Brief Answer: needs management Detailed Answer: Thank you for asking! Recurrent bacterial vaginosis infections has one or more of the following reasons. Recent antibiotic use Decreased estrogen production of the host Wearing an intrauterine device (IUD) Douching Sexual activity that could lead to transmission (eg, having a new sexual partner or a recent increase in the number of sexual partners) Now the general basic principles for recurrent BV like in you case include following management. Antibiotics are the mainstay of therapy dietary supplementation with Lactobacillus (acidophilus) Asymptomatic women with G vaginalis colonization do not need treatment BV occurring in pregnant women should be treated Treatment before cesarean delivery, total abdominal hysterectomy, or insertion of an IUD is also recommended Uncomplicated cases typically resolve after standard antibiotic treatment BV that does not resolve after one course of treatment may be cured by giving a second course of the same agent or by switching to another agent (eg, from metronidazole to clindamycin or from clindamycin to metronidazole) Some women with recurrent BV may benefit from evaluation or treatment of G vaginalis colonization in their sexual partner (controversial) Patients should be advised to stop douching or using bubble bath or any other over-the-counter vaginal hygiene products Patients should wash only with hypoallergenic bar soaps or no soap at all and should avoid liquid soaps and body washes Surgery is not indicated Testing for other infections (eg, N gonorrhoeae, C trachomatis, or herpes simplex virus [HSV]-1) may be appropriate Therapy with metronidazole or clindamycin may alter the vaginal flora and predispose the patient to development of vaginal candidiasis You should stop douching or using bubble bath or any other over-the-counter vaginal hygiene products.Wash only with hypoallergenic bar soaps or no soap at all. Avoid liquid soaps and body washes. Prophylaxis with vaginal probiotic product (8 billion units of Lactobacillus rhamnosus, L acidophilus, and Streptococcus thermophilus per capsule) for recurrent bacterial vaginosis prevention is advised. The dosage regimen should consist of short-term use of 7 days on, 7 days off, then 7 days on. Consult with an infectious disease specialist or obstetrician/gynecologist to sort out nonresolving and/or recurring BV or more serious infections, such as endometritis, pelvic inflammatory disease, and chorioamnionitis( in case of pregnancy only). I hope it helps. Dont forget to close the discussion please. Take care S Khan

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