Bacterial vaginosis (BV) tends to “keep coming back” for many people because the vaginal ecosystem is easy to upset and often never fully returns to a stable, protective state after treatment.

What BV Actually Is

  • BV is not “dirty” or your fault; it is an imbalance of bacteria in the vagina, where protective Lactobacillus bacteria drop and other bacteria overgrow.
  • This shift changes vaginal pH, often causing thin gray/white discharge and a fishy smell, especially after sex or during your period.

Think of it like a garden: the “good” plants get cleared out, weeds move in, and unless the soil is fixed, the weeds keep returning.

Why It Keeps Coming Back

Several things can create a cycle of recurring BV:

  1. Biofilms and hard‑to-kill bacteria
    • Some BV‑related bacteria form a biofilm (a slimy shield) on the vaginal wall, which makes them harder to clear with standard antibiotics.
 * Symptoms improve, but a small “core” of bacteria survives and regrows after treatment.
  1. Not enough “good” bacteria returning
    • Antibiotics kill the overgrown bacteria but do not always rebuild Lactobacillus that keep the vagina acidic and protected.
 * If those protective bacteria don’t come back, the imbalance can happen again with even small triggers.
  1. Triggers in daily life and sex
    Common triggers that can keep restarting BV include:
 * New or multiple sexual partners, or sex without barrier protection
 * Semen (it’s alkaline and can raise vaginal pH)
 * Douching, scented washes, wipes, bubble baths, or strong soaps
 * Smoking and high stress
 * Tight, non‑breathable underwear or staying in wet/sweaty clothes
 * Some types of contraception (e.g., spermicides, certain IUDs or products)
  1. Partner and reinfection cycle
    • Partners can carry and share BV‑related bacteria, so you may clear it and then get re‑exposed.
 * This is one reason some guidelines discuss considering partner evaluation or consistent condom use when BV keeps recurring.
  1. Hormones and health conditions
    • Hormonal changes (cycle, pregnancy, perimenopause, hormonal birth control) can change vaginal pH and bacteria.
 * Conditions like diabetes or immune issues and repeated courses of systemic antibiotics can make recurrence more likely.
  1. Even if you’re not sexually active
    • BV can still recur with no sex at all; things like periods, stress, hygiene products, and clothing alone can disrupt the microbiome.

What You Can Do About Recurring BV

Only a clinician who knows your history can properly diagnose and treat you, but common approaches to reduce recurrences include:

  1. Medical strategies to ask your provider about
    • Extended or suppressive regimens (for example, longer or repeated courses of metronidazole or similar medications) are sometimes used for recurrent BV.
 * Vaginal probiotics or microbiome‑supporting approaches (often Lactobacillus-based) may help some people rebuild protective bacteria, though results vary.

 * Reviewing your contraception, general medications, and any underlying conditions (like diabetes or immune problems) may uncover contributors.
  1. Lifestyle and hygiene changes that often help
    • Avoid douching and skip scented products (washes, sprays, wipes, perfumes) on the vulva and inside the vagina.
 * Use mild, unscented soap on the vulva only, and do not clean inside the vagina (it is self‑cleaning).

 * Wear breathable cotton underwear, change out of wet gym/swim clothes quickly, and sleep without underwear if comfortable.

 * If sex is a trigger, talk to your provider about using condoms consistently and whether partners should be evaluated.

 * Support overall health: manage stress, aim for a balanced diet (including fermented/probiotic foods if appropriate), and avoid smoking where possible.
  1. When to see a doctor urgently
    • Pelvic or lower abdominal pain, fever, foul odor with pain, or bleeding outside your period can signal something more serious that needs prompt care.

A Quick “Why Do I Keep Getting BV?” Checklist

People with recurrent BV often find that one or more of these are true for them:

  • I finish treatment, but symptoms come back within weeks or months.
  • I use scented products, wipes, or douches.
  • I have new or multiple partners, or don’t usually use condoms.
  • I’m on or recently changed birth control, or I’m in a hormonally “shifty” time (like postpartum, perimenopause).
  • I take antibiotics often for other infections.
  • I have high ongoing stress, smoke, or have health issues like diabetes.

If you recognize yourself in several of those, it’s worth taking that list to a gynecologist or sexual health clinic and asking specifically about “recurrent BV” and long‑term strategies, not just another one‑off treatment.

Bottom note (per your prompt): Information gathered from public forums or data available on the internet and portrayed here.