Bacterial Vaginosis (BV) is the most common vaginal infection among women of reproductive age. While BV is typically easy to treat, many women  experience persistent or recurrent BV that returns repeatedly—even shortly after completing antibiotics. If you’ve ever asked yourself, “Why do I keep getting BV?” or “Why does BV keep coming back with the same partner?” you’re far from alone.

BV occurs when there is an imbalance between good bacteria and bad bacteria in the vagina. When healthy Lactobacillus (beneficial bacteria) declines, harmful bacteria multiply and disrupt the environment, leading to common symptoms such as:

• Strong or fishy vaginal odor (especially after sex)

• Thin, gray or watery discharge

• Itching or irritation

• Vaginal discomfort or burning sensation

While BV is not classified as a sexually transmitted infection (STI), sexual activity can influence vaginal pH and bacterial balance—which plays a major role in why BV persists or recurs.

What Causes BV to Keep Coming Back?

Persistent BV happens when underlying triggers repeatedly disrupt vaginal flora. Some of the most common causes include:

Imbalance of Vaginal Flora

A healthy vagina maintains an acidic pH of around 3.8–4.5, primarily supported by Lactobacillus bacteria. When Lactobacillus levels fall, the pH becomes more alkaline, creating an environment where harmful bacteria thrive.

Douching and Harsh Cleansers

Many women believe douching or scented products improve hygiene, but these products actually:

• Wash away good bacteria

• Raise vaginal pH levels

• Introduce irritating chemicals

This can make BV much worse and increase the likelihood of recurrence.

Scented Soaps, Bubble Baths, and Vaginal Deodorants

Fragrances and preservatives can irritate delicate vaginal tissue and cause inflammation that triggers imbalance. Even body washes labeled “gentle” or “natural” can disrupt the microbiome.

Hormonal Fluctuations

Changes in estrogen levels—during menstruation, pregnancy, postpartum, or perimenopause—can alter natural bacterial balance. Many women report flare-ups:

• Right before or right after a period

• When skipping or switching birth control

• During times of stress or fatigue

Sexual Activity

While BV is not considered an STI, sex can influence vaginal pH and bacterial balance in several ways:

• Exposure to semen (which is alkaline)

• Introduction of new bacteria from skin, hands, saliva, or genital contact

• Micro-tears from friction or inadequate lubrication

A Weakened Immune System

Stress, poor sleep, illness, and diet can affect the body’s ability to regulate bacteria, making BV more difficult to control.

BV and Relationships: Why BV May Recur With the Same Partner

One of the biggest misconceptions is that recurrent BV means a partner is cheating. This assumption often causes relationship anxiety and shame—but it is not supported by science.

BV Is Not Caused by Cheating

BV is not a sexually transmitted infection, and it is not something that a partner “gives” someone through infidelity. The timing of symptoms can make it appear linked to partner behavior, but BV is caused by an internal imbalance, not betrayal.

Every Body Has Unique Bacterial Chemistry

Each partner has a unique microbiome. This means a woman may be more sensitive to certain bacteria from one partner than another. When the vaginal environment is already vulnerable, even natural bacterial contact may trigger recurring imbalance.

Why BV Symptoms May Appear After Sex

BV flare-ups after intercourse may occur due to:

• Semen altering vaginal pH to more alkaline levels

• Friction or irritation affecting the microbiome

• Residual bacteria if condoms are not used

• Shared microflora developing over time

This explains why some women experience BV that recurs with the same partner, while others never do.

BV Without Any Sexual Activity

Another important reminder: BV can occur even when someone is not sexually active.
Common non-sexual triggers include:

• Douching or cleansing internally

• Tight or non-breathable underwear

• Sweat or moisture buildup

• Changes in diet or hygiene products

• Stress or immune system changes

• Antibiotic use

This reinforces that BV is a microbiome condition, not a moral or relationship issue.

How to Reduce the Risk of Recurrent BV

1. Avoid Douching and Scented Products

The vagina cleans itself naturally—internal washing disrupts the microbiome.

2. Support Healthy Vaginal pH

Using probiotics (oral or vaginal), especially Lactobacillus strains, can help replenish healthy bacteria. Many women find that probiotic supplementation significantly reduces recurrence.

3. Use Condoms

Because semen alters pH, condoms can help prevent imbalance during treatment or management.

4. Choose Breathable Clothing

Cotton underwear reduces trapped moisture and bacteria growth.

5. Change Laundry Detergent

Fragrance-free detergents can help reduce irritation for sensitive skin.

6. Improve Immune Support

Hydration, sleep, balanced nutrition, and stress management support microbiome stability.

7. Maintain Open Communication With Your Partner

Shared understanding reduces emotional stress and relationship tension.

When to See a Healthcare Provider

If BV continues to return even after treatment and lifestyle adjustments, a healthcare provider can help assess:

• Whether treatment was long enough

• If the infection is antibiotic-resistant

• If another condition may be present (yeast infection, STI, pelvic inflammatory disease, etc.)

• Whether additional therapies, such as extended or combination antibiotic treatment, may be helpful

Persistent BV is common and does not mean something is wrong with you. It means your vaginal microbiome needs balanced support and personalized care.

Understanding Persistent BV Empowers Healing

Persistent or recurrent BV can be exhausting—but with the right knowledge and proactive care, it is manageable. Understanding what disrupts vaginal balance, what strengthens it, and why recurring BV does not indicate infidelity helps remove stigma and support healing.

BV does not define you, and you are not alone.
Your body is not broken—it's asking for balance and support.