Gynecology · Vaginal health
Bacterial Vaginosis Treatment in Gangnam: Antibiotics and Recurrence
Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge in women of reproductive age: protective lactobacilli are replaced by an overgrowth of other bacteria, causing thin gray discharge and a fishy smell. At Hommage Clinic in Gangnam, Seoul, female OB/GYN specialist Dr. Park Yuna confirms BV with a swab test, prescribes antibiotics and helps you reduce recurrences.
Quick answer
Bacterial vaginosis treatment uses antibiotics, usually metronidazole tablets for 7 days, metronidazole gel for 5 days or clindamycin cream for 7 days, after BV is confirmed with a pH check and swab. At Hommage Women's Clinic in Gangnam, Seoul, female OB/GYN specialist Dr. Park Yuna diagnoses BV in one visit and plans longer preventive treatment if it keeps coming back, which happens in up to half or more of women within a year.
Key takeaways
- BV is a bacterial imbalance, not a hygiene problem and not a classic STI.
- Three of four Amsel signs(discharge, pH above 4.5, whiff test, clue cells) confirm it.
- Finish the whole course: stopping early raises the chance of recurrence.
- For BV three or more times a year, a suppressive plan works better than repeated short courses.
Infographic
Bacterial vaginosis in numbers
Women with BV
Global prevalence in reproductive age.
Vaginal pH in BV
Healthy pH is about 3.8–4.5.
Amsel criteria
Signs needed to diagnose BV.
Standard course
Metronidazole tablets or gel, or clindamycin cream.
Recurrence in 12 months
Upper estimate from the CDC evidence review.
Asian women, N. America
Prevalence varies widely by group and region.
BV treatment at a glance
| Key fact | Details |
|---|---|
| What it is | An imbalance of vaginal bacteria, not a classic STI, though it is linked to sexual activity |
| Common signs | Thin gray-white discharge and a fishy smell, often worse after sex; about half have no symptoms |
| How it's diagnosed | Speculum exam, vaginal pH above 4.5 and clue cells on microscopy of a swab |
| Treatment | Metronidazole tablets or gel, or clindamycin cream, usually for 5–7 days |
| Recurrence | Common: up to half of women have BV again within a year |
| Partners | Male partners do not usually need treatment; female partners with symptoms should be checked |
| Reviewed by | Dr. Park Yuna, OB/GYN specialist |
Book an assessment if you have
- Thin, gray or white discharge with a fishy smell, especially after sex or your period
- Symptoms that came back after earlier BV treatment
- BV symptoms and you are pregnant or planning a pregnancy
- A planned IUD insertion or other gynecological procedure and unusual discharge
Seek urgent care instead if you have
- Fever, lower abdominal pain or pain during sex with abnormal discharge
- Pregnancy with abdominal pain, bleeding or leaking fluid
- A widespread rash, swelling of the face or difficulty breathing after starting an antibiotic
What is bacterial vaginosis?
Bacterial vaginosis is an imbalance of the bacteria that normally live in the vagina. Protective lactobacilli, which keep the vagina mildly acidic, fall in number, and other bacteria such as Gardnerella overgrow. The vaginal pH rises above 4.5, and the bacteria release compounds that cause the typical fishy smell.
BV is not caused by poor hygiene, and you cannot catch it from toilet seats, pools or bedding. It is more likely with a new or more than one sexual partner, douching or vaginal washes, smoking and, for some women, a copper IUD. Women who have never had sex can get BV, but it is less common. It is one of several causes of discharge, so see our overview of vaginal infections to compare BV with yeast and trichomoniasis.
How is BV diagnosed?
BV is diagnosed with a quick exam and a swab test, often with an answer at the same visit. Doctors look for at least three of four signs, known as the Amsel criteria:
- Thin, gray-white discharge coating the vaginal walls.
- Vaginal pH above 4.5.
- A fishy smell when a drop of potassium hydroxide is added to the sample (the whiff test).
- Clue cells, which are vaginal cells covered with bacteria, seen under a microscope.
A Gram stain or a PCR test from the swab can confirm BV when the picture is unclear. Because BV often occurs together with other infections, Dr. Park may suggest checking for trichomonas, chlamydia and gonorrhea with STD testing from the same visit, especially if you have a new partner.
BV treatment options
BV is treated with antibiotics, which clear symptoms in most women within a few days. Treatment is recommended for everyone with symptoms, and for women without symptoms before some procedures, such as IUD insertion . The usual first-line options are:
- Metronidazole tablets: taken twice a day for 7 days.
- Metronidazole vaginal gel: inserted once a day for 5 days, with fewer stomach side effects.
- Clindamycin vaginal cream: inserted at bedtime for 7 days, an alternative if you cannot take metronidazole.
Finish the whole course even if you feel better after a day or two, as stopping early makes recurrence more likely. Tinidazole or a single-dose secnidazole may be used in some situations. You can usually continue normal activities, but avoid sex or use condoms until treatment is finished.
Why does BV keep coming back?
BV returns in up to half of women within 12 months, even after successful treatment. Antibiotics clear the overgrowth, but lactobacilli do not always recover, and some bacteria form a protective film on the vaginal walls that survives treatment.
If you have BV three or more times a year, Dr. Park first confirms each episode is really BV and not a mixed or different infection. Options then include a longer course of treatment followed by metronidazole gel twice a week for several months to keep BV from returning. Simple habits help too: avoid douching and scented washes, use condoms with new partners and stop smoking. Probiotics are popular, but evidence that they prevent BV is still limited.
For male partners, routine treatment has not generally been recommended. A 2025 clinical trial in couples in a monogamous relationship found that treating the male partner at the same time lowered the chance of BV returning, so this can be discussed, particularly if BV keeps coming back. BV can pass between female partners, so a female partner with symptoms should also be checked.
BV in pregnancy
BV in pregnancy is linked to a higher risk of preterm birth, early rupture of the membranes and infection after delivery. If you are pregnant and have symptoms, treatment is recommended. Oral metronidazole is considered safe in all trimesters, and clindamycin is an alternative; tinidazole and secnidazole are avoided in pregnancy. Routine BV testing of pregnant women without symptoms is not generally recommended, but tell your doctor about any change in discharge. If you are breastfeeding, metronidazole is generally considered compatible at standard doses, and vaginal gel passes into milk in smaller amounts.
Risks of untreated BV and side effects of treatment
Untreated BV is not usually dangerous, but it is not harmless. It raises the chance of catching other STIs, including HIV, and the risk of infection after procedures such as IUD insertion, abortion or hysterectomy. It has also been linked to pelvic inflammatory disease .
Antibiotic treatment has possible side effects:
- Metronidazole: nausea, a metallic taste and stomach upset are common. Product labels advise avoiding alcohol during treatment and for about 2–3 days after, because of a possible reaction with flushing and vomiting.
- Vaginal gel or cream: local irritation. Clindamycin cream is oil-based and can weaken latex condoms for several days.
- Any antibiotic: a yeast infection can follow treatment. Tell us if itching and thick white discharge start; see yeast infection treatment .
Contact the clinic if symptoms are not better by the end of treatment, or if you develop a rash, severe diarrhea, fever or pelvic pain.
BV treatment at Hommage Clinic
Hommage Clinic is a women's clinic in Gangnam, a short walk from Sinnonhyeon Station, and welcomes walk-ins during opening hours. Dr. Park Yuna, a female OB/GYN specialist, examines you privately, and swab tests, STI tests and a Pap smear can be done in the same visit. You can see our othergynecology serviceshere.
If you are enrolled in Korea's National Health Insurance, the consultation, standard tests and prescribed antibiotics are usually covered in part. Some PCR tests are paid directly, as are all fees for visitors without coverage. We explain which tests we recommend and their cost before the swab is taken.
How it happens
What causes BV? Healthy vaginal flora vs bacterial vaginosis
In a healthy vagina, lactobacilli dominate. They produce lactic acid, keep the pH low and leave little room for other bacteria. In BV, lactobacilli drop sharply and a mix of other bacteria, led by Gardnerella, takes over. Some of these bacteria form a sticky film, called a biofilm, on the vaginal wall. The biofilm protects them from antibiotics, which is one reason BV can come back after a course of treatment that seemed to work.
The illustration below shows this shift in simplified form. It also explains why treatment has two goals: clearing the overgrowth now, and giving lactobacilli the chance to recover so the balance holds.
How BV is confirmed: the Amsel criteria
At the visit, Dr. Park checks four simple signs. When at least three are present, BV is confirmed and treatment can start the same day. If the picture is unclear, a Gram stain or PCR test from the same swab can settle it.
Compare treatments
Metronidazole tablets vs gel vs clindamycin cream: which BV treatment?
The three first-line treatments work similarly well, so the choice is mostly about side effects, convenience and your situation. Tablets are easy to take but cause more nausea and metallic taste. Gels and creams act directly in the vagina with fewer stomach effects, but some women find them messy. Clindamycin cream is oil-based and weakens latex condoms. If you are pregnant, Dr. Park chooses an option considered safe in pregnancy.
Metronidazole
- Twice a day for 7 days
- Easy to take on the go
- Nausea, metallic taste common
- Can be used in pregnancy
Metronidazole gel
- Once a day for 5 days
- Fewer stomach side effects
- Local irritation possible
- Also used twice weekly to prevent recurrence
Clindamycin cream
- At bedtime for 7 days
- Option if metronidazole is unsuitable
- Oil-based: weakens latex condoms
- Yeast infection may follow
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Finishing the full course lowers the chance of BV returning. Illustrative photo.
Recurrent BV
Recurrent bacterial vaginosis treatment plan, step by step
If BV returns three or more times in a year, a longer plan usually works better than another short course. The timeline below shows the typical approach: confirm the diagnosis, clear the infection with a full course, then keep it from returning with twice-weekly metronidazole gel for several months while lactobacilli recover. Dr. Park adapts the length and the medicine to you, and reviews partners and triggers along the way.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
BV symptoms in pregnancy should always be checked. Illustrative photo.
Special situations
BV before an IUD, during pregnancy and while breastfeeding
Some situations change how BV is handled. The cards below summarize the main points; Dr. Park explains what applies to you.
- Before an IUD or other procedure BV raises the risk of infection after procedures, so it is treated first, even without symptoms. See IUD insertion.
- Pregnant with symptoms Treatment is recommended because BV is linked to preterm birth. Oral metronidazole is considered safe in all trimesters; clindamycin is an alternative.
- Pregnant without symptoms Routine BV testing is not generally recommended, but report any change in discharge.
- Medicines avoided in pregnancy Tinidazole and secnidazole.
- Breastfeeding Metronidazole is generally considered compatible at standard doses; vaginal gel passes into milk in smaller amounts.
During and after treatment
BV treatment tips: do's and don'ts
A few simple steps help treatment work and lower the chance of BV coming back. The evidence is strongest for avoiding douching and using condoms with new partners; evidence for probiotics and diet changes is still limited.
Do
- Finish the whole course, even if you feel better
- Use condoms, or avoid sex, until treatment is finished
- Wash the vulva with water or a mild unscented wash
- Tell us if itching and thick discharge start: it may be yeast
- Come back early if the smell returns
Don't
- Douche or wash inside the vagina
- Use scented washes, wipes or deodorants
- Rely on latex condoms while using clindamycin cream
- Drink alcohol with metronidazole, per product labels
- Restart old antibiotics without a new check
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
A written schedule helps with longer suppressive treatment. Illustrative photo.
Evidence
How well does BV treatment work? What the research says
The evidence review written for the 2021 US CDC STI Treatment Guidelines summarizes how common BV is, how often it returns and how newer single-dose treatments compare. Standard treatments clear symptoms for most women; the bigger challenge is keeping BV from coming back.
Global prevalence
Reproductive-age women.
Muzny et al., Clin Infect Dis, 2022Recurrence in 12 months
After treatment that initially worked.
Muzny et al., 2022Single-dose secnidazole
Clinical cure at 3–4 weeks vs placebo in trials.
Muzny et al., 2022Varies by group
North American prevalence ranged from 11% (Asian) to 33% (African American).
Muzny et al., 2022Traveling or living in Seoul
BV treatment in Seoul for international patients
BV can usually be diagnosed and treated in a single visit, which suits short stays. The pH check and microscopy often give an answer the same day, and you leave with a prescription you can finish while traveling. If PCR or STI results come back after you leave, we share them privately.
Before your visit
- Message us by WhatsApp, KakaoTalk or the contact form with your travel dates and ask for language support if needed.
- Bring the names of antibiotics or vaginal products you have used for earlier episodes.
- Tell us if you are pregnant, breastfeeding or planning an IUD.
- If possible, avoid douching, vaginal creams and sex for a day or two before the swab.
After you fly home
Take the written prescription details with you. If BV returns, a local doctor can continue a suppressive plan, or you can contact the clinic with questions.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Most BV visits need only one appointment. Illustrative photo.
Hommage · Gangnam
Hommage Women's Clinic · Gangnam, Seoul
Clue cells seen under the microscope help confirm BV. Illustrative photo.
Choosing well
How to choose a clinic for BV treatment in Seoul
Use these questions at any clinic, including ours:
- Is BV confirmed before treatment? A pH check and microscopy avoid treating the wrong infection.
- Are STIs considered? BV often occurs with trichomoniasis or other infections.
- Is there a plan if BV returns? Suppressive treatment, not repeated short courses.
- Are pregnancy and IUD plans asked about? Both change how BV is managed.
- Are side effects explained? Including condoms and clindamycin, and alcohol and metronidazole.
- Is the cost explained before tests? Especially for PCR panels.
What affects the cost of BV treatment in Seoul?
Cost depends on the tests needed (pH and microscopy, Gram stain or a PCR panel), whether STD testing is added, the medicine chosen and, for recurrent BV, the length of the suppressive plan. For patients enrolled in National Health Insurance, consultation, standard tests and antibiotics are usually partly covered; some PCR tests and all fees for visitors without coverage are paid directly. We explain the recommended tests and their cost before the swab is taken.
Your visit
What to expect at your BV appointment
01
Consultation
Dr. Park asks about your discharge, smell, past episodes, sexual health, pregnancy and the treatments you have tried.
02
Exam and swab
A gentle speculum exam with a pH check and a swab for microscopy; STI tests are added when appropriate.
03
Treatment
A prescription for tablets, gel or cream that suits you, with clear instructions on how to use it.
04
Follow-up
No retest is needed if symptoms clear. If BV returns, we plan longer treatment and prevention.
Your doctor
Dr. Park Yuna
Medical Director · OB/GYN Specialist
Dr. Park confirms BV with a swab test before prescribing, since yeast, trichomoniasis and mixed infections can look similar. For women whose BV keeps coming back, she reviews possible triggers and plans a longer, preventive treatment schedule instead of repeating short courses.
OB/GYN specialist (Korea) and representative director of Hommage Clinic. Leads the clinic's women's health care, from screening and infections to hormones, contraception and fertility checks.
Bacterial vaginosis: frequently asked questions
Does BV go away on its own?
Sometimes. BV can clear without treatment in some women, but it often lasts or returns, and it raises the risk of other infections and pregnancy complications. If you have symptoms, a short course of antibiotics is the reliable way to clear it. Treatment is also advised before procedures such as IUD insertion, even without symptoms.
Is BV a sexually transmitted infection?
BV is not classed as an STI, but it is linked to sex. It is more common after a new partner or with more than one partner, and it can pass between female partners. You can also get BV without being sexually active. Because BV and STIs can occur together, testing for both is often sensible; see STD testing.
Does my male partner need treatment for BV?
Usually not. Routine treatment of male partners has not been recommended because earlier studies showed no benefit. A 2025 trial in monogamous couples found that treating the male partner lowered the chance of BV returning, so it may be discussed if you have a regular partner and BV keeps coming back. Female partners with symptoms should be checked and treated if needed.
Can I drink alcohol while taking metronidazole?
No, avoid it. Product labels advise avoiding alcohol during metronidazole treatment and for about 2–3 days after, because the combination can cause flushing, nausea, vomiting and a fast heartbeat in some people. Recent research suggests the reaction is uncommon, but the course is short, so most doctors advise waiting until it is finished.
Can BV cause infertility?
BV itself does not directly cause infertility. However, it is linked to pelvic inflammatory disease, which can damage the fallopian tubes, and to infection after gynecological procedures. Treating BV promptly, and testing for chlamydia and gonorrhea if you are at risk, helps protect your fertility. If you are trying to conceive and have recurring BV, mention it at your visit.
Can foreigners get BV treatment in Seoul?
Yes. International patients and foreign residents can book BV testing and treatment at Hommage Clinic in Gangnam. Bring your passport or residence card and the names of any antibiotics you have used before. If you are traveling, we can choose a treatment that is easy to finish on the road. Contact us before your visit to arrange language support.
How is BV diagnosed?
Usually with a short exam and a swab. Doctors look for at least three of four Amsel signs: thin gray-white discharge, vaginal pH above 4.5, a fishy smell when a test drop is added (whiff test), and clue cells under the microscope. A Gram stain or PCR test can confirm BV when the picture is unclear.
How quickly does BV treatment work?
Most women notice the smell and discharge improve within a few days of starting antibiotics. Finish the whole course, usually 5–7 days, even if you feel better sooner, because stopping early makes recurrence more likely. A retest is not needed if your symptoms clear.
Which is better for BV: metronidazole tablets, gel or clindamycin cream?
All three are recommended first-line treatments and work similarly well. Tablets are convenient but cause more nausea and metallic taste; gel and cream act locally with fewer stomach side effects. Clindamycin cream can weaken latex condoms. Dr. Park helps you choose based on side effects, pregnancy and your preferences.
How can I stop BV from coming back?
Avoid douching and scented washes, use condoms with new partners and stop smoking. If BV returns three or more times a year, a longer plan with twice-weekly metronidazole gel for several months after clearing the infection is often used. Evidence for probiotics is still limited.
Is there a single-dose BV treatment?
Yes. Secnidazole is a single-dose oral option; in trials, about 53% of women were clinically cured at 3–4 weeks compared with 19% on placebo. It is not used in pregnancy, and availability varies, so Dr. Park will discuss whether it is suitable for you.
Can I have sex during BV treatment?
It is best to avoid sex, or use condoms, until you have finished treatment. If you use clindamycin cream, remember it is oil-based and can weaken latex condoms and diaphragms for several days after the last dose.
Can BV cause a yeast infection?
BV itself does not cause yeast, but the antibiotics used to treat it can upset the vaginal balance and allow yeast to grow. If you notice itching and thick white discharge during or after treatment, tell us, and see yeast infection treatment.
References
Sources used for this page, reviewed by Dr. Park Yuna, OB/GYN specialist. Read our editorial and medical review policy.
- Muzny CA, Balkus J, Mitchell C, et al. Diagnosis and management of bacterial vaginosis: summary of evidence reviewed for the 2021 CDC Sexually Transmitted Infections Treatment Guidelines. Clin Infect Dis. 2022;74(Suppl 2):S144–S151. Clin Infect Dis
- Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021 (bacterial vaginosis section). MMWR Recomm Rep. 2021;70(4):1–187. CDC
- University of Nebraska Medical Center, Division of Infectious Diseases. High-level review: updated STI guidelines, part 2 (2021). UNMC
This page is general information and does not replace a personal consultation. Illustrations are original works of Hommage Women's Clinic, Gangnam, Seoul; photos marked illustrative are not of patients.
Related vaginal health services
Vaginal Infections
Compare BV, yeast and trichomoniasis symptoms and learn when to get tested.
Yeast Infection Treatment
Antifungal treatment for itching and thick white discharge, including after antibiotics.
STD Testing
Confidential tests for chlamydia, gonorrhea, trichomonas and other infections.
Pelvic Inflammatory Disease
Infection of the uterus and tubes: warning signs and why prompt treatment matters.
IUD Insertion
Hormonal and copper IUDs, and why infections are checked before insertion.
Well-Woman Exam
A yearly checkup with screening tests matched to your age and history.
Clear BV and keep it from coming back
Book a private swab test with Dr. Park Yuna near Sinnonhyeon Station and get treatment, plus a prevention plan if BV keeps returning.
Hommage Clinic · 4F, Building A, 509 Gangnam-daero, Seoul (near Sinnonhyeon Station) · Mon & Fri 10:00–20:00 · Tue–Thu 10:00–19:00 · Sat 10:00–15:00