Many medical studies have been conducted to examine the cure rates of bacterial vaginosis (BV) treatments with antibiotics. Generally, about 80% of women would have their BV cleared up initially. However, up to one-third of these women would have recurring bacterial vaginosis in 3 months’ time.

A long-term medical study found that more than half of women who were treated with antibiotics would be hit by at least another episode of BV. Most relapses took place in less than a year, and were mostly associated with having contact with new sexual partners.

For women who are at risk of recurring bacterial vaginosis, their risk can be greatly reduced by making some lifestyle changes, such as stop douching or replace IUD with another form of contraceptive.

So far, clinical observations suggest that recurrent bacterial vaginosis is not sexually transmitted, because treating the male sexual partner of a BV-affected woman didn’t seem to stop bacterial vaginosis from recurring. Current medical evidence is more supportive of the relapsing theory, which explains that the disruption of vaginal flora are actually triggered by some factors, and that causes bacterial vaginosis symptoms.

Exactly how recurring bacterial vaginosis occurs remains to be studied. It is still unknown which of these takes place first - a reduction in lactobacilli, an increase in vaginal pH, or an overgrowth of the naturally occuring BV-causing bacteria. Nevertheless, there are several therapeutic options available to help prevent bacterial vaginosis recurrence.

Bacteria replacement therapy

This method uses harmless bacteria to replace BV-causing bacteria with lactobacilli, and is considered natural and safe. Lactobacilli bacteria are used, either given orally or applied vaginally. However, scientists found that not all lactobacilli strains can stick on well to the vaginal lining.

The lactobacilli group found in yogurt doesn’t seem to stick very well to the vaginal wall. The L crispatus and L jensenii showed better ability to adhere compared with other lactobacilli strains. A medical study reported that normal flora vagina can be regained following a combination of oral and vaginal lactobacilli replacement therapy for 60 days. There are now studies to examine the effectiveness of vaginal pessaries containing L crispatus in repopulating the vagina with lactobacilli.

Maintaining a vaginal pH of 4.5 or less

Before the normal vaginal microflora balance is restored and able to naturally maintain the vaginal pH themselves, using external aid to adjust the vaginal pH is important to prevent overgrowth of BV-causing pathogens. One study showed that by using intravaginal lactate gel, 88% of women with recurring bacterial vaginosis were able to eliminate BV compared to only 10% of women who didn’t use the vaginal maintenance therapy.

Preventing overgrowth of BV-causing organisms

Bacterial vaginosis recurrences most often take place within the first 7 days of the menstrual cycle, and frequently followed a Candida infection. Medical experts propose the use of oral or vaginal metronidazole for the first 3 days of menstruation for 3-6 months. If there is a history of candidiasis, it is also advisable to add on anti-fungal treatment.

Using one of the above therapeutic options may help some women to end recurring bacterial vaginosis, but may not cure all cases. A combination therapy seems to work more effectively for the majority of women. For example, in a study where women took a single dose of oral metronidazole followed by vaginal lactate tablets, there was an improved rate of normal vaginal flora in 94% of women, compared to only 71% of women if no vaginal maintenance treatment was used.

In short, it would be ideal if recurring bacterial vaginosis can be managed through bacteria replacing treatment and maintaining the vaginal pH at 4.5, and if necessary also adding complementary treatment to control bacteria overgrowth. In fact, many natural cures for bacterial vaginosis practiced today are in line with these medical evidence, and many women are turning to natural remedies as a resort to their BV woes.