Why You Need Specific Antibiotics for BV—And How to Treat It Right

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Did you know that taking the wrong antibiotic—or stopping it too early—could make bacterial vaginosis come back even worse?

Bacterial vaginosis (BV) is one of the most common vaginal infections, yet it’s still misunderstood and often mistreated. While many women experience symptoms like unusual discharge or a fishy smell, others have no symptoms at all—and still need treatment. This blog unpacks why specific antibiotics are required for BV, and how to get treatment right so it doesn’t keep coming back. Because when it comes to your vaginal health, guessing isn’t good enough.

What is BV, and Why Is It So Common?
BV happens when there’s a shift in the natural balance of bacteria in your vagina. Healthy bacteria like lactobacilli are supposed to dominate, but when harmful bacteria overgrow, BV can develop. It’s not an STI, but things like sex, stress, and even your soap can throw things off.

Many women don’t realise how common BV really is—up to 1 in 3 women will have it at some point. And while it’s not dangerous in most cases, it can lead to complications if left untreated, including increased risk of STIs and pregnancy-related issues.

Why You Need a Specific Antibiotic (Not Just Any One)
Let’s clear this up: BV can’t be fixed with probiotics alone or over-the-counter products. It needs prescription antibiotics—ones that target the anaerobic bacteria responsible for the imbalance. But not all antibiotics are created equal.

Here are the most commonly used (and why they matter):

  • Metronidazole: This is the go-to treatment. It’s available as a pill or vaginal gel. It works by killing the bad bacteria—but be warned, it doesn’t play well with alcohol.

  • Clindamycin: This is a good alternative for people who can’t tolerate metronidazole. It’s usually in cream form but also comes in pills.

  • Secnidazole: A newer option with the convenience of a single-dose treatment. Super helpful for busy women who just want a one-and-done solution.

Taking the wrong antibiotic or not finishing the course can leave bacteria behind—and those survivors are more likely to cause a repeat infection.

Top 4 Tips to Get BV Treatment Right

  1. Finish the full antibiotic course—even if you feel better early.
    Stopping early means the bad bacteria can regroup and come back stronger.

  2. Don’t douche. Ever.
    It might feel like it “cleans” you, but douching can actually disrupt your healthy bacteria and make BV worse.

  3. Skip the sex (for now).
    Hold off on intimacy during treatment. If you do have sex, use protection to reduce irritation and reinfection risk.

  4. Consider adding a probiotic.
    While antibiotics clear out bad bacteria, probiotics help repopulate the good ones. Look for strains like Lactobacillus rhamnosus or Lactobacillus reuteri.

Anecdote – A Real Story From One of Us
A friend of mine had been dealing with BV for nearly a year—treated it once, thought it was gone, but it kept creeping back. She was frustrated and embarrassed. It wasn’t until she finally got a second opinion, completed the entire course of the right antibiotics, and started using a daily probiotic that the cycle stopped. That experience showed her (and me!) that BV isn’t about being “dirty”—it’s about balance, knowledge, and doing things properly.

Your Top Questions Answered

Can I treat BV without antibiotics?
No. Natural remedies might help prevent recurrence, but antibiotics are essential to eliminate an active infection.

Is BV contagious?
Not technically—but it can be influenced by sexual activity. It's not an STI, but you can get it again after sex if your flora gets disrupted.

What happens if I don’t treat it?
Untreated BV can lead to complications like pelvic infections, especially if you’re pregnant. Best to get it sorted early.

Can Après help?
Yes. Our Après post-intimacy care product is gentle—perfect for helping support your vaginal microbiome while you’re healing or maintaining balance between flare-ups. Think of it as backup for your good bacteria.

Key Takeaways

  • BV is caused by an imbalance in vaginal bacteria—not poor hygiene.

  • It requires specific antibiotics like metronidazole or clindamycin.

  • Finishing the full course of treatment is crucial to prevent it from coming back.

  • Avoid douching, wear breathable underwear, and consider probiotics to support healing.