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What is bacterial vaginosis (BV)?

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The right balance of bacteria can help keep the vagina healthy. Bacterial vaginosis, also known as BV, is a vaginal infection that occurs when someone’s vagina has more “bad” bacteria than “good bacteria.”

This can happen for many reasons, whether due to a genetic predisposition or lifestyle practices like douching or having multiple sex partners. BV can happen to anyone with a vagina, but it’s more common in people of reproductive age.

If you suspect you may have bacterial vaginosis, it’s important to seek medical care. Untreated BV can result in uncomfortable symptoms and, in some people, cause medical risks.

What are the symptoms?

Bacterial vaginosis doesn’t always cause symptoms. When it does, BV can result in:

  • Gray, white, or green vaginal discharge that may be thin, watery, or milky
  • Fishy-smelling vaginal odor
  • Foul smell that’s most noticeable after sex or during menstruation
  • Itching in or around the vagina
  • Pain in the vagina
  • Burning while peeing

These symptoms can be uncomfortable and even painful. In some cases, bacterial vaginosis can cause other health problems.

For example, it’s thought that BV can make people more vulnerable to sexually transmitted infections, particularly HIV. It can also increase the risk of pelvic inflammatory disease if left untreated. In pregnant people, BV can result in preterm delivery or low birth weight.

If you think you may have bacterial vaginosis, consult with a healthcare provider who can recommend the best treatment option for you.

What are the causes?

Bacterial vaginosis happens due to an imbalance of bacteria in the vagina. Certain factors can increase a person’s risk for developing BV, such as:

  • Douching: Washing your vagina with soap or vinegar, using scented bubble bath, or applying vaginal deodorant or scented wipes can result in an imbalance of bacteria and, eventually, bacterial vaginosis. Doctors don’t recommend scented vaginal care products, because the vagina typically keeps itself clean.
  • Having sex with someone new: BV isn’t technically considered a sexually transmitted infection, but sex can increase your risk. It’s more likely to occur in someone who has more than one sex partners or has sex with someone new without using protection. It’s also more common in women who have sex with women.
  • Sharing sex toys: If you use sex toys, be sure to thoroughly wash them before sharing them with a partner. Unhygienic practices with sex toys can increase the likelihood of a BV infection.
  • Poor bathroom hygiene: Harmful bacteria from your digestive tract can infect your vagina. Always wipe from front to back after you go to the bathroom.
  • Smoking: Tobacco use can alter the chemistry of your vaginal microbiome, resulting in a higher chance of developing BV. If you smoke, talk to your doctor about quitting ASAP to prevent bacterial vaginosis and many other serious health conditions.
  • Pregnancy: The hormones of pregnancy can disrupt your vaginal bacteria and result in a higher chance of developing bacterial vaginosis. If you have BV while pregnant, seek medical care; harmful bacteria can increase the risk of preterm labor or low birth weight.
  • Genetics: Some people simply don’t produce enough “good” bacteria. An imbalance of these microorganisms in your vagina can cause bacterial vaginosis.

Even if you don’t have these risk factors, it’s possible to have bacterial vaginosis. A doctor can help you understand your symptoms and how to properly treat them.

What are the treatment options for BV?

Sometimes, bacterial vaginosis goes away on its own. But most of the time, BV requires treatment. If you have BV symptoms and you’re sexually active or pregnant, speak to your medical provider right away. A doctor can diagnose you and recommend the best treatment option.

The best way to treat bacterial vaginosis is with antibiotics, a type of medication that helps with infection symptoms by stopping bacteria from growing. Most commonly, medical providers prescribe the following antibiotics for bacterial vaginosis:

  • Clindamycin (Cleocin, Clindesse)
  • Metronidazole (Flagyl, Metrogel-Vaginal
  • Tinidazole (Tindamax)
  • Secnidazole (Solosec)

These antibiotics may be prescribed as a cream or gel suppository (Clindamycin and Metronidazole) you apply directly inside your vagina with an applicator. Or, you can take antibiotics for bacterial vaginosis in pill form (Tinidazole and Secnidazole).

Usually, BV infections clear up with treatment within five to seven days. Until you stop your medication and your symptoms are resolved, it’s best to avoid sexual activity. It’s common for bacterial vaginosis to recur within a year, especially in sexually active people.

If you have a prescription for treating bacterial vaginosis, always follow your medical provider’s instructions. It’s important to finish the whole course of antibiotics, even if you feel better; stopping too soon can contribute to antibiotic resistance or cause the infection to come back.

How much does BV treatment cost?

How much BV treatment costs varies, depending on several factors, such as the type of medication and dosage strength. Whether you have insurance also plays a role in BV treatment cost.

If you have health insurance, it may partially or fully cover antibiotic treatment. Typically, generic medication is cheaper than brand-name drugs. If you’re concerned about price, speak to your prescriber about a generic option.

Whether or not you have health insurance, it may be more cost-effective to treat your bacterial vaginosis online. You can see an online doctor for diagnosis and treatment, then order your prescription at an online pharmacy, which delivers your medication to your home.

Can I treat BV online?

Treating bacterial vaginosis with antibiotics requires a prescription from a licensed medical professional. A K Health doctor can diagnose your BV based on your symptoms and medical history, then prescribe the medication that’s most likely to resolve your infection.

You can choose where you purchase your prescription, whether a storefront or an online pharmacy. Ordering BV treatment online and having it shipped directly to your home is one way to cut costs and access affordable treatment.

If you think you may have bacterial vaginosis, connect with a medical provider as soon as possible to learn about your treatment options that can resolve your symptoms and prevent future complications.

Irmanie Hemphill, MD

Irmanie Hemphill, MD

David Morley, MD

David Morley, MD

Francis Goldshmid, MD

Francis Goldshmid, MD

Bright  Odei, MD

Bright Odei, MD

James Teet, DO

James Teet, DO

Sally Sartin, MD

Sally Sartin, MD

Monsur Ali, DO

Monsur Ali, DO

Edmond Nelson, MD

Edmond Nelson, MD

Nancy Tejedor-Velilla, MD

Nancy Tejedor-Velilla, MD

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Frequently asked questions

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What's included in the K Health membership?

Our K Health membership includes nearly everything K Health offers for $29/month.

  • Unlimited text-based visits with board-certified clinicians
  • Clinicians online day and night for Primary Care and Urgent Care
  • Free Pediatrics for your kids ages 3-17
  • Easy prescription management and renewals
  • As always, no insurance needed, all on your own schedule


*24/7 Urgent Care is available in 48 states of the US. Not available in Alaska or Hawaii. Pediatrics is only available in California, Colorado, Florida, Georgia, Illinois, Minnesota, Nevada, New Jersey, New York, Tennessee, Texas, Vermont, Wisconsin, West Virginia, and Wyoming. Children ages 3-17 must have parental consent.

K Health memberships are not insurance and do not include any ancillary services, (i.e.) laboratory tests, durable medical equipment, appointments with other providers or specialists that we may refer you to, emergency or in-person urgent care facility visits; cost of medication and other referrals. See Terms of Service.

Learn more about what we can and cannot treat

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Can I use an FSA or HSA to pay?

Yes, prescription medication, telemedicine, and telehealth visits are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) and health reimbursement arrangement (HRA).

You can submit a claim to be reimbursed by your FSA, HSA, or HRA provider whenever you make a payment to K Health for your medication, K Health membership (which includes unlimited Primary Care, Mental Health, Pediatric, and Urgent Care visits), specialized treatment plans, or one-time visit.

If you have an FSA or HSA debit card, it can be used to pay for one-time K Health visits or prescriptions you pick up in-person at the pharmacy. You can't use your FSA or HSA debit card for any recurring payments, which includes a K Health membership or an ED treatment plan.

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Are there any conditions that K Health does not treat?

K Health-affiliated clinicians can diagnose and treat most things you might see an in-person primary care doctor for. However, there are sometimes instances when we recommend you see a doctor in person.

For example, ear infections and strep throat are two common conditions that require an in-person consultation for diagnosis. However, K Health-affiliated clinicians can help assess severity and provide guidance on what to do next.

We also don't treat women with pregnancy-related symptoms, or anyone with orthopedic concerns.

We don't prescribe controlled substances, and we cannot prescribe other high risk medications that are subject to abuse. Learn more on our Policy page.

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Is the data I share with K Health private?

K Health is HIPAA compliant and we apply high-security standards to protect your personal information and your privacy. K Health is also compliant with the California Consumer Privacy Act (“CCPA”). We will use your data only to improve our services and to provide them to you. You can learn more about our privacy policy here.

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Do you provide doctor's notes and sick notes?

During a pediatric consultation, clinicians can write notes for your children to return to, or be dismissed from, school, activities, camp, and more, if needed.

During an adult consultation, K Health-affiliated clinicians can only provide a note stating the date when a patient was seen and that a treatment plan/care was established.

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Can I use my insurance to pay for this?

No, but it’s cheaper than your insurance copay so you still win!

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Can I get a prescription online through the K Health app?

Yes! Your K-affiliated doctor will evaluate you to determine what prescription, if any, is appropriate. Once a doctor or clinician determines you need a prescription, he or she will send it to your local pharmacy or mail it to your door, if available.

Learn more about what we treat and our refill policy here.

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How much does K Health cost?

It's free to use the symptom checker.

If you want to chat with a clinician, a one-time visit costs $35. This includes three days of follow-up.

Our K Health Primary Care membership includes nearly everything K Health offers for $29/month.

  • Unlimited text-based visits with board-certified clinicians
  • Doctors online day and night for Primary Care and Urgent Care*
  • Free Pediatrics care for your kids over 3-17
  • Easy prescription management and renewals management, plus steep discounts
  • As always, no insurance needed, all on your own schedule

Our Mental Health membership includes everything the Primary Care membership does, in addition to treatment for anxiety & depression for $49/month.


*24/7 Urgent Care is available in all 48 continental US states. Not available in Alaska or Hawaii.

K Health memberships are not insurance and exclude ancillary services (e.g., referrals, labs, equipment, cost of medication, etc). See Terms of Service.

Learn more about what we can and cannot treat

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Does K Health offer discounts on medication?

Discounts are available with the RxSaver Card, which can save you up to 80% on many medications.

Here's how to use it:

Show your RxSaver card (located in the app under "Profile" > "RxSaver Card") to your pharmacist when you pick up your prescription. Ask them to check the RxSaver discount price, and to compare it to your insurance or Medicare plan price (if you have insurance or Medicare). You and your pharmacist can determine the lowest price available.

To get an idea of price before picking up your medication, visit rxsaver.com and search for your medication.

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Can I really chat with a doctor whenever I want to?

Yes! Doctors are available 24/7 via the K Health app for Urgent Care needs in all 48 continental US states. Not available in Alaska or Hawaii.

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Do you need insurance to use K Health?

Nope!

One-time visits cost $35, or you can sign up for our K Health membership for $29 per month and get access to Primary Care, Urgent Care, Pediatrics, our mental health program, and more.

Our ED treatments start at $11/month.

Our symptom checker is always free to use.

Learn more about our approach to pricing

K Health memberships are not insurance and exclude ancillary services (e.g., labs, equipment, cost of medication, etc). See Terms of Service.

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