If you're dealing with unusual vaginal discharge or discomfort, you might be wondering whether you have bacterial vaginosis (BV) and how long it could last if you don’t treat it. Many women hope it might resolve on its own, but it’s important to understand what bacterial vaginosis is, why it happens, and the risks of leaving it untreated.

What is bacterial vaginosis?

Bacterial vaginosis is a common vaginal infection caused by an imbalance in the bacteria that naturally live in the vaginal microbiome. Normally, the vagina contains a balanced mix of bacteria, with the healthy bacteria (Lactobacilli) keeping the "bad" bacteria in check by maintaining an acidic vaginal pH. However, when this natural balance is disrupted, certain bacteria, such as Gardnerella and Prevotella can overgrow, leading to bacterial vaginosis.

The exact cause of this imbalance isn’t always clear, but several factors may increase the likelihood of bacterial vaginosis. Sexual activity, especially with new or multiple sex partners, can contribute to changes in vaginal bacteria. Although sometimes BV spreads via unprotected sex, it isn’t classified as a sexually transmitted infection (STI). You can still develop BV even if you're not sexually active.

Other potential triggers include douching, which can disrupt the vaginal flora, and using scented feminine hygiene products such as vaginal deodorants. Hormonal changes during menopause or your menstrual cycle may also play a role in making some women more susceptible to bacterial vaginosis.

Bacterial vaginosis symptoms

The most common bacterial vaginosis symptoms include: 

However, most women with bacterial vaginosis don’t have any symptoms. It’s also possible for these symptoms to be caused by other vaginal infections or sexually transmitted infections.  

How long does it take for BV to go away without treatment?

Mild cases of bacterial vaginosis may clear up on their own, but there’s no guarantee that it will. Even if symptoms temporarily improve, bacterial vaginosis can linger and resurface later. Without treatment, the infection might last for weeks or even months, making you uncomfortable and potentially leading to more serious health risks.

Risks of untreated BV

Bacterial vaginosis can lead to complications that are best avoided when left untreated. Having bacterial vaginosis increases your risk of contracting STIs, including HIV, because the imbalance of bacteria can make the vaginal environment more susceptible to harmful pathogens. This in turn can increase your risk of developing pelvic inflammatory disease (PID), which can cause fertility issues if it spreads to the uterus and fallopian tubes.

Additionally, pregnant women with bacterial vaginosis are at an increased risk of pregnancy complications like premature birth or low birth weight, which is why it’s important to get proper treatment — especially if you’re expecting.

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How to treat BV

The most effective way to treat bacterial vaginosis is with prescription antibiotics. Common treatments include oral antibiotics like metronidazole or topical treatments in the form of creams or gels. It’s important to complete the full course of treatment, even if your symptoms improve quickly, to ensure the infection doesn’t return. You should also avoid sex until you've finished your full course of treatment and your BV symptoms have fully cleared up.

Each antibiotic works differently depending on the type of bacteria. When treating BV, knowing the specific bacteria in your microbiome responsible for the infection can help choose the right antibiotic.

Evvy’s Clinical Care platform provides an at-home vaginal microbiome test and personalized care for bacterial vaginosis. This includes a comprehensive treatment program of prescription medication and research-backed supplements, based on your unique vaginal microbiome. Our whole approach is focused on not only treating harmful bacteria but also helping you maintain a healthy vaginal microbiome to prevent future symptoms.

A study looking at the effectiveness of Evvy’s Clinical Care platform found that 83% of participants transitioned from dysbiosis to a protective microbiome, and all reported an improvement in bacterial vaginosis symptoms.

Infections that cause symptoms similar to bacterial vaginosis

Bacterial vaginosis shares symptoms with several other vaginal or urinary infections, which is why it's essential to see a doctor if you experience any signs of infection. 

Yeast infections, for example, can cause itching and unusual vaginal discharge, but the discharge is typically thicker and has a different consistency than bacterial vaginosis. STIs, such as trichomoniasis, can also cause fishy-smelling discharge and discomfort.

Urinary tract infections (UTIs) can sometimes be confused with bacterial vaginosis if the infection irritates the urethra, leading to discomfort during urination. Because these different conditions require different treatments, getting an accurate diagnosis is crucial.

When should you see a healthcare provider?

While bacterial vaginosis may clear up on its own in some cases, it’s not something you should ignore. If you notice any symptoms like unusual vaginal discharge, a fishy odor, or discomfort, it’s a good idea to consult your doctor. They can confirm whether you have bacterial vaginosis or another condition and provide the right treatment. 

While bacterial vaginosis isn’t usually dangerous, the potential risks of leaving it untreated make it worth addressing quickly. Plus, many other infections share similar symptoms, so seeing a doctor ensures the correct diagnosis and care.

You can also take Evvy’s at-home Vaginal Health Test + STD Test, which tests for bacteria that cause bacterial vaginosis, as well as four of the most common STIs. Eligible users can also receive personalized care for their symptoms. 

FAQ

Is it OK to leave BV untreated?

It’s generally not a good idea to leave bacterial vaginosis untreated. While it may sometimes go away on its own, this isn't guaranteed and can lead to several complications. First, bacterial vaginosis can increase your risk of more serious infections. It makes the vaginal environment more vulnerable to STIs, including chlamydia, gonorrhea, and HIV. Additionally, it can lead to pelvic inflammatory disease, a condition that can affect the uterus and fallopian tubes, potentially causing fertility issues. For pregnant women, leaving bacterial vaginosis untreated can increase the risk of complications such as preterm labor. Even if your symptoms seem mild, it's important to seek treatment to avoid these risks. Antibiotics are effective at restoring the balance of vaginal bacteria and reducing the chances of recurrence.

Can BV clear up without treatment? 

Bacterial vaginosis can sometimes clear up without treatment, especially if the bacterial imbalance is mild. However, it's hard to predict if or when bacterial vaginosis will go away on its own. Even if symptoms improve temporarily, the infection can persist or return later if left untreated. Relying on bacterial vaginosis to clear up without treatment is risky because untreated bacterial vaginosis can lead to complications, such as an increased risk of STIs, pelvic inflammatory disease, and, for pregnant women, complications like preterm labor. To effectively restore the balance of vaginal bacteria and reduce the risk of these issues, it's best to consult your doctor and use prescribed antibiotics or recommended treatments. Another option is to seek personalized care for bacterial vaginosis through Evvy's Clinical Care platform.

How do I know if my BV is completely gone? 

You'll know your bacterial vaginosis is likely gone when your symptoms have completely resolved — this means no unusual vaginal discharge, fishy, or discomfort. If you're no longer experiencing these symptoms, it's a good indication the infection has cleared up. That said, some women may feel better even if the infection isn’t fully resolved. To be certain, it's important to finish the full course of antibiotics if you’ve been prescribed them, even if your symptoms improve before you’re done. In some cases, your doctor may recommend a follow-up visit or test to confirm that the infection is fully cleared, especially if you have recurrent bacterial vaginosis. If symptoms return, it’s best to check in with your provider again or take an Evvy Vaginal Health Test.

What can I drink to flush out BV?

There’s no specific drink that will directly "flush out" bacterial vaginosis, as it’s caused by a bacterial imbalance in the vagina and not something that can be resolved through fluids alone. There’s no evidence that certain drinks or dietary choices treat or prevent bacterial vaginosis.