Discreet, non-judgmental evaluation for bacterial vaginosis. Metronidazole or clindamycin prescribed by a board-certified provider — sent to your pharmacy same day.

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What Is Bacterial Vaginosis?

Bacterial vaginosis (BV) is the most common vaginal condition among people of reproductive age, affecting an estimated 21 million women in the United States annually. BV is not a single-organism infection but rather a polymicrobial dysbiosis — a disruption of the normal vaginal microbiome in which protective Lactobacillus species are replaced by a diverse overgrowth of anaerobic bacteria. Gardnerella vaginalis is considered the primary organism associated with BV, but the polymicrobial community also includes Prevotella, Mobiluncus, Mycoplasma hominis, and other anaerobes. The exact trigger for this dysbiosis is not fully understood, but risk factors include new or multiple sexual partners, douching, smoking, and use of an IUD.

Diagnosis of BV is classically based on Amsel criteria, which requires three of four findings: (1) a homogeneous, thin, grayish-white vaginal discharge; (2) vaginal pH greater than 4.5; (3) a positive Whiff test — the release of a fishy odor when potassium hydroxide (KOH) is added to vaginal discharge; and (4) the presence of clue cells (vaginal epithelial cells heavily coated with bacteria) on microscopy. Because the Whiff test and microscopy cannot be performed via telehealth, providers use clinical symptom history, reported discharge characteristics, and odor description to guide diagnosis. A laboratory vaginal swab with NAAT or culture can be ordered at a local lab to confirm the diagnosis when needed.

BV is associated with significant health consequences beyond symptoms, including increased susceptibility to STIs (including HIV), preterm birth in pregnancy, and pelvic inflammatory disease. your board-certified provider, provides evidence-based evaluation and treatment aligned with CDC STI Treatment Guidelines — without judgment, and entirely via telehealth for patients in Delaware, Maryland, and Washington.

Common Symptoms of Bacterial Vaginosis

How Innocre Treats BV Online

your provider will conduct a thorough telehealth evaluation including your symptom history, discharge characteristics (color, consistency, odor), prior BV diagnoses and treatments, sexual health history, current medications, and relevant history such as pregnancy status or IUD use. Laboratory confirmation (vaginal swab for pH, NAAT, or culture) can be ordered at a nearby lab and reviewed before or after treatment initiation depending on symptom clarity.

Per current CDC STI Treatment Guidelines, recommended first-line treatments for BV include: metronidazole 500 mg orally twice daily for 7 days (most commonly prescribed oral option); metronidazole 0.75% vaginal gel once daily for 5 days; or clindamycin 2% vaginal cream once daily at bedtime for 7 days. For patients who prefer oral clindamycin, clindamycin 300 mg orally twice daily for 7 days is also effective. The choice between oral and intravaginal formulations depends on patient preference, tolerance, and prior treatment response. Patients should be counseled that alcohol must be avoided during metronidazole therapy and for at least 72 hours (3 days) afterward to prevent a disulfiram-like reaction.

For recurrent BV (three or more episodes within 12 months), a suppressive regimen using metronidazole 0.75% gel twice weekly for 16 weeks has demonstrated benefit in reducing recurrence. your provider will also discuss the evidence base for boric acid 600 mg vaginal suppositories as adjunctive therapy, the role of oral and vaginal lactobacillus probiotics in restoring healthy flora, and behavioral modifications including avoiding douching. Prescriptions are sent electronically to your pharmacy in DE, MD, or WA.