Gardnerella Vaginalis Treatment: Antibiotics, Probiotics & Prevention

Gardnerella vaginalis treatment typically consists of a short course of antibiotics used to treat bacterial vaginosis (BV). That’s because Gardnerella vaginalis is one of the many bacteria that can cause BV, which is the most common vaginal infection amongst pre-menopausal women. 

In small amounts, G. vaginalis is actually a normal inhabitant of the vaginal microbiome and doesn’t cause any symptoms. However, if it goes a bit rogue, it can disturb the vaginal community, leading to unpleasant symptoms like unusual vaginal discharge. 

Although it's easy to think that bacterial vaginosis and GV are one and the same, G. vaginalis is just one of the many bacteria involved in bacterial vaginosis.

Keep scrolling to learn more about Gardnerella vaginalis treatment and the best way to prevent bacterial vaginosis. 

What is Gardnerella vaginalis?

G. vaginalis is a strain of Gadnerella bacteria, a species often found in the vaginal microbiome. While it usually lives happily alongside other vaginal flora, sometimes it can overgrow, create a biofilm, and lead to bacterial vaginosis. 

When this happens, you might experience symptoms like abnormal vaginal discharge that is thin and gray with a strong “fishy” odor — the trademark symptoms of bacterial vaginosis. 

Researchers still don't know why Gardnerella vaginalis overgrows, but studies have found several risk factors for BV: 

• Sexual intercourse (especially with multiple sex partners)
• Hormonal fluctuations (e.g., birth control, pregnancy, and menopause)
• Smoking 
• Chronic stress
• Douching. 

Gardnerella vaginalis testing

To test for G. vaginalis, your healthcare provider will do a vaginal swab and examine your vaginal fluid (aka vaginal discharge) under a microscope to determine the relative amount of protective Lactobacilli to other organisms like Gardnerella.  

You can test for Gardnerella vaginalis with Evvy's at-home vaginal microbiome test, too. Though it’s not a diagnostic test and shouldn’t replace your doctor's advice, it can help you uncover what strains are present and in what capacity to understand how they may contribute to any symptoms. 

Every Evvy Vaginal Health Test also comes with a custom plan of clear next steps, and if eligible, an Evvy-affiliated provider will develop a custom care program for you that may include both prescription medication and research-backed supplements to ensure that we don’t just fight the disruptive microbes, but regrow the protective ones as well.

Best treatment options for Gardnerella vaginalis

Let’s start with the good news: if you’re not experiencing symptoms, there’s no need to treat Gardnerella vaginalis. If it is causing symptoms, however, it’s important to keep the infection under control because untreated bacterial vaginosis is associated with an increased risk of:

• Contracting sexually transmitted infections
• Pelvic inflammatory disease (PID)
• Infertility
• Adverse pregnancy outcomes and preterm birth. 

First-line bacterial vaginosis treatment includes a short round of oral or intravaginal antibiotics prescribed by your healthcare provider. Frustratingly, the current treatments for bacterial vaginosis aren't always effective in providing long-term relief. 

While antibiotics can clear up as many as 85% of bacterial vaginosis cases within a month, the infection can return within just six months for over half of these patients. 

Antibiotics have varying effectiveness on different types of bacteria, and some can harm beneficial bacteria while others do not. When dealing with recurrent bacterial vaginosis, it can be helpful to know the specific bacteria present in your microbiome, as this information can aid in selecting the most appropriate antibiotic.

Metronidazole 

Metronidazole is an antibiotic that can help kill bacteria and other microbes that can cause infections. It's especially effective against anaerobic bacteria, which are bacteria that can survive without oxygen. This medication has been tested and found to be effective against a number of bacterial species that are associated with bacterial vaginosis, including Gardnerella vaginalis. 

In case your healthcare provider prescribes metronidazole to treat your bacterial vaginosis, they may recommend one of the following treatment options based on your unique medical history:

• 500 mg pills of oral metronidazole taken twice a day for seven days
• A full applicator of 0.75% metronidazole vaginal gel applied inside the vagina once daily for five days.

It's important to note that these are just common recommendations, and your healthcare provider will tailor the treatment specifically to your needs. Don't hesitate to ask your healthcare provider any questions you may have about the treatment, as they are there to help you through this process.

Tinidazole

Tinidazole is an oral medication that belongs to the same class of antibiotics as metronidazole and is effective against many of the bacteria that cause bacterial vaginosis, including Gardnerella vaginalis. 

Like metronidazole, tinidazole doesn't eliminate Lactobacillus, which are the protective bacteria in your vaginal microbiome. Additionally, researchers have found that it may cause fewer negative side effects on the GI tract, making it a desirable alternative to metronidazole in certain cases.

If you have bacterial vaginosis, your healthcare provider may prescribe tinidazole to be taken orally for a two or five-day course. While longer courses of treatment appear to be more effective against bacterial vaginosis than shorter ones, they may be less convenient. 

Clindamycin

Clindamycin is a commonly used antibiotic to treat bacterial vaginosis. It slows down and, at times, even stops the growth of bacteria. It has been proven to be effective against several bacterial species that can cause bacterial vaginosis, such as Gardnerella vaginalis, just like metronidazole.

You can take clindamycin as an oral pill or apply it intravaginally as a cream, with both treatments lasting for about a week. Alternatively, your healthcare provider may suggest using clindamycin "ovules", which are small pills that you insert into the vagina and let dissolve. This option is a little quicker and only requires a three-day course of treatment. 

Probiotic supplements for BV

While probiotics are not a treatment for BV, they can play an important supportive role in maintaining vaginal microbiome balance. BV is an umbrella term for an imbalance vaginal flora — usually caused by an overgrowth of anaerobic bacteria like Gardnerella vaginalis —  and probiotic supplements containing Lactobacillus strains have been shown to promote healthy vaginal flora. 

Evvy Women’s Complete Probiotic

Evvy Women’s Complete Probiotic is a 3-in-1 formula thoughtfully designed to support the vaginal, gut, and urinary microbiomes. Our researchers meticulously selected each strain based on the best available research in women’s health. The formula includes the clinically studied UREX® Blend (Lactobacillus reuteri RC-14® and Lactobacillus rhamnosus GR-1®), as well as Lactobacillus crispatus, Lactobacillus acidophilus, and Lactobacillus plantarum. These strains have been shown to help maintain balance across the body’s microbial ecosystems. While not a treatment for BV, this probiotic can be a powerful daily tool to support microbiome health, especially for those prone to recurrent imbalances.

How to prevent Gardnerella vaginalis overgrowth

BV has a nasty tendency to come back, even after treatment, but there are a few things you can do to look after your vaginal flora and prevent recurrence (to a certain extent):

• Avoid douches. Your vagina is self-cleaning, and douching can alter your vaginal pH and increase your risk of bacterial vaginosis. 
• Use condoms or dental dams during sex. Although bacterial vaginosis isn’t officially classified as an STI, Gardnerella can be sexually transmitted. Having unprotected sex increases your chances of developing it.
• Cover sex toys with a condom during partnered sex, and wash them after each use.
• Change your period products within the recommended time frame based on your flow and the product’s absorbency.
• Consider taking a probiotic like Evvy Women’s Complete Probiotic, formulated with clinically-studied Lactobacillus strains to promote healthy vaginal bacteria.
• Stop smoking. 

FAQ

What is the best treatment for Gardnerella?

The best treatment for Gardnerella overgrowth, which is commonly linked to bacterial vaginosis, is usually prescription antibiotics. Metronidazole, tinidazole, and clindamycin are the first-line options and effectively target the bacteria. These medications can be taken orally or applied as vaginal gels or creams, depending on your provider’s recommendation. Completing the full course of antibiotics is important to fully clear the infection and reduce the risk of recurrence. If you experience frequent BV, your provider may suggest additional supportive treatments, such as boric acid. 

Can Gardnerella go away on its own?

Gardnerella may sometimes decrease on its own if your vaginal microbiome restores balance. However, many people experience ongoing symptoms or recurrence without treatment, so we really wouldn’t recommend waiting for it to go away on its own. Because Gardnerella overgrowth is often linked to bacterial vaginosis, leaving it untreated can lead to discomfort or increase the risk of other infections. If you notice symptoms like unusual discharge, odor, or irritation, it’s best to consult a healthcare provider for diagnosis and treatment options.

Can I treat Gardnerella without antibiotics?

No. Antibiotics are the first-line treatment for Gardnerella overgrowth, especially when it causes bacterial vaginosis. Medications like metronidazole or clindamycin are the most effective way to eliminate the bacteria. In cases where antibiotics haven’t fully resolved the infection or symptoms keep coming back, a healthcare provider may recommend boric acid suppositories as a secondary option to help restore vaginal pH and reduce recurrence. Probiotics, such as Evvy Women’s Complete Probiotics, can also play a supportive role by promoting a healthy vaginal microbiome and helping to maintain balance after treatment

Does my partner need to be treated for Gardnerella?

Although there currently aren’t official guidelines recommending treatment for male partners, recent breakthrough research shows that treating male partners can significantly reduce the recurrence of bacterial vaginosis in women. While BV isn’t classified as a traditional sexually transmitted infection, BV-causing bacteria can be harbored in the male genital tract and potentially reintroduced during sex. Because of this, some healthcare providers are beginning to explore partner treatment, especially for couples experiencing frequent BV recurrences. If you’ve dealt with recurrent bacterial vaginosis, it’s worth discussing partner treatment with your provider as part of a more comprehensive and preventative care approach.

What antibiotic kills Gardnerella vaginalis?

The antibiotics that effectively kill Gardnerella vaginalis include metronidazole, tinidazole, and clindamycin. These medications target the bacterial overgrowth responsible for bacterial vaginosis and are available in oral and vaginal formulations. It’s important to follow your healthcare provider’s instructions and complete the full treatment course to fully eradicate the infection and reduce the chance of recurrence.

Can probiotics get rid of Gardnerella vaginalis?

Probiotics can support a healthy vaginal microbiome by promoting the growth of beneficial bacteria like Lactobacillus species, which may help keep Gardnerella vaginalis in check. However, probiotics alone won’t eliminate Gardnerella bacteria or bacterial vaginosis. They’re best used as a complementary approach alongside prescribed treatments, like antibiotics, to help restore balance and reduce the risk of recurrence.