The short answer
BV can recur, sometimes repeatedly, but recurrent odor or discharge is not the same thing as a confirmed recurrent BV episode. CDC describes persistent or recurrent BV as common and advises reevaluation when symptoms recur. 1 The diagnostic task is to confirm what is present now while keeping other vaginal or noninfectious causes open. 1 2
Start by confirming the current episode
Clinicians diagnose BV with Amsel criteria, Nugent scoring, or an appropriate NAAT for symptomatic women. A high pH, fishy odor, or familiar discharge can be a clue, but the current episode still needs confirmation. 1
A familiar smell can suggest BV, but it cannot confirm that the current episode is the same. Trichomoniasis, candidiasis, cervicitis, mixed vaginitis, irritation, and other causes can overlap with BV-like symptoms. 2
Why BV-like symptoms can return
CDC notes that recurrent BV is common, but the mechanisms are not fully reduced to a single explanation. 1 A recurrence should not be used to assign partner blame, infer infidelity, or claim that one exposure necessarily “caused it again.”
The same caution applies to self-treatment. Repeated empirical antibiotics or repeated vaginal products can make the history more complicated while leaving the current diagnosis unconfirmed.
How different tests answer different questions
Amsel criteria combine several clinical findings. Nugent scoring evaluates vaginal Gram stain patterns. BV NAATs detect bacterial signatures associated with BV and are intended for symptomatic women. 1 Testing helps show whether bacterial vaginosis is present during the current episode. It does not by itself explain why symptoms recur.
For the first-level comparison of BV and yeast, see yeast infection vs bacterial vaginosis. For home BV-testing methods and their limitations, see home test for BV.
Why treatment needs an individual plan
CDC describes treatment and recurrent-BV management options. A clinician can decide whether a suppressive regimen fits your diagnosis and medical history. Recurrent-BV management depends on the confirmed diagnosis, prior treatment, symptoms, pregnancy context and other clinical factors.
What should you take away?
When BV-like symptoms return, first confirm what is present now with diagnostic criteria or appropriate laboratory testing. If the current evidence does not fit BV, look into other possible causes. Recurrence alone does not prove the diagnosis, explain the cause, or justify an automatic treatment repeat.
What are the limits of this information?
Use this information to understand the topic and prepare for next steps. For recurrent symptoms, work with your gynecologist to confirm the diagnosis and discuss a treatment plan suited to your history. See the medical information disclaimer.
Sources
- CDC: Bacterial Vaginosis. Evidence reviewed 2026-09-14. Amsel/Nugent/NAAT diagnosis and explicit persistent/recurrent BV follow-up context.
- CDC: Vulvovaginal itching, burning, irritation, odor or discharge. Evidence reviewed 2026-09-14. Nonbinary vaginitis differential and testing limits when symptoms recur.