If you've ever had bacterial vaginosis (BV), you know it can be uncomfortable and frustrating, and you probably want fast relief. Many women wonder if they can treat bacterial vaginosis with an over-the-counter (OTC) option to avoid scheduling a doctor’s visit. Here, we’ll cover what BV is, how it’s treated, what options are available over the counter, and how you can access personalized treatment through Evvy's Clinical Care platform.

What is BV and how is it treated?

Bacterial vaginosis is one of the most common vaginal infections, affecting almost 30% of people with vaginas every year according to the Centers for Disease Control and Prevention (CDC).

BV occurs when there’s an imbalance in the bacteria that naturally reside in the vagina. Normally, "good" bacteria (mainly Lactobacillus species) help keep the vaginal environment slightly acidic and prevent harmful bacteria from growing. However, when these good bacteria decrease or are outnumbered, it allows "bad" bacteria to take over, which leads to bacterial vaginosis. 

BV isn't a sexually transmitted infection, but you are more likely to develop BV if you're sexually active — especially if you have unprotected sex, have a new sex partner, or multiple sex partners.

Aside from sexual activity, other factors that put you at a higher risk of a BV infection include:

Bacterial vaginosis symptoms

Bacterial vaginosis symptoms may include:

  • A strong, fishy vaginal odor (often worse after sex)
  • Abnormal vaginal discharge that may be gray and watery
  • Vaginal itching or a burning sensation

Some women may have no symptoms, but when symptoms do appear, they can be bothersome and uncomfortable. Importantly, untreated BV can increase the risk of sexually transmitted infections (STIs) and complications, especially in pregnancy.

The proven treatments for BV are typically antibiotic medications prescribed by a healthcare provider. These include:

  • Metronidazole: Available as an oral tablet or a vaginal gel, metronidazole is one of the most commonly prescribed antibiotics for BV.
  • Clindamycin: This antibiotic is available as a vaginal cream and is another option for effectively treating BV.

It’s important to note that these are the only medically proven treatments for BV, and they require a prescription. While some women might try home remedies or over-the-counter products to manage their symptoms, these aren’t usually effective at treating the underlying bacterial imbalance.

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Can you get BV treatment over the counter?

Unfortunately, no effective over-the-counter treatments for bacterial vaginosis exist. While some OTC products claim to promote vaginal health or "rebalance" bacteria, they haven’t been clinically proven to treat bacterial vaginosis specifically.

Many OTC vaginal health products are probiotic supplements or pH-balancing gels that may help support vaginal health in a general sense. However, these products don’t eliminate the bacteria causing BV. In other words, while OTC products might alleviate some mild symptoms or discomfort, they don’t address the root cause of BV.

If you’re experiencing symptoms of BV, it’s best to seek a treatment that’s proven to work. And thankfully, there are ways to get access to the right treatment without having to go to an in-person doctor’s office.

What about boric acid?

Boric acid is sometimes used as a supplementary treatment for recurring or chronic bacterial vaginosis, but it’s not considered a first-line bacterial vaginosis treatment. 

Boric acid suppositories are often recommended by some healthcare providers for people who experience frequent bacterial vaginosis, as they help maintain a balanced vaginal pH. However, boric acid doesn’t kill the bacteria that cause bacterial vaginosis and isn’t a replacement for antibiotics, which are the only clinically proven, effective treatments for bacterial vaginosis.

Boric acid suppositories help to create a slightly acidic vaginal environment, which can make it more challenging for disruptive bacteria to grow. This may help in restoring the natural balance of the vaginal microbiome, especially after a course of antibiotics, which can sometimes lead to an imbalance of bacteria in the vaginal area. For some people, this helps prevent recurrent bacterial vaginosis by supporting an environment where good bacteria can thrive.

Evvy’s Pure Boric Acid is compounded in a 503a NABP-accredited pharmacy — ensuring prescription-grade quality you can't get over the counter — for powerful, reliable, and clean relief.

BV treatment with Evvy’s Clinical Care Platform

Evvy's Clinical Care program is a convenient solution for those looking for a hassle-free way to manage BV symptoms. 

Here’s how it works:

  1. At-home Vaginal Health Test: Evvy provides an at-home vaginal microbiome test that allows you to collect a sample in the privacy of your own home. This sample is then sent to a lab for analysis, where it’s tested for a variety of bacterial and fungal conditions that may be affecting your vaginal health.
  2. Comprehensive analysis: Once your results are ready, you’ll receive a detailed report with insights into your vaginal microbiome. This report helps you understand exactly what’s going on with your vaginal health and whether you have bacterial vaginosis, yeast, or another issue.
  3. Access to personalized treatment: Evvy’s Clinical Care platform connects you with a licensed healthcare provider who can prescribe the appropriate antibiotic treatment tailored to your specific needs. The prescription can even be delivered to your home, saving you a trip to the pharmacy.
  4. Follow-up and support: After your treatment, Evvy provides guidance on how to maintain a balanced vaginal microbiome to reduce the likelihood of recurrent BV. They even offer ongoing support to help you with any questions or concerns you may have.

Evvy’s Clinical Care program is especially valuable for women who want quick, convenient access to personalized care without having to go to a physical clinic. Plus, it’s a great option if you’ve had recurrent BV in the past and want a comprehensive approach to understanding and managing your vaginal health.

When to see a healthcare provider

While Evvy’s Clinical Care platform offers a highly effective, convenient way to treat BV, there are certain situations where it’s best to consult a doctor in person. For example:

  • If you’re pregnant and experiencing symptoms of bacterial vaginosis, it’s crucial to speak with your OB-GYN, as bacterial vaginosis can lead to complications during pregnancy (such as preterm birth).
  • If you’re experiencing recurring bacterial vaginosis and have tried multiple treatments without success, a specialist may be able to help you determine underlying factors or additional treatment options.
  • If you have uncomfortable symptoms that don’t seem typical for bacterial vaginosis, such as pain or abnormal bleeding, it’s worth seeing a doctor. They may want to perform a pelvic exam or run tests to rule out if the cause is another type of vaginal infection (such as a yeast infection).

FAQ

Can you clear BV over the counter?

Unfortunately, OTC products aren’t able to fully clear up bacterial vaginosis. The most effective way to treat BV is through prescription antibiotics like metronidazole or clindamycin, which specifically target the bacteria causing the imbalance. While there are some OTC products out there that claim to support vaginal health or help restore pH balance, they don’t really tackle the root of the problem. These products might give you temporary relief from some symptoms, but they won’t fix the underlying bacterial imbalance.

What is the best medicine to get rid of BV?

The best way to treat bacterial vaginosis is with antibiotics like metronidazole, clindamycin, tinidazole, and secnidazole. These medicines do a great job targeting the bacteria responsible for the infection. It's worth noting that the effectiveness of these antibiotics can vary because bacterial vaginosis isn't caused by just one harmful bacterium; usually, it's a blend of bacteria that outgrow the healthy Lactobacilli in your vagina. While metronidazole and clindamycin are popular options, they might not work the same way for everyone, especially if there are some rarer bacteria at play. A helpful step to consider is getting an Evvy Vaginal Health Test — which offers a detailed look at your unique vaginal microbiome, telling you which specific BV-causing bacteria might be at play. With all this personalized information, your healthcare provider can recommend the antibiotic that's most likely to tackle the specific bacterial imbalance you're dealing with. 

Is there any way to treat BV at home? 

Yes! You can manage bacterial vaginosis from the comfort of your own home via Evvy’s Clinical Care program. You can order an Evvy Vaginal Health Test that allows you to collect a sample right at home. Once you send the sample off to the lab, they’ll analyze it to see if BV-causing bacteria or something else might be behind your symptoms. After that, Evvy connects you with a licensed healthcare provider who can prescribe personalized prescription treatment based on your test results and medical history. Plus, the prescribed treatment can even be delivered right to your doorstep, so you can start feeling better without having to go anywhere.