Gray discharge that smells like fish, an odor that intensifies after intercourse or during menstruation, and the feeling that it keeps coming back even after treatment. You are not alone. 23 to 29% of women of childbearing age have already had bacterial vaginosis.
It's not a sexually transmitted infection, it's not a hygiene issue, and no, you haven't done anything "dirty." It's an imbalance in your vaginal flora that has specific causes and effective solutions. This article explains how vaginosis develops, why it recurs in some women, and, most importantly, how to get rid of it for good.
💡 What you will understand
What Is Bacterial Vaginosis (Without the Jargon)
Your vagina is naturally home to millions of bacteria. It sounds disgusting, but these bacteria are there to protect you. The most important ones are called lactobacilliThey are what maintain an acidic pH (between 3,8 and 4,5) in your vagina to prevent pathogenic bacteria from proliferating.
Bacterial vaginosis occurs when this balance is disrupted. Lactobacilli decrease, and other bacteria (Gardnerella vaginalis, Prevotella, Atopobium vaginae) take advantage of this to multiply. The vagina's pH becomes more alkaline (rising to 5-5,5), and this is when unpleasant symptoms appear.
⚠️ Important to understand
Vaginosis is NOT a sexually transmitted infection. You don't catch it like chlamydia or gonorrhea. It's your own vaginal flora that becomes unbalanced. Even women who have never had sex can get it. However, sexual activity can contribute to this imbalance (more on that later).
Symptoms You Can't Miss
Not all women have symptoms; some have vaginosis without realizing it. But when symptoms do occur, they are quite characteristic.
🆚 Vaginosis VS Yeast Infection: How to Tell the Difference
These two infections are often confused. However, they have nothing to do with each other.
How You "Catch" Vaginosis (The Real Causes)
You don't catch vaginosis like you catch a cold. It's your own flora that becomes unbalanced due to specific factors. Some are controllable, others less so.
1. Douching (Mistake Number One)
Flushing the inside of your vagina with water or a cleanser literally destroys your protective flora. Lactobacilli are flushed out with the water, and pathogenic bacteria take advantage of this to colonize the empty terrain.
🚫 Never, ever
Your vagina cleans itself. You NEVER need to wash the inside. Wash only the vulva (the outside) with clean water or a mild, pH-neutral soap. Douching significantly increases the risk of bacterial vaginosis.
2. Excessive Hygiene (Yes, Too Much Is Too Much)
Washing your vulva 3-4 times a day with scented shower gels, antibacterial soaps, or scented intimate wipes can unbalance your vaginal pH. You destroy "good" bacteria by trying to be "clean."
✅ The right hygiene routine
- One toilet a day maximum (two in case of menstruation or high heat)
- Clear water or mild soap at neutral/slightly acidic pH
- Only the vulva (the outside), never the inside of the vagina
- Pat dry, do not rub
- Cotton underwear, avoid synthetics which do not breathe
3. Antibiotics (Boomerang Effect)
Antibiotics kill bacteria without distinguishing between good and bad. When you take antibiotics for a sore throat, a UTI, or anything else, your vaginal flora suffers too. The lactobacilli disappear, and boom, vaginosis.
💡 Solution : After antibiotic treatment, take probiotics (Lactobacillus acidophilus, Lactobacillus rhamnosus) to restore your vaginal flora. Talk to your doctor or pharmacist.
4. Sexual Activity (Not an STI, But Still)
Intense sexual activity or frequent partner changes can disrupt vaginal flora. Semen has an alkaline pH (7,2-8), which can temporarily increase vaginal pH and promote the proliferation of Gardnerella vaginalis.
Important details
- Vaginosis is NOT an STI, your male partner usually does not need treatment
- On the other hand, it can be transmitted between women during sexual intercourse.
- People with vaginosis have an increased risk of contracting a real STI (HIV, chlamydia, gonorrhea) because the protective flora is weakened
- A recent study (2025) shows that treating the male partner (oral antibiotics + topical cream) reduces recurrences of vaginosis in some women
5. The Copper IUD (IUD)
Le Copper IUD Slightly alters the vaginal environment and may promote the development of vaginosis in some women. If you have an IUD and experience repeated vaginosis, talk to your gynecologist.
6. Periods (Blood Changes pH)
Menstrual blood has a pH of 7,4 (alkaline). When it flows, it dilutes the protective lactobacilli and temporarily raises vaginal pH. This is why many women develop vaginosis right after their period.
💡 Tip during menstruation
Avoid scented tampons and pads, which irritate the mucous membrane. Change your protection regularly (tampon every 4-6 hours max, cup every 8-12 hours). Period Panties allow you to breathe and limit maceration.
7. Stress and Tobacco (Aggravating Factors)
Chronic stress alters your immune system and can disrupt your vaginal flora. Smoking has also been identified as a risk factor for bacterial vaginosis, although the exact mechanism is not fully understood.
8. Natural Lack of Lactobacilli (Genetics)
Some women naturally produce less lactobacilli than others. This isn't your fault; it's your basic vaginal microbiota. In this case, recurrences are more frequent and sometimes require long-term treatment with probiotics.
Solutions for Treating Vaginosis
Vaginosis is easily treated with antibiotics. The problem isn't the lack of treatments, it's the recurrence, which occurs in 30 to 40% of cases within 3 months of treatment.
Standard Treatment (Antibiotics)
The reference treatment is the metronidazole, an antibiotic that targets anaerobic bacteria like Gardnerella vaginalis.
⚠️ Precautions with metronidazole
- Zero alcohol during treatment and 48 hours after (risk of Antabuse effect: nausea, vomiting, severe headaches)
- May cause nausea, metallic taste in the mouth
- Local treatments (gel, ovules) have fewer side effects than oral tablets
- Ask your doctor or pharmacist for advice
Probiotics (To Prevent Recurrences)
Antibiotics kill pathogenic bacteria, but they don't restore your protective flora. That's where probiotics come in. Numerous studies show that they significantly reduce the rate of recurrence.
📊 What the scientific studies say
- A study of 120 women (2010) shows that probiotics reduce the recurrence of vaginosis by 45% to 15,8% over 11 months
- A systematic review (2024) identifies Lactobacillus rhamnosus TOM 22.8 as the most effective strain
- Probiotics containing Lactobacillus crispatus reduce the recidivism rate by 30 to 50%
- Vaginal administration appears to be more effective than oral administration according to several studies
Which probiotics should you choose?
- Lactobacillus rhamnosus GR-1 et Lactobacillus reuteri RC-14 : the most studied strains
- Lactobacillus crispatus IP 174178 : very effective in vaginal administration
- Lactobacillus acidophilus : available in many products
- Recommended dose : at least 10⁹ CFU (10 billion colonies) per day
- Duration : 2 to 3 months to sustainably restore the flora
- Form : vaginal suppositories/capsules or oral capsules (both can work)
Natural Treatments (Supplement, Not Replacement)
Some natural treatments can help as a complement, but they are NOT a substitute for doctor-prescribed antibiotics. Don't gamble with your health.
🚫 NEVER do this
- Inserting garlic into the vagina (risk of chemical burn)
- Make vinegar or bicarbonate baths
- Use pure, undiluted essential oils
- Try to treat yourself without consulting a doctor if symptoms persist for more than 2-3 days
Recurrent Vaginosis: Why It Comes Back
This is THE question that comes up most. You did the treatment, it worked, and 2-3 weeks later, it starts again. Frustrating, right?
The reasons for recurrences
1. Antibiotics do not restore flora
They kill the pathogenic bacteria, but do not reintroduce the lactobacilli. As a result, the playing field is empty, and Gardnerella vaginalis returns.
2. Risk factors persist
If you continue douching, excessive hygiene, unprotected sex with changing partners, or if you keep your IUD, the imbalance will recur.
3. Your basic flora is weak
Some women naturally produce less lactobacilli. In this case, long-term treatment with probiotics (over several months) is often necessary.
4. Reinfection by the partner
Although controversial, some studies suggest that male partners can carry Gardnerella vaginalis and reinfect the woman. Treatment of the partner may be considered in cases of multiple recurrences.
🔄 The anti-recidivism protocol that works
Step 1 : Complete antibiotic treatment (do not stop before the end even if the symptoms disappear)
Step 2 : Vaginal probiotics for 2-3 months (Lactobacillus rhamnosus or crispatus)
Step 3 : Correct risk factors (stop douching, appropriate hygiene, condoms)
Step 4 : Maintenance probiotic treatment if frequent recurrences (1 week per month for 6 months)
Step 5 : Consider partner treatment if unsuccessful (discuss with your doctor)
Mistakes That Make the Situation Worse
Some well-intentioned habits make the problem worse instead of better.
❌ Increase the number of intimate toilets
The more you wash, the more you destroy your flora. Once a day is enough. Two at the most in case of menstruation or extreme heat.
❌ Use “special intimate hygiene” products
"Special intimate hygiene" gels, wipes, and soaps are often full of perfumes and irritants. Plain water or a mild, pH-neutral soap is more than enough.
❌ Wear thongs and synthetic underwear
Thongs rub against each other and encourage the passage of bacteria from the anus to the vagina. Synthetic materials don't allow you to breathe and create a warm, moist environment perfect for bacteria. Choose cotton instead.
❌ Stopping treatment too early
Symptoms often disappear after 2-3 days. But if you stop the antibiotics before the end of the course, the surviving bacteria will multiply again. Follow through.
❌ Treat only the symptoms without looking for the cause
If you have recurring bouts of vaginosis, you need to identify and correct the risk factors. Otherwise, you'll be going around in circles.
Comfortable Protection During Periods
Menstruation can promote the development of vaginosis by changing vaginal pH. Our breathable cotton Period Panties limit maceration and wetness, unlike scented pads and tampons that irritate the mucous membrane.
Complications If You Don't Treat
Bacterial vaginosis isn't just "unpleasant." If left untreated, it can lead to more serious complications.
🤰 Pregnant women: consult quickly
If you are pregnant and experience symptoms of vaginosis (gray discharge, fishy odor), seek medical help immediately. Treatment is compatible with pregnancy and can prevent serious complications for your baby.
Understanding to Better Care
Bacterial vaginosis is neither a sexually transmitted infection, nor a hygiene issue, nor something to be ashamed of. It's an imbalance in your vaginal flora that has identifiable causes and effective solutions. Antibiotics (metronidazole or clindamycin) can treat the infection in a few days, but restoring your flora with probiotics and correcting risk factors will prevent recurrences.
If you have gray discharge, a fishy odor, or recurring vaginosis, consult a doctor or midwife. Don't let it drag on, and above all, stop blaming yourself or thinking it's your fault. Your vagina is doing what it can to protect itself; sometimes it just needs a helping hand.
Sources & Scientific References
This article is based on recent scientific publications and international public health data.
Epidemiology and definition
- World Health Organization. (2024). Bacterial vaginosis. WHO Fact Sheet
- Kenyon C, Colebunders R, Crucitti T. (2013). The global epidemiology of bacterial vaginosis: a systematic review. American Journal of Obstetrics and Gynecology. DOI: 10.1016/j.ajog.2013.05.006
Probiotics and prevention of recurrences
- Ya W, Reifer C, Miller LE. (2010). Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study. American Journal of Obstetrics and Gynecology. DOI: 10.1016/j.ajog.2010.05.023
- Bohbot JM, Daraï E, Bretelle F, et al. (2018). Efficacy and safety of vaginally administered lyophilized Lactobacillus crispatus IP 174178 in the prevention of bacterial vaginosis recurrence. Journal of Gynecology Obstetrics and Human Reproduction. DOI: 10.1016/j.jogoh.2017.11.005
- Udjianto U, Sirat NA, Rahardjo B, Zuhriyah L. (2025). Effective probiotic regimens for bacterial vaginosis treatment and recurrence prevention: A systematic review. Narra Journal. DOI: 10.52225/narra.v5i1.1671
- Homayouni A, Bastani P, Ziyadi S, et al. (2014). Effects of probiotics on the recurrence of bacterial vaginosis: a review. Journal of Lower Genital Tract Disease. DOI: 10.1097/LGT.0b013e31829156ec
Antibiotic treatment
- Workowski KA, Bachmann LH, Chan PA, et al. (2021). Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recommendations and Reports. CDC Guidelines
- Bradshaw CS, Sobel JD. (2016). Current Treatment of Bacterial Vaginosis—Limitations and Need for Innovation. The Journal of Infectious Diseases. DOI: 10.1093/infdis/jiw159
Complications and risk factors
- Atashili J, Poole C, Ndumbe PM, et al. (2008). Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. AIDS. DOI: 10.1097/QAD.0b013e3282f2e165
- Brotman RM, Klebanoff MA, Nansel TR, et al. (2010). Bacterial vaginosis assessed by gram stain and diminished colonization resistance to incident gonococcal, chlamydial, and trichomonal genital infection. The Journal of Infectious Diseases. DOI: 10.1086 / 657320
Note: DOI links provide direct access to the original scientific publications. This article was written in accordance with current medical knowledge.
Medical Warning: This article is for informational purposes only and is not a substitute for professional medical advice. If you experience symptoms of bacterial vaginosis, consult a doctor, midwife, or gynecologist.
