the vagina and thus bad-bacteria-fighting lactobacilli remain more intact.

Take Oral Metronidazole

This antibiotic is the preferred treatment for bacterial vaginosis, but there is some evidence to suggest that it can also be used as a preventative measure. A placebo-controlled trial assessed the effect of monthly oral metronidazole treatment compared to a placebo for 12 months and found that the intervention of this antibiotic reduced the incidence of BV by up to 50%.

If you can't get to your doctor's for a prescription, you can buy Metronidazole online from Prescription Doctor. Simply fill out our short medical questionnaire and our doctors will assess whether the treatment is suitable for you.

Use Intravaginal Metronidazole

In another placebo controlled trial it was found that 0.75% metronidazole vaginal gel, used twice a week for 16 weeks, was superior to a placebo, with 70% of women being relapse-free compared to 39% in the placebo group.

However, only 34% of patients remained cumulatively free of recurrence 12 weeks after stopping treatment, compared to 22% of controls. There was also an excess of Vulvo-vaginal Candidosis (yeast infection) in those receiving metronidazole: 43% compared to 21%. Despite this, Intravaginal Metronidazole is still considered the best method to prevent recurrent bouts of BV according to the European IUSTI/WHO guidelines.

Intravaginal Lactate Gel

In another small placebo-controlled trial, researchers found that 88% of women who applied 5ml of intravaginal lactate gel for 3 days after menstruation during a 6-month period were BV-free, compared with just 10% of those using a placebo.

Speak to your doctor

If you experience recurrent BV, speak to your doctor for advice. They will be able to make a suitable judgment of your condition and propose an appropriate treatment.

Moreover, they may be able to ascertain as to what is causing your BV symptoms.



In a systematic review of probiotics for the treatment of Bacterial Vaginosis, the authors concluded that the results do not provide sufficient evidence for or against recommending probiotics for the treatment of BV. A subsequent meta-analysis concluded probiotic interventions were effective for treatment and prevention of BV but the quality of the studies varied. More good quality research is needed to strengthen the body of evidence needed for application by clinicians.

While Probiotics may be useful, you might be better off using a recommended treatment from your doctor.

During Pregnancy

Because the potential effects BV can have on women during pregnancy (low birth weight, premature birth, miscarriage etc.) are serious, it is integral that pregnant women are treated immediately for a suspected infection.

While Metronidazole is an effective treatment in this case, some studies show that it can enter breast milk and affect its taste, therefore, according to The European Guidelines Group, the current best treatment for recurrent BV in pregnant women is the alternative antibiotic clindamycin.

Authored & Reviewed By

Mohamed Imran Lakhi

MPharm - Lead Pharmacist
Imran Lakhi is the superintendent pharmacist and founder at Prescription Doctor. He has been at the core of our team.

Published on: 07/01/2020 Reviewed on: 24/08/2023
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