How to Stop Recurring BV Infections Permanently

Bacterial vaginosis (BV) often feels like a never-ending cycle. One week you’re fine, the next you're dealing with odor, discharge, and discomfort again. 

Because researchers still don’t fully understand what triggers this imbalance, it's impossible to completely prevent bacterial vaginosis, especially since many common life events (like your period or hormone shifts) can throw things off.

Bacterial vaginosis can be incredibly stubborn. About 50% of women have a recurrence within six months after finishing standard antibiotic treatment. Factors that affect these recurrence rates include the persistence of BV-related bacteria, the formation of biofilms, reinfection from sexual partners, and a failure to restore a healthy Lactobacillus-dominant vaginal microbiome.

But don’t lose hope. While a permanent cure doesn’t exist (yet!), you can take meaningful steps to reduce how often bacterial vaginosis comes back. Knowing your risk factors and taking care of your vaginal microbiome can make a big difference.

Let’s dive into how to finally get some peace of mind when it comes to your vaginal health.

Causes and risk factors

Bacterial vaginosis is a diagnosis used for an imbalance in the vaginal microbiome. While the exact cause of BV remains unknown, it's believed to be tied to a drop in beneficial bacteria like Lactobacillus and an increase in anaerobic bacteria, such as Gardnerella and Prevotella. 

Your vaginal microbiome is a dynamic ecosystem that responds to internal and external changes. For example, hormone levels fluctuate during your menstrual cycle, which can shift your vaginal pH and bacterial balance. Similarly, certain lifestyle habits and hygiene products can significantly alter your microbiome, leaving it more vulnerable to bacterial overgrowth.

Here are some of the most common factors that increase your risk of developing BV:

• Being sexually active, especially with new or multiple sexual partners, can introduce unfamiliar bacteria that disrupt your natural flora.
• Vaginal douching and over-cleansing disturb the healthy bacteria that protect your vagina.
• Hormonal changes during menstruation, pregnancy, or menopause can all influence your microbiome.
• Fragranced products, such as scented tampons, soaps, and vaginal deodorants, can irritate and imbalance the vaginal environment.
• Smoking has been shown to reduce the presence of good bacteria like Lactobacillus.

Beyond discomfort and inconvenience, bacterial vaginosis is linked to more serious outcomes, such as premature labor, pelvic inflammatory disease, and increased risk of sexually transmitted infections (STIs), including HIV, HPV, and gonorrhea. That’s why it’s so important to manage bacterial vaginosis proactively.

How to stop recurring BV

Stopping recurrent bacterial vaginosis isn’t just about treating symptoms when they appear. It’s about understanding the underlying imbalances in your microbiome and committing to a prevention-first approach. The good news is that with the right strategy, many people can reduce or even eliminate frequent BV episodes.

Get an accurate diagnosis

First things first: don’t self-diagnose. Symptoms like unusual discharge, itching, and a strong fishy smell can be caused by a variety of vaginal conditions, from yeast infections to trichomoniasis to STI-related inflammation. Misdiagnosing yourself can lead to using the wrong treatments, which may only worsen the problem.

Instead, see a healthcare provider for a proper diagnosis. They may perform a swab test or lab analysis to confirm whether it’s bacterial vaginosis and rule out other causes. If you've had repeated bouts of BV, make sure your provider knows — recurrent bacterial vaginosis often requires a different treatment plan than a one-time infection.

Test your microbiome

Not all bacterial vaginosis infections are caused by the same bacterial imbalance. Some people may have a total lack of Lactobacillus crispatus, while others may be dealing with an overgrowth of Gardnerella vaginalis or biofilm-forming bacteria.

That’s where Evvy’s Vaginal Health Test comes in. This at-home test uses metagenomic sequencing to give you a detailed picture of your vaginal microbiome. You’ll learn which bacteria are dominant, which ones are missing, and how balanced your vaginal environment is overall.

Armed with this information, you and your provider can tailor a treatment plan that addresses your unique microbiome composition, rather than relying on trial and error.

Get effective treatment

Treatment for recurrent BV often involves a longer course of antibiotics followed by maintenance therapy.

The standard first-line bacterial vaginosis treatment is oral metronidazole (500 mg twice daily for seven days) or metronidazole vaginal gel (0.75%) once daily for five days. 

For people with frequent recurrences, treatment also includes a maintenance regimen of vaginal metronidazole twice a week for six months. This regimen targets both the acute infection and biofilms (clusters of bacteria that stick together and resist treatment). 

The type of antibiotic you’ll be prescribed depends on which bacteria are causing your bacterial vaginosis, since antibiotics are only effective when they target the right microbes, making microbiome testing beforehand essential for choosing the most effective treatment.

However, antibiotics alone don’t always solve the problem. For tough cases, many doctors recommend adding boric acid suppositories to help disrupt the biofilm and restore vaginal pH. These are especially helpful if you tend to develop yeast infections after antibiotic treatment.

Evvy’s Pure Boric Acid Suppositories are gentle, effective, and designed to be part of a balanced recovery plan. Many users find that they help maintain comfort and reduce recurrence post-treatment.

Practice safe sex

Sexual activity can trigger BV for a few reasons. Introducing semen, saliva, or bacteria from hands and sex toys can upset the delicate ecosystem of your vagina. 

Although bacterial vaginosis isn’t officially classed as an STI, new research has confirmed what many experts long suspected: bacterial vaginosis can be sexually transmitted, particularly through the exchange of genital fluids and bacteria during sex. This means that even if your partner doesn’t have symptoms, they can still reintroduce disruptive bacteria into your vaginal microbiome. That’s why using protection (like condoms and dental dams) isn’t just about STI prevention; it’s also a key step in reducing your risk of recurring bacterial vaginosis. It’s also smart to wash hands and toys before use and avoid sharing them without proper cleaning.

Even if your symptoms seem to pop up after every intimate encounter, don’t be discouraged. Many people find that adopting safer sex habits significantly reduces their bacterial vaginosis episodes.

Consider partner treatment

Recent research suggests that bacterial vaginosis can be passed between sexual partners, particularly from men to women. While bacterial vaginosis is not officially classified as an STI, studies have shown that treating both partners simultaneously can reduce the chance of reinfection.

For people with regular male partners, doctors may prescribe antibiotics for the male sexual partner to use during your treatment window. This can help eliminate the bacteria from his genital area, cutting the cycle of reintroduction.

If you’ve tried everything and bacterial vaginosis keeps coming back, talk to your provider about whether partner treatment is appropriate for your situation.

Take a probiotic

Antibiotics wipe out both good and bad bacteria, which means your microbiome needs help rebuilding after treatment.

Taking probiotics has shown significant improvements in BV recurrence rates at 12 and 24 weeks, especially when started right after antibiotic treatment. While no supplement is a silver bullet, restoring a strong Lactobacillus presence is one of the most effective long-term strategies for maintaining balance.

Evvy Women’s Complete Probiotic contains carefully selected strains, including Lactobacillus crispatus, Lactobacillus rhamnosus, and Lactobacillus reuteri. These strains have been clinically proven to support vaginal health and reduce the risk of recurrence when used as an adjunct to antibiotics.

Don’t douche

Despite what old ads might suggest, your vagina does not need cleaning. It is self-regulating and does best when left alone.

Douching washes away not only bacteria but also healthy protective mucus and good microbes. Studies consistently show that people who douche regularly have higher rates of BV, yeast infections, and STIs.

If you want to feel fresh, stick with unscented, gentle external cleansers and avoid putting anything inside your vagina other than recommended treatments.

Stop smoking

Here’s one more reason to consider quitting: smoking negatively impacts your vaginal microbiome. It reduces the presence of Lactobacillus and increases oxidative stress, which makes your vaginal environment more susceptible to bad bacteria. Smokers have been shown to have higher rates of both initial bacterial vaginosis and recurrence. Quitting smoking can improve not only your general health but also your body’s ability to maintain a stable, resilient microbiome.

FAQ

Can you permanently stop BV?

Unfortunately, there’s no guaranteed way to permanently stop bacterial vaginosis. That’s because bacterial vaginosis is caused by an imbalance in the vaginal microbiome, not a single harmful bacteria, and many of the triggers — like hormones, menstruation, or even being sexually active — are hard to avoid completely. However, while you can’t eliminate the risk forever, you can significantly reduce how often bacterial vaginosis comes back by identifying your personal risk factors, getting the right diagnosis and treatment, and supporting your vaginal microbiome through testing, targeted antibiotics, probiotics, and protective habits like using condoms and avoiding douching. So while permanent prevention isn’t currently possible, long-term management is.

Why am I getting BV so often?

Recurring bacterial vaginosis is incredibly common and usually tied to a persistent imbalance in your vaginal microbiome. When the healthy bacteria that normally protect your vagina (especially Lactobacillus species) are reduced, it creates space for harmful bacteria to overgrow, leading to symptoms like odor, vaginal discharge, and discomfort. Several things can trigger or maintain this imbalance, including sex (especially without protection), hormonal changes, your period, douching, or even your partner’s microbiome. In some cases, the bacteria form a biofilm, a protective layer that makes them harder to eliminate with standard antibiotics, which is why the infection keeps coming back even after initial treatment. The best way to understand why bacterial vaginosis keeps returning is to test your vaginal microbiome.

How do you treat recurrent BV at home?

Treating recurrent BV at home can be tricky, especially because most common home remedies — like yogurt, tea tree oil, or apple cider vinegar — haven’t been proven to work and can actually make things worse by irritating your vagina or disrupting your microbiome even further. The most effective approach is to treat the root cause: the imbalance in your vaginal bacteria. That’s why Evvy offers a science-backed, at-home solution. You can start by taking the Evvy Vaginal Health Test, which uses advanced metagenomic sequencing to identify exactly which bacteria are contributing to your symptoms. If eligible, a licensed provider will review your results and, if appropriate, create a personalized prescription treatment plan tailored to your unique microbiome. The entire process happens from the comfort of your home, without the need for a doctor’s office visit.