Bacterial Vaginosis (BV)
that keeps coming back
If symptoms improve… then return weeks later, you’re not alone — and the underlying cause may not have been fully addressed.
Understand BV symptoms, causes, and treatment options — including more targeted approaches for recurrent BV.
What is Bacterial Vaginosis?
Bacterial vaginosis (BV) is a common condition caused by an imbalance in the vaginal microbiome.
When protective Lactobacillus bacteria are reduced, other bacteria can overgrow — leading to symptoms such as discharge, odour, and irritation.
In some women, this imbalance can persist or return after treatment — leading to recurrent BV.
Symptoms of Bacterial Vaginosis
Symptoms can vary — and some women experience none at all. When present, they may include:
Thin grey or white discharge
Strong or unusual odour (often more noticeable after sex)
Vaginal irritation or discomfort
A noticeable change in vaginal balance or pH
Why BV can keep coming back?
Symptoms improve… then return
Treatment works temporarily — but doesn’t last
You’ve had multiple courses of antibiotics without lasting relief
Many women experience recurrent BV because treatment often targets the bacteria causing symptoms — but may not fully restore the underlying vaginal microbiome balance needed for long-term stability.
In some cases, repeated antibiotic use may further disrupt an already sensitive microbiome, contributing to ongoing recurrence.
Possible complications of BV
BV is more than just a temporary or minor infection.
Research suggests that vaginal dysbiosis may influence broader aspects of vaginal and reproductive health,
which is one reason recurrent symptoms deserve further assessment rather than simply repeated treatment.
Why symptoms can return after treatment
Antibiotics are effective at reducing BV-associated bacteria and are an important part of evidence-based care. However, recurrence is common.
In some cases, treatment may not fully restore the protective Lactobacillus bacteria needed to maintain a stable vaginal microbiome.
Emerging research suggests that repeated antibiotic use may further disrupt an already sensitive microbiome in some women, contributing to ongoing or recurrent symptoms. In addition, factors such as microbiome imbalance, hormonal influences, and possible partner-related factors may play a role in recurrence — and are not always fully addressed in standard approaches.
A comprehensive approach to recurrent BV
Care is focused on understanding why symptoms keep returning — not just treating each episode.
This approach looks at the full picture, including:
- Detailed assessment of symptom patterns
- Review of previous treatments and response
- Exploration of vaginal microbiome balance
- Identification of contributing factors (including hormonal, lifestyle, and partner-related influences)
- Personalised management strategies tailored to your presentation
If BV keeps coming back
It may be time to look beyond short-term treatment and explore what’s really driving your symptoms.
Book an initial consultation to explore what may be contributing to your symptoms and develop a more personalised, long-term approach.
Why does BV keep coming back?
Many women experience recurrent BV after treatment. While antibiotics can reduce BV-associated bacteria, recurrence is common and may be influenced by factors such as changes in the vaginal microbiome, hormonal influences, sexual activity, and individual susceptibility.
What are the symptoms of BV?
Symptoms can vary, but may include:
• Thin grey or white discharge
• A noticeable or unusual odour
• Vaginal irritation or discomfort
• Changes in vaginal pH and microbiome balance
Some women experience no symptoms at all.
Can BV go away on its own?
In some cases, symptoms may improve without treatment. However, if symptoms persist, recur, or cause concern, medical assessment is recommended to determine the most appropriate management approach.
Is BV a sexually transmitted infection (STI)?
No. BV is not generally considered a sexually transmitted infection. However, sexual activity may influence the vaginal microbiome and can be associated with changes in vaginal bacterial balance in some women.
Why do antibiotics sometimes not prevent BV from returning?
Antibiotics are effective treatments for BV and remain an important part of evidence-based care. However, recurrence is common in some women, particularly if factors contributing to vaginal microbiome imbalance have not fully resolved.
What is the vaginal microbiome?
The vaginal microbiome refers to the community of microorganisms that naturally live within the vagina.
Protective bacteria, particularly Lactobacillus species, help maintain a healthy vaginal environment.
Changes in this balance may contribute to vaginal symptoms and recurrence in some women.
When should I seek medical advice for recurrent BV?
You should seek medical review if:
• Symptoms continue to return despite treatment
• Symptoms are affecting your quality of life
• You are unsure whether your symptoms are due to BV
• You have concerns about recurrent infections or vaginal health
Can recurrent BV be associated with other vaginal health conditions?
Some women experiencing recurrent BV may also experience other vaginal symptoms or conditions. A comprehensive assessment can help identify factors that may be contributing to ongoing symptoms and guide a more personalised management plan.
Can BV affect other aspects of vaginal health?
Bacterial vaginosis is more than just a temporary vaginal infection.
Research suggests that BV and vaginal dysbiosis may be associated with a range of broader vaginal and reproductive health outcomes. Studies have found associations between BV and an increased susceptibility to certain sexually transmitted infections (STIs), as well as other reproductive and pregnancy-related complications.
Maintaining a healthy vaginal microbiome is increasingly recognised as an important component of overall vaginal health.
For enquiries or to book a consultation, feel free to get in touch.
Confidential, Telehealth consultations focused on recurring vaginal health concerns — private, accessible, and designed for a more comprehensive approach.
Email us: [email protected]
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