Bacterial Vaginosis: Merck Manuals Shares What Women and Partners Need to Know

RAHWAY, N.J., July 29, 2026 /PRNewswire/ -- Bacterial vaginosis is the most common vaginal infection among women worldwide, yet many people still have questions about what causes it, how to recognize symptoms, and which treatments are most effective. As doctors continue to learn more about the condition, clear, reliable information remains essential for women and their partners.

A new editorial from MerckManuals.com discusses the very latest on bacterial vaginosis, with insights from Christina Muzny, MD, MSPH. Dr. Muzny is Professor of Medicine, Epidemiology, and Obstetrics & Gynecology in the Division of Infectious Diseases at the University of Alabama at Birmingham, Medical Director of the UAB ID Vaginitis Clinic and Sexual Health Research Clinic, and a Scientist with the UAB Center for Clinical and Translational Research.

Bacterial vaginosis can occur when the natural balance of bacteria in the vagina changes. Protective bacteria decrease, while other bacteria increase, creating an imbalance that can lead to symptoms.

The reasons for this imbalance are not fully understood, says Muzny. Until recently, bacterial vaginosis was not considered a sexually transmitted infection, though it appeared to be associated with some aspects of sexual activity. Today, a growing body of research is prompting doctors to reconsider that understanding and increasingly view bacterial vaginosis as a sexually transmitted infection.

The primary symptom of bacterial vaginosis is vaginal discharge that is typically thin, white or gray, and fishy-smelling. Treatment usually involves antibiotics, taken either by mouth or applied inside the vagina as a medicated gel or cream.

With treatment, bacterial vaginosis often resolves within a few days, says Muzny. However, recurrence is common: 60 to 80 percent of women may experience bacterial vaginosis again after initial treatment. For frequent recurrences, doctors may prescribe antibiotics for several weeks or months.

For women with recurring bacterial vaginosis, research suggests that male partners can carry bacteria associated with the condition. In some cases, doctors may recommend that long-term partners seek similar treatment to help eliminate the bacteria and reduce the likelihood of recurrence.

If left untreated, bacterial vaginosis can be associated with serious health complications. These may include pelvic inflammatory disease and, for pregnant women, infection of the membranes around the fetus (intra-amniotic infection), preterm labor and delivery, and infections of the uterus after delivery or following an abortion. Muzny also notes that bacterial vaginosis can negatively impact mental health, particularly for women experiencing recurrent infections.

Women may be tempted to use non-prescription remedies such as probiotics, yogurt, apple cider vinegar, garlic, douching, or boric acid to treat bacterial vaginosis. However, research has not found these to be effective treatments or prevention for bacterial vaginosis, and applying substances to the vagina may cause further irritation of the tissue, says Muzny.

In short: Home remedies and over-the-counter treatments are not recommended for bacterial vaginosis; they are not effective and may make things worse.

Rather than pursuing at-home remedies, the best approach to diagnosing and treating bacterial vaginosis is to see a healthcare professional as soon as possible, says Muzny. This should be part of or in addition to routine exams and other preventive care.

To read more of Muzny's insights on bacterial vaginosis, visit the editorial at MerckManuals.com.

First published in 1899 as a pocket-sized reference for physicians and pharmacists, The Merck Manual has evolved into one of the world's most trusted and widely-used medical resources. Today, it serves professionals and consumers alike with expert-authored, regularly updated medical content. Available in 16 languages and reaching nearly 250 countries, The Manuals offer far more than text. The website and mobile apps feature an ever-growing collection of videos, podcasts, infographics, and interactive 3D models designed for medical professionals, students, veterinarians, and curious consumers. For over a century, The Merck Manual has been fully committed to making reliable medical knowledge accessible to everyone, everywhere. Access The Manuals online in the United States and Canada at MerckManuals.com, and worldwide at MSDManuals.com.

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