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What Supplements Can I Take for BV? The Evidence, Graded
In this article
Antibiotics are the treatment for bacterial vaginosis (BV), and no supplement replaces them. Of the supplements people ask about, one has consistent trial evidence: live cultures taken after a course of antibiotics, which in ten trials of 1,234 women were associated with BV recurrence of 14.8% against 25.5%. Vitamin D, the most studied vitamin, made no difference to recurrence in a trial of 118 women; we found no trial of vitamin C by mouth, and the trial that exists used a vaginal tablet; boric acid alone has no randomised trial we found; and the home remedies have small studies at most.1, 2, 3, 4 The table grades each one. This page sits in the Wellgard guide to what causes BV.
Sources checked on 29 October 2026.
What supplements can I take for BV?
"After antibiotics" is the design the trials used, not a substitute for the course. What to look for on a live-culture label is on reading a women's live-culture label.
| Supplement | What the trials found | Where the evidence stands |
|---|---|---|
| Live cultures, taken after a course of antibiotics | Ten randomised trials, 1,234 women: BV recurrence 14.8% against 25.5% (RR 0.55), assessed at least one cycle later. A 2026 network meta-analysis rated the vaginal route moderate certainty and the oral route low.1, 5 | The one supplement with repeatable trial data, as an addition after treatment |
| Live cultures instead of antibiotics | Three head-to-head trials pooled: RR 1.12, confidence interval 0.60 to 2.07. The 2009 Cochrane review called the evidence insufficient either way.6, 7 | Inconclusive; antibiotics remain the treatment |
| Vitamin D | 118 women given metronidazole then high-dose vitamin D or placebo for 24 weeks: recurrence hazard ratio 1.11 (0.68 to 1.81). A 2026 review of observational studies: odds ratio 1.00, very low certainty.2, 8 | No effect shown |
| Vitamin C | By mouth: no BV trial. As a 250 mg vaginal tablet used six days a month for six months after antibiotics, 142 women: recurrence 16.2% against 32.4%.3 | Evidence for a vaginal product, not a capsule |
| Lactic acid gels | Acidifying agents reduced short-term recurrence in the 2026 network meta-analysis (RR 0.22, moderate certainty).5 | Short-term effect while in use |
| Boric acid pessaries | No randomised trial; one chart review of 58 women, half relapsed by 36 weeks. Clinician-directed use only; never by mouth or in pregnancy.4, 9 | No trial; a prescriber's decision |
| Garlic, tea tree oil, yoghurt, hydrogen peroxide, vinegar | Small studies of garlic tablets and yoghurt only; tea tree, peroxide and vinegar irritate vaginal skin. | Small studies only |
| Diet and sugar | One cross-sectional survey of 1,521 women: higher fat intake associated with BV (odds ratio 1.5); no diet trial.10 | Association only; cannot show cause |
Can I get rid of BV by taking probiotics? has the ten trials one by one; how many a day and how to take them with antibiotics cover dose and timing. Anyone with a weakened immune system, a central venous line or a serious illness should ask a pharmacist or GP before taking live cultures.11
Which vitamins help with bacterial infections like BV?
None taken by mouth has cut recurrence in a trial. Vitamin D is the one oral vitamin tested against recurrence: 118 women were given metronidazole and then nine high doses of vitamin D over 24 weeks or placebo. Blood levels rose as intended, and BV came back just as often (hazard ratio 1.11).2 A 2026 review found no overall association between low vitamin D and BV in observational studies (odds ratio 1.00); its four small supplementation trials, 281 women, showed a non-significant trend (relative risk 0.68, confidence interval 0.28 to 1.63), and it rated the evidence very low certainty.8 Vitamin C has no oral trial in BV; the quoted study used a vaginal tablet that acidifies the vagina directly, not a capsule.3 Vitamin C and vitamin D each carry the GB-authorised wording "contributes to the normal function of the immune system", a statement about the nutrient, not a result in BV (the Wellgard vitamin D guide); no vitamin carries wording about vaginal health.
Do lactic acid gels, boric acid or home remedies work?
Lactic acid gels act while in use: in the 2026 network meta-analysis, acidifying agents had the largest short-term effect on recurrence (RR 0.22), and in long-term prevention they ranked among the most effective options only in women at low baseline risk.5 Boric acid pessaries sit in UK and US guidelines for resistant thrush and recurrent BV as a clinician-prescribed option; for BV the evidence is a 58-woman chart review in which recurrence reached 50% by 36 weeks, with no randomised trial.4, 9 Boric acid is poisonous if swallowed and is not used in pregnancy.4 The home remedies, garlic, tea tree oil, yoghurt on a tampon, peroxide or vinegar douches, have small studies at most, and the NHS says not to douche.12 Nothing food-based goes inside the vagina.
Is there anything that works instead of antibiotics?
No. The NHS treatment for BV is antibiotic tablets, a gel or a cream prescribed by a GP or sexual health clinic.12 The three trials that set live cultures against antibiotics head to head were inconclusive, and a 2024 analysis of a 228-woman trial of a vaginal L. crispatus product found live cultures reduced recurrence only where the antibiotics had worked first.6, 13 Antibiotics work on the day; the problem is that BV returned in 58% of 139 women within twelve months of an oral course.14 What reduces the return has numbers: the triggers, partner treatment, the NHS option of a longer course of vaginal gel for more than four episodes a year, and live cultures after the course.12, 1 Why do I keep getting BV? sets that plan out in order.
When does BV need a GP or a sexual health clinic?
If you think you have BV, so it is confirmed and an STI ruled out; any symptoms in pregnancy; if it comes back, especially more than four times a year, when a vaginal antibiotic gel for a few months may be offered; and after a change of partner.12 Pelvic pain, pain deep inside during sex, bleeding between periods or after sex, or a high temperature point to pelvic inflammatory disease, not BV: an urgent GP appointment or 111, and 999 if the pain is severe.16 Many sexual health clinics offer a walk-in service.12
What we don't know
No supplement by mouth other than high-dose vitamin D (118 women, no effect) has a trial against BV recurrence.2 The live-culture trials used different strains, doses and routes, so the pooled figure cannot say which product to choose.1 Boric acid has no randomised trial, and whether lactic acid gels prevent recurrence once stopped is untested.5, 9
Frequently asked questions
Does vitamin C help with BV?
Not by mouth: there is no trial. The vaginal tablet trial (142 women, recurrence 16.2% against 32.4%) is evidence for a pharmacy pessary that acidifies the vagina, not for a vitamin C capsule.3
Does vitamin D help BV?
The recurrence trial, 118 women over 24 weeks, found no reduction in recurrence despite blood levels rising, and the 2026 review rated the evidence very low certainty.2, 8
Is there a supplement to keep things healthy down there?
The ten pooled trials gave live cultures for 8 to 60 days after antibiotics and measured recurrence at least one menstrual cycle after cure, and are probiotics good for your vagina? covers what live cultures can and cannot do.1
Can I take supplements with metronidazole?
The NHS says there is not enough information to call herbal remedies and supplements safe with metronidazole, and to tell the pharmacist what you take; no trial tested spacing live cultures by hours, and the pooled BV trials gave them after the course.1, 15 Alcohol is the thing to avoid, during the course and for two days after it.15
Do apple cider vinegar pills help with BV?
We found no trial of apple cider vinegar for BV, by mouth or as pills (PubMed, searched 14 October 2026). Vinegar douches count as douching, which the NHS says to avoid, and vinegar irritates vaginal skin.12
Sources
- Chieng WK, et al. Probiotics, a promising therapy to reduce the recurrence of bacterial vaginosis in women? A systematic review and meta-analysis of randomized controlled trials. Frontiers in Nutrition, 2022. Meta-analysis, 10 randomised trials, 1,234 women. PubMed 36204368.
- Turner AN, et al. A blinded, randomized controlled trial of high-dose vitamin D supplementation to reduce recurrence of bacterial vaginosis. American Journal of Obstetrics and Gynecology, 2014. Randomised trial, 118 women, 24 weeks; products donated by a manufacturer. PubMed 24949544.
- Krasnopolsky VN, et al. Efficacy of vitamin C vaginal tablets as prophylaxis for recurrent bacterial vaginosis: a randomised, double-blind, placebo-controlled clinical trial. Journal of Clinical Medicine Research, 2013. Randomised trial, 142 women, six months; two authors at the manufacturer. PubMed 23864922.
- Mittelstaedt R, et al. Data on safety of intravaginal boric acid use in pregnant and nonpregnant women: a narrative review. Sexually Transmitted Diseases, 2021. Narrative review. PubMed 34561373.
- Gardella B, et al. Rethinking prevention of recurrent bacterial vaginosis: a comparative effectiveness network meta-analysis. Journal of Lower Genital Tract Disease, 2026. Network meta-analysis of randomised trials to January 2026. PubMed 42611724.
- Chen R, et al. Probiotics are a good choice for the treatment of bacterial vaginosis: a meta-analysis of randomized controlled trial. Reproductive Health, 2022. Meta-analysis, 20 randomised trials. PubMed 35698149.
- Senok AC, et al. Probiotics for the treatment of bacterial vaginosis. Cochrane Database of Systematic Reviews, 2009. Cochrane review, four trials. PubMed 19821358.
- Yang D, Gong X. Association between vitamin D status and bacterial vaginosis in non-pregnant women of reproductive age: a systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2026. Systematic review, 9 observational studies and 4 trials (281 women). PubMed 42235462.
- Reichman O, Akins R, Sobel JD. Boric acid addition to suppressive antimicrobial therapy for recurrent bacterial vaginosis. Sexually Transmitted Diseases, 2009. Uncontrolled chart review, 58 women. PubMed 19704395.
- Neggers YH, et al. Dietary intake of selected nutrients affects bacterial vaginosis in women. Journal of Nutrition, 2007. Cross-sectional, 1,521 women. PubMed 17709453.
- Doron S, Snydman DR. Risk and safety of probiotics. Clinical Infectious Diseases, 2015. Narrative review. PubMed 25922398.
- NHS. Bacterial vaginosis, reviewed 19 June 2026. nhs.uk/conditions/bacterial-vaginosis.
- Hemmerling A, et al. Response to antibiotic treatment of bacterial vaginosis predicts the effectiveness of LACTIN-V (Lactobacillus crispatus CTV-05) in the prevention of recurrent disease. Sexually Transmitted Diseases, 2024. Post hoc analysis of a 228-woman trial; senior author advises the developer. PubMed 38733973.
- Bradshaw CS, et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. Journal of Infectious Diseases, 2006. Cohort, 139 women, 12 months. PubMed 16652274.
- NHS. Metronidazole, reviewed 31 December 2025. nhs.uk/medicines/metronidazole.
- NHS. Pelvic inflammatory disease, reviewed 17 December 2025. nhs.uk/conditions/pelvic-inflammatory-disease-pid.
Spotted something out of date? Email support@wellgard.co.uk with the page address and the sentence.
General information, not medical advice. Food supplements are not a substitute for a varied and balanced diet and a healthy lifestyle; do not exceed the recommended daily dose.
