Generally 3 days to permanent bacterial vaginosis relief, 80-90% of women with bacterial vaginosis (BV) showed good initial response to antibiotic treatments. 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 occurred within the first year, and were obviously related to having new sexual partners.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 occurring 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, and is considered natural and without side effects. Lactobacilli bacteria are used, either given orally or applied vaginally. Unfortunately, not all strains of lactobacilli are able to adhere well to the vaginal wall.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 lactobacilli and other microflora are restored and once again able to maintain the vaginal pH themselves, it is necessary to prevent overgrowth of pathogens in the vaginal environment. One study demonstrated that about 88 out of 100 women who used intravaginal lactate gel had their BV completely cured, versus only 10 out of 100 women cured when no vaginal maintenance therapy was employed.