Wellness Tips from Josef Schenker, MD
Welcome to our Wellness Tips blog series, brought to you by Dr. Josef Schenker, the Medical Director at Centers Urgent Care. In this series, Dr. Schenker shares his extensive knowledge and experience in internal medicine and emergency medical services, including bacterial vaginosis treatment and prevention, to help you lead a healthier life.
Dr. Schenker will cover a range of crucial health topics, offering expert advice on how to avoid common ailments. With a focus on prevention and practical tips, each blog post is designed to empower you with the information you need to make informed decisions about your health and well-being.
Bacterial Vaginosis Treatment And Prevention
A sudden fishy odor, thin gray discharge, or itching can disrupt work, intimacy, and sleep. Bacterial vaginosis affects about 29% of U.S. women aged 14–49, making it the most common cause of vaginitis in this group. Recurrence stays high, with 50–80% relapsing within a year after antibiotics.
If you want to know how BV develops, how to treat it, and what steps lower recurrence, let Dr. Josef Schenker guide you through the next sections.
Dr. Josef Schenker Explains the Symptoms of Bacterial Vaginosis
Bacterial vaginosis symptoms center on changes in discharge and odor, with irritation patterns that can vary. According to Dr. Josef Schenker, clear descriptions help you spot BV and avoid confusing it with a yeast infection early in care.
- Discharge: Discharge often turns thin, homogeneous, and gray-white. CDC guidance describes a “milklike” fluid that coats the vaginal walls and accompanies higher vaginal pH.
- Odor: Odor often smells “fishy,” and it may be stronger after sex or during menses. The classic “whiff test” adds potassium hydroxide to the sample and releases this amine odor.
- Irritation patterns: Irritation can include mild itching, burning with urination, or general discomfort, yet some people have no irritation.
- Yeast vs BV cues: Yeast infections usually cause intense itching, redness, and a thick “cottage cheese” discharge with minimal odor. BV tends to cause thin gray-white discharge with a noticeable fishy smell and a vaginal pH above 4.5.
Many with BV report no symptoms. When symptoms occur, discharge and odor shifts lead the picture, while irritation ranges from none to mild.
What Is Bacterial Vaginosis?
Bacterial vaginosis (BV) describes a shift in the vaginal microbiome. Healthy vaginal flora usually feature Lactobacillus species that produce lactic acid and keep pH low. BV replaces this balance with a polymicrobial mix dominated by anaerobes such as Gardnerella and Prevotella, which raises pH and drives symptoms.
It is a microbiome imbalance first, with testing used to confirm the cause when symptoms appear. Bacterial vaginosis affects roughly 29% of U.S. women ages 14–49, and many have no symptoms. Prevalence varies by population and often goes unrecognized without testing.
The condition links to sexual activity but is not classified as an STI in guidelines. Risk rises with a new or multiple partners, lack of condom use, and douching. BV is uncommon in people who have never been sexually active.
Can You Prevent Bacterial Vaginosis?
Bacterial vaginosis prevention focuses on habits that protect the vaginal microbiome. According to Dr. Josef Schenker, simple choices about products, sex practices, and hygiene lower risk without adding complexity.
- Hygiene: Clean the vulva with warm water and avoid scented soaps, sprays, and powders that irritate tissue. Choose unscented pads or tampons and wash reusable items like menstrual cups per maker guidance.
- Condom use context: Use condoms consistently, especially with new or multiple partners, because exposure to semen and new flora is linked with BV.
- Douching avoidance: Skip douching and intravaginal cleansing. The CDC and WHO report these practices increase BV risk and do not prevent infections; after-sex washing does not protect and may worsen risk.
- Behavioral tips: Limit new or multiple sexual partners to reduce BV risk. Do not share sex devices; clean personal devices before and after use. If sex is painful or you notice irritation after products or lubricants, stop use and switch to unscented, water-based options.
How Long Does Bacterial Vaginosis Last?
Bacterial vaginosis duration depends on treatment and the tendency to recur. According to Josef Schenker, MD, set clear expectations: symptoms often ease within days on antibiotics, but many people experience a return of symptoms within months, so plan a follow-up if they come back.
Moreover, the condition can clear without therapy, though many cases persist or recur. It typically improves quickly after starting therapy. Trials report median or mean symptom resolution around 5–7 days, with odor often improving by day 2–3. Complete the full 5–7-day course even if symptoms ease sooner.
Bacterial vaginosis often comes back. But the recurrence may be lower when both partners are treated in select scenarios. A 2025 NEJM randomized trial found a 12-week recurrence of 35% with male-partner treatment versus 63% with standard care, an emerging strategy some clinicians consider when BV keeps returning.
Josef Schenker, MD, Explains Bacterial Vaginosis Treatment And Prevention
Bacterial vaginosis care starts with guideline-backed antibiotics and a recurrence plan. As Josef Schenker, MD notes, clear steps shorten symptoms and lower the chance of return.
- First-line regimens: Metronidazole 500 mg by mouth twice daily for 7 days, metronidazole gel 0.75% once daily for 5 days, or clindamycin 2% cream at bedtime for 7 days are CDC-recommended. Short-term clinical cure often reaches ~70–90% by 2–4 weeks across trials and practice. Avoid oil-based clindamycin products with latex during use because they can weaken condoms and diaphragms.
- Alternatives when needed: Secnidazole 2 g oral granules (single dose), tinidazole regimens, and oral or intravaginal clindamycin serve as alternatives. In a phase 3 trial, secnidazole showed a 53% clinical cure at days 21–30 vs 19% with placebo; it is listed as an alternative due to cost and fewer long-term data.
- Recurrent BV notes: Recurrence is common; many patients relapse within 3–12 months. Suppressive metronidazole gel (0.75% twice weekly for 4–6 months) can reduce episodes; some protocols add a 21-day course of intravaginal boric acid before suppression.
How to Reduce Recurrence of Bacterial Vaginosis
Bacterial vaginosis tends to come back, so prevention needs a plan. Focus on habits that protect lactobacilli, plus timely follow-up when symptoms return. Many people see recurrence within months, so small changes add up.
- Risk-reduction habits: Use unscented products on the vulva and rinse with warm water; avoid perfumes and “freshening” sprays. Keep menstrual items clean and change them regularly.
- Condom strategy: Use condoms during treatment and for a stretch afterward, especially with a new partner.
- No douching or intravaginal “cleanses”: Skip douching and internal washes; they disturb the microbiome and raise relapse risk.
- Follow-up timing and suppression: Book a follow-up if symptoms persist after therapy or return within 3–12 months.
Plan for prevention after each treatment course. Combine daily habits, condom use, and no douching with timely follow-up and, when appropriate, suppression or partner therapy. These steps work together to cut relapse risk.
What to Do if Someone Has Bacterial Vaginosis
Bacterial vaginosis needs testing and a clear plan. According to Josef Schenker, act early when discharge or odor changes so treatment starts fast and complications stay low.
- When to seek care: Book a visit if discharge turns thin and gray-white, a fishy odor appears (often after sex), or irritation occurs. See a clinician sooner for fever, pelvic pain, or bleeding not from periods.
- Pregnancy considerations: Arrange prompt care if you are pregnant and have BV symptoms. BV in pregnancy is linked with preterm birth and low birth weight; treatment with metronidazole or clindamycin is standard and has not shown fetal harm in guideline reviews.
- Testing steps: Expect questions about symptoms, a pelvic exam, and a swab. Diagnosis may use Amsel criteria (discharge pattern, pH >4.5, “whiff” test, clue cells) or a lab test such as NAAT.
- Where to get treated: Primary care, gynecology, sexual health clinics, and many urgent care settings evaluate and treat BV. If severe pain, high fever, or heavy bleeding occurs, use emergency care.
You can visit an urgent care facility like Centers Urgent Care for same-day evaluation, testing, and prescriptions. Teams can check pH, look for clue cells, and start guideline-based therapy, then advise on prevention at home.
Josef Schenker, MD, Answers Frequently Asked Questions:
BV usually causes discharge and odor, sometimes soreness or burning, but it does not typically cause cramps. Lower-abdominal pain or cramping suggests other conditions like pelvic inflammatory disease (PID). New pelvic pain, fever, or worsening symptoms require prompt medical evaluation, especially in pregnancy.
Treat BV while pregnant with antibiotics proven safe in pregnancy. Common regimens include metronidazole 500 mg orally twice daily for 7 days or clindamycin given orally or vaginally under clinician direction. Routine screening without symptoms is not advised, but new discharge or odor requires evaluation and prompt treatment.
Bacterial vaginosis is not an STD. BV results from an imbalance in vaginal bacteria. Sexual activity, new partners, and lack of condom use increase risk, and BV raises susceptibility to STIs and pregnancy complications. Guidelines classify BV as non-STD, with diagnosis by exam and antibiotics for treatment.
You cannot reliably heal BV on your own. BV usually requires antibiotics such as metronidazole or clindamycin. Home remedies like yogurt, garlic, or peroxide lack proven benefit and may delay care. Prevention steps include avoiding douching, using condoms, and skipping scented products. Testing confirms diagnosis and guides proper treatment.
You can go to urgent care for bacterial vaginosis. Urgent care can test for BV and other infections, confirm the cause of discharge or odor, and start antibiotics the same day. Go urgently if pregnant, if symptoms are severe, or if pelvic pain, fever, or tenderness suggest possible PID.
Protect Your Well-being with Expert Care for Bacterial Vaginosis
Bacterial vaginosis is common and often comes back, but early treatment and prevention steps can make a difference. As discussed, symptoms like thin gray discharge and a fishy odor point to BV, while hygiene habits, condom use, and avoiding douching help lower recurrence. Antibiotics remain the main treatment, and follow-up care is essential if symptoms return.
Visit an urgent care facility in New York for same-day evaluation, testing, and treatment tailored to your needs. At Centers Urgent Care, our experienced clinicians provide guideline-based care in a supportive setting. Led by Dr. Josef Schenker, our team ensures you receive the right treatment and clear prevention guidance.
Whether you need a first diagnosis or support for recurrent BV, our 12 NYC locations are ready to help. Locate a Centers Urgent Care near you and take the next step toward protecting your health.
About Josef Schenker, MD:
Dr. Josef Schenker, a board-certified expert in internal medicine and emergency medical services, brings extensive experience and compassion to his role as Medical Director and Partner at Centers Urgent Care. With leadership in SeniorCare Emergency Medical Services and as an Attending Physician at New York-Presbyterian Brooklyn Methodist Hospital, Dr. Schenker oversees critical care and treatment protocols across varied medical needs. His dedication extends to chairing NYC REMAC, ensuring adherence to state standards in emergency medical procedures. At Centers Urgent Care, Dr. Schenker's expertise ensures prompt, high-quality emergency care for patients of all ages, supported by state-of-the-art facilities including a dedicated pediatric suite.
