How Effective Is Metronidazole for Bacterial Vaginosis?

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  • Written By: B. Chisholm
  • Edited By: O. Wallace
  • Last Modified Date: 19 July 2019
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Oral or topical metronidazole is usually very effective for treating bacterial vaginosis. Bacterial vaginosis is a vaginal infection seen frequently in women and is normally caused by overgrowth of an anaerobic organism, Gardnerella vaginalis. The use of metronidazole, both topically and orally, has shown good results in eradicating the condition.

The bacterial flora in the vagina is a finely maintained balance of anaerobic and Lactobacillus bacteria. The exact cause of vaginosis is not established, but it seems that a number of factors can affect the balance. It is thought that some practices may increase a woman's risk of developing this condition, including douching and unprotected sexual intercourse. It does not, however, only occur in sexually active women. It does commonly recur, however, causing some medical practitioners to treat sexual partners, although this is controversial.

While bacterial vaginosis may be asymptomatic and, in these cases, probably doesn't need treatment, it usually presents with vaginal discharge, a "fishy" odor, and pain during intercourse. Should these symptoms occur, medical help should be sought. Bacterial vaginosis usually doesn't have any complications but may increase a women's risk of getting a sexually transmitted disease (STD) and, in pregnant women, may increase the risk of premature labor.


Metronidazole is the most well-recognized treatment for bacterial vaginosis. It is known by different trade names in different countries, by manufacturer, and is usually available by prescription only. It is important that the prescribed dose is taken and the full course is completed, even if symptoms subside. Stopping taking the drug before the course is finished may increase the chances of recurrence and make treatment more difficult.

The usual dose of oral metronidazole for bacterial vaginosis is a daily or twice daily dose for seven days. If used topically, metronidazole is inserted intra-vaginally at bedtime every night for five nights. It is important for a woman who is pregnant, trying to get pregnant, or breastfeeding discuss this with the prescribing medical professional before beginning treatment.

As with any medication, metronidazole may interact with other drugs, including over-the-counter, homeopathic and complementary medicines, and they should be discussed with the prescribing healthcare professional. Alcohol should be avoided completely while taking this drug, as it may cause a disulfiram-like reaction that can cause flushing, abdominal cramps, and severe nausea and vomiting. Side effects include headache and gastrointestinal problems, such as diarrhea, nausea, and vomiting. Patients who experience severe side effects should seek medical attention.


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Post 2

@jennythelib - Those are good tips! There are also natural treatments for bacterial vaginosis and for yeast that some women may want to try before going the pharmacy route, especially if they're pregnant.

For yeast, a lot of women find rinsing with diluted vinegar (ask your doctor) clears things up; I've also heard of using gentian violet or yogurt-soaked tampons.

For bacterial vaginosis, I think there have actually been clinical studies showing that a vaginal wash with diluted hydrogen peroxide is an effective treatment. My understanding is that hydrogen peroxide helps your body return to its natural pH, thus encouraging the growth of those all-important natural healthy flora. (They tend to choke out yeast and "bad" bacteria.)

Post 1

You have to be careful with bacterial vaginosis and yeast infections because you can get into this vicious cycle where you cause the other in clearing up the one. (I once went two months without relief.)

The treatment for a yeast infection can kill off your body's natural flora, making you more vulnerable to bacterial infection. Likewise, oral or topical antibiotics also kill off the natural flora, which makes you vulnerable to an overgrowth of yeast!

So if you are treating for one or the other, it's wise to take steps to prevent the other from occurring. Yeast likes sugar, so if you have either BV or yeast, you should cut waaaay down on your sugar and white

carbs (potatoes, white bread, etc.) Eating yogurt or taking probiotic supplements is a good idea for either one.

And garlic is a natural, mild antibiotic, so some people like to take garlic when they're treating a yeast infection to discourage BV from occurring. Ask your doctor what else you can do, especially if you have a history of repeat infections.

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