In many women BV either causes no symptoms or only very mild symptoms therefore the condition will often clear gradually without treatment. However, due to the unpleasant or embarrassing nature of the symptoms a lot of women will choose to treat the condition.

The only treatment that can be recommended OTC to treat BV and return the vagina's pH balance to normal is lactic acid.

Lactic acid

Treatments containing lactic acid return the acidity levels in the vagina back to normal which makes the environment less hospitable for the offending bacteria. They are inserted directly into the vagina through single use tube applicators or pessaries. 

The recommendations for use of these treatments differ depending on whether they are being used to treat symptoms, to maintain the natural pH balance or prevent symptoms; refer to the individual patient information leaflets or product packaging for details. Lactic acid products can be recommended for use in pregnant women although any pregnant woman who thinks she may have a vaginal infection should be referred to the pharmacist.

Side effects of lactic acid treatments are minimal, but some women may experience a temporary stinging sensation. A tip you can provide to customers using these treatments is to apply them at night and after application use a panty liner as leakage may occur. This is normal and it does not impact on the effectiveness of the treatment.

If a customer is trying to conceive they should not be recommended a lactic acid treatment as they act to reduce the pH of the vagina which is unsuitable for sperm. Lactic acid preparations will also have no contraceptive action.

If a customer finds that OTC treatments are not relieving their symptoms or they are experiencing recurrent symptoms they should be referred to the pharmacist as they may require oral or intra-vaginal antibiotics. The recurrence of BV is very common and up to 70%² of sufferers will experience recurring symptoms within three months even after treatment with antibiotics.