If you have dealt with bacterial vaginosis more than once, you already know how frustrating it can be. The symptoms show up, you take the antibiotics, things improve for a while, and then somehow you are right back where you started.
Here is the truth I want you to hear first.
Your body is not broken.
It is communicating.
Bacterial vaginosis, or BV, is not a hygiene failure or something to be ashamed of. It is one of the most common vaginal imbalances worldwide and it is incredibly common in women of all ages[1]. For many, the issue is not treating BV once. The issue is why it keeps coming back.
BV happens when the vaginal ecosystem shifts out of balance. In a healthy vagina, beneficial bacteria called Lactobacillus help maintain an acidic environment that keeps unwanted bacteria in check. When those protective bacteria decline, opportunistic bacteria such as Gardnerella vaginalis can overgrow [2, 3].
This imbalance often shows up as:
Antibiotics can reduce harmful bacteria, but they often do not rebuild the protective environment needed to prevent recurrence. This is why studies show that up to 50 to 80 percent of women experience BV again within a year after standard treatment [5].
BV is more than an inconvenience. When left untreated or when it keeps returning, it is associated with higher risks of:
This is why looking deeper matters. Treating BV is not just about symptom relief. It is about restoring balance.
Your vaginal microbiome does not exist on its own. It is influenced by gut health, hormones, immune function, stress, and lifestyle [3, 4]. When one system is out of rhythm, the others often feel it too.
Integrative physician Aviva Romm, MD explains this beautifully in her article
Prevent and Treat Bacterial Vaginosis Naturally, which is an excellent resource and inspiration for many of the approaches below [4].
The vagina thrives in a slightly acidic environment. Semen, saliva, douching, fragranced products, antibiotics, and antifungals can raise vaginal pH and create space for imbalance [2,3].
Repeated exposure to antibiotics and antifungals can also disrupt both the vaginal and gut microbiome, reducing protective Lactobacillus species and increasing the risk of ongoing dysbiosis and recurrence [2,5].
Estrogen supports vaginal tissue health and Lactobacillus growth. Estrogen naturally dips after menstruation, which is why many women notice BV symptoms flare at specific points in their cycle [6].
Hormonal birth control can also influence vaginal and gut microbiome balance by altering endogenous estrogen and progesterone signaling, which may impact vaginal pH, immune response, and the ability of protective Lactobacillus species to thrive [3,4].
In some individuals, these hormonal shifts may contribute to increased susceptibility to dysbiosis, particularly when combined with other factors such as antibiotic exposure, stress, or insulin resistance (including conditions like PCOS, polycystic ovarian syndrome) [2,3].
Some BV related bacteria form protective layers called biofilms. These make them harder to eliminate and help explain why antibiotics alone often fall short [2, 7].
Chronic stress plays a significant role in vaginal health by increasing cortisol levels, which can impair immune response and alter microbial balance in both the gut and vagina [3,4].
Over time, this stress-driven immune dysregulation may make it more difficult for protective bacteria to reestablish after treatment [3].
A diet rich in fiber and fermented foods supports the microbiome from the inside out. Minimizing refined sugar and alcohol are instrumental to prevent feeding unwanted bacteria and yeast [4].
Both oral and vaginal probiotics that contain Lactobacillus crispatus and Lactobacillus reuteri can help restore balance and reduce recurrence. L. crispatus in particular is linked to stable, resilient vaginal ecosystems [8].
Additional Lactobacillus species, including Lactobacillus rhamnosus, have also been highlighted in integrative medicine for their role in supporting vaginal and gut microbial balance, particularly following antibiotic exposure[4].
For those interested in a more traditional or DIY approach, plain, unsweetened yogurt containing live active cultures may also be used intravaginally as a temporary support to help reintroduce beneficial Lactobacillus species following antibiotic treatment [4].
This practice is discussed in greater detail by integrative physician and midwife Aviva Romm, MD, including important guidance on appropriate use and safety considerations [4].
Boric acid helps restore acidity and disrupt unwanted bacterial growth. Research shows improved outcomes when it is used thoughtfully as part of a broader plan for recurrent BV [9].
You can also look for vaginal suppositories made with Calendula (Calendula officinalis) and Sea Buckthorn (Hippophae rhamnoides), which help with inflammation and microbial balance.
These support the acidic environment where beneficial bacteria thrive and can be helpful tools for maintaining balance [2].
Yoni steaming is a traditional practice documented across multiple cultures, particularly in postpartum and menstrual care, and is rooted in ritual, self-care, and ancestral healing traditions rather than modern clinical medicine [12, 13].
Some individuals choose to explore yoni steaming as a gentle, external self-care ritual to support relaxation, pelvic awareness, and connection to the body. In traditional herbal systems, aromatic herbs were historically used in steam form for their soothing, circulatory, and calming qualities rather than for direct antimicrobial effects [12, 13].
Herbs commonly referenced in traditional vaginal steaming practices include:
At this time, there are no high-quality clinical trials evaluating yoni steaming for bacterial vaginosis, vaginal infections, or vaginal microbiome restoration, so any proposed benefits are based on traditional use rather than clinical evidence [11].
If someone chooses to explore yoni steaming, it should be done with caution. Steam should never be hot enough to cause discomfort or burns, the practice should be avoided during pregnancy or active infection, and it should always remain an external practice only. Case reports have documented vaginal burns associated with steaming practices, underscoring the need for safety and informed decision-making [16].
Avoid tight or non-breathable underwear styles, including thongs, which can increase moisture, friction, and bacterial transfer to the vaginal area, potentially contributing to recurrent imbalance [3,11].
When it comes to menstrual care, opt for organic cotton pads or reusable cotton alternatives, which reduce exposure to fragrances, synthetic fibers, and chemical residues that may disrupt the vaginal environment [4,11].
→ Tampons and conventional pads may be irritating for some individuals, particularly if they contain fragrances, bleaching agents, or synthetic materials, and may contribute to dryness or altered vaginal pH in susceptible individuals [3].
→ Reusable cotton options such as GladRags offer a breathable, low-toxicity alternative to conventional disposable pads.
→ Menstrual cups from medical grade silicone are another option many people find helpful. Current research on silicone menstrual cups and BV risk is limited but does not show a clear association with increased BV. Individual response varies, and proper hygiene, fit, and regular cleaning are essential [11].
For a deeper discussion on menstrual cups and alternative cycle care options, you can explore my blog here:
https://www.marinabuksov.com/toperiodcupornot/
If you’ve been dealing with recurrent BV, I want you to know that it’s not punishment. It is a signal from your body of disharmony in the vaginal microbiome. When you heal with plant medicine, honor your cycles, and trust your body’s innate wisdom, you’re not just treating symptoms—you’re reclaiming your birthright as the sovereign guardian of your own health[4].
Healing does not have to be harsh. It can be gentle, informed, and deeply supportive.
If you want a deeper dive into natural, evidence based approaches to BV, I highly recommend reading Aviva Romm, MD’s full article here [4]:
https://avivaromm.com/prevent-treat-bacterial-vaginosis/
Your body knows the way back to balance. Sometimes we just need to quiet down to listen to it, and offer the right support.
Ready for a deeper look into herbal education and reclaiming your feminine health sovereignty?
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Share your story below: What’s your experience with recurrent BV been like? Have you tried any natural approaches that worked for you? Your wisdom might be exactly what another sister needs to hear. 💚
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