The treatment on this page is the bacterial vaginosis treatment that most doctors currently believe is the most effective. Remember metronidazole vaginal gel is only for non pregnant women. Because of other underlying health problems your own doctor may decide some other treatment is more suitable for you and you should always follow their advice.
There can be serious complications with untreated BV. It is important to have a healthy vaginal Lactobacilli microflora to help prevent sexually transmitted diseases2 and preterm labour.3 Remember, it is VITAL that bacterial vaginosis in pregnancy is treated.
Interestingly, a 2005 study on vaginal microflora does suggest that it is possible to have bacterial species other than Lactobacilli dominant and yet for the vagina to be healthy.
If you're pregnant then you must seek treatment for the baby's sake. Note that although both pregnant and non-pregnant women are treated with Metronidazole or Clindamycin, the doseage is different for each group.
Currently (2014) the bacterial vaginosis treatments recommended give you a choice of taking a tablet by mouth, or a gel or cream inserted into the vagina. Your doctor might prescribe one of these treatments. Your doctor might also prescribe a different treatment because these treatments should not be taken with some health problems.
These are all antibiotics for bacterial vaginosis and will NOT be effective against yeast.
The Center for Disease Control and Prevention recommend that if you're NOT pregnant that you should be treated if you display symptoms of bv. Unfortunately, 50% of women don't have any symptoms1, but if through some other health check you learn that you have asymptomatic bacterial vaginosis, medical advise is that you still undergo bacterial vaginosis treatment as it is known that BV - whether you have any symptoms or not - increases your chance of infectious complications after an abortion or hysterectomy, and increases your risk of catching an STD or HIV.
Bacterial vaginosis treatment of male partners has not prevented the reinfection of women with this vaginal infection.
Metronidazole 500 mg taken by mouth twice a day for 7 days.
Metronidazole vaginal gel 0.75% one full applicator inserted into the vagina once a day for 5 days.
Clindamycin cream 2% one full applicator inserted into the vagina at bedtime for 7 days.
Metronidazole 500 mg taken by mouth twice a day for 7 days.
Metronidazole 250 mg taken by mouth THREE times a day for 7 days.
Clindamycin 300 mg taken by mouth twice a day for 7 days.
METRONIDAZOLE DURING PREGNANCY - it crosses the placenta and enters the fetal circulation rapidly. Don't take during the first trimester. It will be secreted in breast milk so if breast feeding then there are better treatment choices.
The Centers for Disease Control and Prevention provide up-to-date treatment for BV options that you can trust. For your convenience, this link will open in a new window so that you can return to Probiotics LoveThatBug when you're finished.
Comes as oral capsules or Metronidazole vaginal gel. US and Canadian brand names include Flagyl, Flagyl 375, Flagyl Er, Protostat and Helidac Therapy.
World-wide brand names include Acromona; Amibazol; Amiyodazol; Anaerobex; Anerobia; Apo-Metronidazole; Arcazol; Arilin; Ariline; Asiazole; Asuzol; Camezol; Clont; Debetrol; Deflamon; Elyzol; Fladex; Flagenase; Flagyl; Flagyl 375; Flasinyl; Fossyol; Frotin; Fulikan; Fuzuzin; Klion; Medai; Melis; Metarsal; Metizol; Metro IV; Metrocream; Metrogel; Metrogyl; Metrolag; Metrolex; Metromidol; Metronidazole IV; Metronidazol McKesson; Metroxyn; Metroxyn 500; Metrozin; Metrozine; Metrozole; Metryl; Nalox; Nida; Nitrozol; Noritate; Norstene; Novazole; Novonidazole; Protostat; Rozagel; Rozex; Rozex Gel; Satric; Servizol; Servizole; Supplin; Takimetol; Trichex; Trichozole; Tricowas B; Tricowas-B; Trikacide; Trofonil; Vaginyl; Vagitrix; Vagyl; Zadstat.
In favour of Metronidazole as a bacterial vaginosis treatment is the fact that it does not target the friendly Lactobacillus spp and other aerobic microorganisms that are commonly found in the vagina.
Against Metronidazole is the fact that it has caused cancer in rats and mice. (Keep in mind that half the drugs you take have likely done this too.) If you need it as a treatment for bacterial vaginosis, then take it — just don't take it unnecessarily. Be sure it is bv that you have.
DON’T DRINK ALCOHOL — They're not just being a bunch of wowsers when they advise this! Mixing Metronidazole and alcohol is a no-no! This particular bacterial vaginosis treatment reacts with alcohol to sometimes cause severe flushing, abdominal cramps, nausea, vomiting, headaches, and chest of stomach pain may occur. So unless you enjoy looking like a strawberry and feeling like sh**, don't drink during or for 72 hours after taking it.
Flagyl ER 750 mg tablets (contains Metronidazole) should be taken at least one hour before or two hours after meals. ER stands for extended release and this aspect of the drug works best on an empty stomach.
If it doesn't state ER then some people find it easier on the stomach to take with food.
It is normal for Metronidazole to make your urine dark brown or black.
In the US and Canada brand names include Cleocin, Clindesse and Dalacin.
World wide brand names include Basocin Akne Gel; Basocin Akne Losung; Cleocin; Cleocin T; Cleocin Phosphate; Cleocin Vaginal; Cleorin; Cindala; Clicinin; Clinac; Dalacin; Dalacin 2% Vaginal Cream; Dalacin T; Dalacin T Lotion; Dalacin T Topical Solution; Dalacin V; Dalacin VC 2%; Dalacine T; Dalagis T; Euroclin; Sobelin Vaginal Creme.
It isn't known if Clindamycin used vaginally gets into breast milk or not. It does when taken as an oral medicine but is not thought to cause harm.
If you have colitis or have any stomach or intestinal problems make sure your doctor is aware of this as Clindamycin has caused diarrhea with some people.
If your period starts during treatment, simply continue with the Clindamycin cream treatment as prescribed. In that situation, use sanitary pads or towels rather than tampons if you can.
The cream will leak out so use sanitary pads or towels but not tampons because they will soak up the medication.
Clindamycin cream contains oils that weakens latex (rubber) so be aware that contraceptive products such as condoms, diaphragms, or cervical caps might perish and not work. Don't use latex or rubber contraceptive means for 72 hours after stopping treatment with vaginal clindamycin cream.
During and for a short time after your bacterial vaginosis treatment you may have some burning, itching and white discharge.
Yikes! And I thought that was what we were trying to fix! Seriously, it is only for a short time as the vaginal tissue "settles down".
When you're finished your bacterial vaginosis treatment, be aware that your vagina is going to be a rather empty bit of real estate. Fill it up with probiotics before the nasties come back. Home treatment of bacterial vaginosis works wonders if you get started immediately after antibiotic treatment.
It is the perfect time to ensure that you never have to go through this again.
1. Centers for Disease Control and Prevention
2. van deWijgert, J.H.H.M, Mason, P.R, Gwanzura, Let.al. (2000) Intravaginal practices, vaginal flora disturbances, and acquisition of sexually transmitted diseases in Zimbabwean women. J. Infect. Dis. 181, 587—594.
3. Chaim, W, Mazor, M, Leiberman, J.R (1997) The relationship between bacterial vaginosis and preterm birth. Arch. Gynecol. Obstet. 259, 51—58.