Natural vs prescription: best bacterial vaginosis treatments that actually work

What is the most effective treatment for BV?

When you’re dealing with bacterial vaginosis (BV), one of the first questions is, ‘what is the best way to treat it, and will it actually work?’ With so many bacterial vaginosis treatments out there, choosing between a prescription and a natural remedy can feel overwhelming.

The truth is, both options can be effective in the right context. However, lasting results come from understanding how BV works, and how to properly disrupt the bacterial overgrowth and restore your vaginal ecosystem.

Here, we break down the pros and cons of natural BV remedies and prescription BV medication, and how to find the most effective BV treatment for your body.

What causes BV, and why it keeps coming back

BV is caused by an imbalance in your vaginal flora, where protective lactobacilli are overrun by anaerobic bacteria like Gardnerella vaginalis, Fannyhessea (Atopobium) vaginae, and others. These bacteria can form biofilms – sticky protective layers that help them resist antibiotics – and thwart immune responses.

If your BV keeps coming back, biofilms and lack of post-treatment support for other unrecognised elements are often to blame. That’s why your choice of BV treatment matters – and why combination or layered approaches are usually more successful.

Prescription BV medication: standard treatment, common relapse

When you go to your doctor with BV symptoms, they’ll typically prescribe an antibiotic. These are the most common options:

Metronidazole – oral or vaginal
Clindamycin – vaginal cream or ovule
Tinidazole – oral (less common)

These antibiotics are designed to kill BV-causing bacteria, and many people find they offer quick symptom relief within a few days.

However, recurrence is common – up to 50% of people report symptoms returning within 3-6 months. That’s because these drugs don’t restore healthy bacteria or address biofilms, nor do they address other factors that can contribute to BV, like hormones and inflammation. Unfortunately for many, prescription BV medication is a short-term fix, not a long-term solution.

Side effects of antibiotics can include nausea, yeast infections, and altered gut flora. There is also growing concern about antibiotic resistance.

Natural BV remedies: treating the ecosystem, not just the bug

Natural BV remedies take a different approach. Rather than focusing only on killing bacteria, they work to rebalance the vaginal microbiome, disrupt biofilms, and support immune function. A high-quality natural treatment plan may include:

1. Herbal antimicrobials

Plants like burr marigold, thyme and coptis, used in My Vagina’s BV treatments, have powerful antibacterial effects that don’t disrupt any remaining protective bacteria. These herbs can be taken orally or used vaginally (when properly formulated). My Vagina has a range of powerful options.

2. Biofilm disruptors

BV bacteria often hide in biofilms. Compounds like EDTA, enzymes (like nattokinase or serrapeptase), and certain herbal formulas can help break these biofilms down, allowing treatments to reach the bacteria. My Vagina’s treatments all contain more than one biofilm agent.

3. Probiotics

Both oral and vaginal probiotics are key to restoring lactobacilli, particularly Lactobacillus crispatus, which most often is a protective element of a healthy vaginal environment. At My Vagina, we have our favourites that we’ve used with great success over more than a decade in clinical practice.

4. Prebiotics

Feeding protective bacteria with prebiotics (like lactulose, in many My Vagina treatments) can help the recolonisation effort by overwhelming disruptive bacteria by sheer numbers. Killing them with kindness, you might say!

Our effective BV remedies combine all of these elements – including practitioner guidance – in our world-famous step-by-step, evidence-informed plan, Killing BV.

Comparing the two: what works best?

Here’s how natural and prescription treatments stack up when it comes to real-world results.

Feature	Prescription BV medication	Natural BV remedies
Kills bacteria	Yes	Yes
Supports healthy flora	No	Yes
Disrupts biofilms	No	Yes
Long-term results	Variable with one-off treatments	More reliable with multipronged approaches
Side effects	Common	Rare
Treats partners	Rarely addressed	Often included

The most effective BV treatment is often a combination approach – starting with prescription antibiotics or a targeted natural treatment, then moving into a natural protocol to prevent relapse, if needed. This method addresses all parts of the condition: the overgrowth, the biofilm, and the lack of beneficial flora.

My Vagina’s clinic provides all the support you need to get well and stay well – without always having to use treatments. Our goal is for you not to need us – or treatments – anymore!

How long does BV treatment take to work?

For prescription or My Vagina’s natural treatment options, you tend to start seeing symptom relief within 2–7 days. But that doesn’t mean the underlying imbalance is resolved, in either case.

Natural BV remedies can take a little longer, 3–6 weeks, depending on severity and how your body responds. That may seem longer, but natural treatments focus on deeper healing, not just symptom suppression.

If you’re combining both approaches – for example, antibiotics followed by a probiotic and antimicrobial protocol – you’ll usually complete treatment in 4–6 weeks with a much lower chance of recurrence.

Patience and consistency are key. Biofilms don’t dissolve overnight, and repopulating lactobacilli takes time and the vaginal environment to be just right for them to be happy. That’s why our effective BV remedies discussed in our treatment guide take you step by step to a healthier, happier vagina, with the option to include practitioner support if things aren’t going according to plan.

Can BV be cured permanently?

Yes – but it depends on your body, your treatment plan, and any underlying contributing factors.

A permanent BV cure means:

Removing the overgrowth
Disrupting biofilms
Recolonising with protective lactobacilli
Addressing partner transmission (if applicable)
Supporting immunity and vaginal environment long-term

We’ve seen many clients completely BV-free for years using our integrative BV treatment options. Others may need periodic maintenance, especially during times of stress, hormonal changes, or after antibiotic use.

The good news is, chronic BV doesn’t have to be your normal – you can shift your vaginal ecology with the right tools and support.

Treating your partner: an often-missed step

BV isn’t officially classified as an STI, but it can be passed back and forth between partners, especially if you’re engaging in unprotected sex with someone who has a penis.

Treating only one partner can lead to recurrence, even after perfect treatment adherence. That’s why our BV treatment options include guidance for partner protocols too.

Lifestyle tips for prevention and support

Regardless of which treatment you choose, here are some helpful habits to support long-term vaginal health:

Avoid scented soaps, wipes, and douches
Use condoms with new or multiple partners
Address digestive issues – gut health and vaginal health are connected
Wear breathable, non-synthetic underwear
Support your immune system with healthy sleep and good eating habits
Avoid unnecessary antibiotics and always follow up with probiotics

Prevention is easier than treatment – but even if you’re dealing with recurrent BV, it’s never too late to start fresh.

Your next step

If you’re tired of the treat–relapse cycle or want to avoid unnecessary antibiotics, our effective BV remedies can help you break the pattern. Designed by naturopaths and based on current science, this protocol targets all angles of BV: