Recurrent BV guide

Recurrent BV prevention online

For adults 18 or older who have had BV 3 or more times in the last 12 months, found by a clinician at least once in that time, and treated each time with a usual BV medicine.

Start online

Start a $59 online review for BV that keeps coming back.

Bacterial vaginosis (BV) is an imbalance of the normal germs in the vagina. It can cause a thin, gray discharge and a fishy smell. For some people it keeps coming back. A prevention plan can help. You first finish a treatment course if you have BV now. Then you use a vaginal gel called metronidazole 0.75% twice a week for about 4 months. The CDC says this plan has been reported to lower the number of times BV comes back. When you stop the gel, BV may come back again.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response times

Already in ongoing care with us for this? Check-ins are $39 (your first one is free).

Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response times apply 24/7, every day

Common symptoms

BV 3 or more times in the last 12 months
A thin, gray discharge and a fishy smell that keep coming back
BV found by a clinician at least once in the last 12 months
Treated each time with a usual BV medicine

May fit online care

Adults 18 and older
You are 18 or older
You are not pregnant and not breastfeeding
If you have BV symptoms now, they feel like your usual BV
You agree to a free check-in at 2 weeks and a check-in at about 8 weeks to get the rest of the gel

Look for another care setting

Bad pain, or pain on one side, in your pelvis or lower belly; or pelvic or lower belly pain with feeling dizzy or faint or a chance of pregnancy (go to the ER now).
A possible HIV exposure in the last 3 days (get care in person now).
Sexual assault (go to the ER).
Other pelvic or lower belly pain, or a fever or chills (see a doctor in person today).
Pregnancy or possible pregnancy (see your pregnancy doctor).
Breastfeeding.
A first BV, or no BV found by a clinician in the last 12 months.
Sores, bleeding between periods or after sex, pain during sex, or an IUD.
Discharge unlike your usual BV, or bad-smelling discharge that is getting worse.
A new sex partner in the last 60 days, or a possible STI (get tested first, or checked in person if you have symptoms).
An allergy to metronidazole, tinidazole, secnidazole, parabens, or anything in the gel.
Disulfiram (Antabuse) in the last 2 weeks, warfarin, lithium, or severe liver disease.

What to have ready

How many times you had BV in the last 12 months, and how it was found
Which medicine you used each time
Whether you have a new sex partner or think you may have an STI
Every medicine you take, including warfarin, lithium, or disulfiram

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

About Ankur Fadia, MD Verify Virginia medical license Verify West Virginia medical license Verify board certification

How do I use the gel?

If you have BV now, you first use the gel once a day at bedtime for 5 days. If your BV is gone, you then use one applicator of gel in the vagina twice a week, at bedtime, on the same 2 days each week. Most people do this for about 4 months. A free check-in at 2 weeks makes sure your BV is gone before the twice-a-week gel starts. A check-in at about 8 weeks, with a fee, gets you the rest.

Does my partner need treatment?

No. Your sex partner does not need treatment. We do suggest testing for HIV and other STIs after the 5-day treatment, because BV makes them easier to catch. Our STI testing visit is a separate visit with its own price, shown before you pay.

When should I get care right away?

Go to the ER now for bad pain, or pain on one side, in your pelvis or lower belly. Stop the gel and call 911 for a seizure, trouble breathing, or swelling of the face, lips, or tongue. Stop the gel and get medical help today for numbness or tingling in your hands or feet.

Other conditions we treat

Not quite what you have? Here are other conditions we treat.

Birth control Bacterial vaginosis Combined birth control Delay your period Morning-after pill Heavy menstrual bleeding