Bacterial vaginosis is like an obnoxious party guest who can't take a hint that it's time to leave. Just when you think they're on the way out the door, they come back in to start yet another tedious conversation. And this party guest also happens to smell like fish, leave a trail of discharge, and cause your vagina to itch.
Anthropomorphizing aside, BV is irritating to say the least, and even tougher to get rid of. Studies suggest that 10-30% of women who have sex with men, and 20-50% of women who have sex with women will experience the glory of BV at some point. And, over 50% of people who get BV will be lucky enough to experience it again over the course of 12 months.
Getting BV even once can be incredibly annoying. The infection leads to a brutal combination of vaginal symptoms: discharge that smells fishy, burning when you pee, and itching in and out of the vagina. Although BV is one of the most common bacterial infections out there, experts still don't know what causes it. The best guess is that BV hits when more "unhealthy bacteria" grow inside the vagina than "healthy bacteria," according to MedlinePlus.
Despite everything we don't know about BV, there are a few factors that can certainly mess with your vaginal pH and influence your risk of getting the infection again (and again, and again). For example, habits like douching or using vaginal deodorants tend to do more harm than good. Additionally, people who have sex with multiple partners is associated with a higher prevalence of BV bacteria, and other microorganisms in the vagina, explains Adeeti Gupta, MD, FACOG, an Ob/Gyn and founder of Walk-In Gyn Care in Manhattan. Having unprotected sex can also trigger BV, although it's not a sexually transmitted infection. And finally, some people have vaginas that are just extra susceptible to BV, and there's not a ton that you can do about it.
As anyone who's had BV knows, treatment options are limited to prescription oral antibiotics or vaginal suppositories. But, when you're getting BV several times a year, it's wildly discouraging to have to take antibiotics frequently only to have your symptoms pop back up again. When patients come to Dr. Gupta with recurrent BV, she'll typically run tests to ensure it's not something more serious (such as trichomoniasis), and then prescribe a "suppressive treatment." That may include a strict diet, genital hygiene, and high dose probiotics, she says.
In a 2016 study in the peer-reviewed journal PLOS One, researchers noted that women who got frequent BV felt frustrated by the available treatments, so they often felt compelled to try their own home remedies and lifestyle modifications to get rid of it. There aren't any proven home cures for BV, but that hasn't stopped people from trying. Many people eat probiotic foods such as yogurt, and take probiotic supplements in hopes that it will help balance out the good and bad bacteria inside the vagina. (That said, there hasn't been a proven link between diet and vaginal health.) Using a boric acid suppository or probiotic tampon is also supposed to be helpful.
Other good-for-your-vag lifestyle habits include wearing cotton underwear and avoiding hot baths or perfumed soaps. Using condoms or dental dams consistently is also often recommended, given the link between unprotected sex and BV. Then, there are some Goop-y holistic remedies that people swear help with BV, including using steaming the vagina with "detoxifying" herbs. Sitting in a bathtub full of apple cider vinegar is often touted as a cure — because, of course it is — but there's no proof that this actually works.
Even though these so-called cures have questionable efficacy, study authors in the same 2016 study said that home remedies made people "more likely to feel in control of their BV, because they felt they were able to treat it somewhat effectively themselves." Feeling like you're in control of your own health is always a good thing, but with something as persistent and finicky as BV, it's a good idea to let your doctor know what you're doing and trying at home.
Also, there's absolutely nothing to be embarrassed about if you get BV a lot. Dr. Gupta says that she sees this problem a lot at her clinic. Speaking up when you notice a pattern is key to stopping it from coming back. "We believe in addressing the root cause of the problem, not just a shorthand fix," she says.