Conditions
Bacterial vaginosis (BV) treatment online in Puerto Rico
Bacterial vaginosis is an imbalance of the bacteria in the vagina that often causes a thin white or gray discharge with a fishy smell, especially after sex. It can be handled by video: the doctor evaluates you and, if the cause is unclear, gives you a lab order. If appropriate, the doctor prescribes and we send your prescription to your pharmacy in Puerto Rico.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Severe lower belly pain with fever
- Sudden severe pain, vaginal bleeding or fainting if you could be pregnant
- Pregnancy with leaking fluid, bleeding or early contractions
Help lines
At a glance
Bacterial vaginosis
Common symptoms
- Thin white or gray vaginal discharge
- A strong fishy smell, especially after sex
- Burning or itching in the vagina
- Burning when you urinate
- Other names
- BV
- Usual test
- Vaginal discharge test, when the cause is unclear
- Treatment
- Oral or vaginal antibiotic, only when the medical evaluation calls for it
- Possible complication
- Higher STI risk and, in pregnancy, preterm birth
On this page(9)
What is bacterial vaginosis?
Bacterial vaginosis (BV) happens when the vagina’s "good" bacteria (lactobacilli) drop and other bacteria overgrow. According to the CDC, it is the most common vaginal condition in women ages 15 to 44, and many women who have it notice no symptoms.
The risk goes up with a new partner or several partners, with douching and without condoms. It rarely affects people who have never had sex. The CDC says it still does not fully understand how BV spreads.
How we treat bacterial vaginosis by video
You see Dr. Diana Nieves Castro, MD, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. She asks what the discharge is like, whether it smells, how long it has lasted, whether it has happened before, whether you could be pregnant and whether you have a new partner.
When the cause is not clear, we give you a lab order for a vaginal discharge test at a lab near you, or refer you for an in-person exam if one is needed. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
Join from a private place; visits are not recorded. Never send intimate photos by email or text message: if the doctor needs to see something, it happens only inside your secure video link. If you also want to talk about birth control online, tell the doctor in the same visit.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If needed, you get a lab order.
What the visit costs
BV is handled in a US$79 doctor visit, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. We do not bill insurance; the lab and the pharmacy charge separately. See all prices.
BV symptoms
Many women have no symptoms. When there are symptoms, the most common are:
- Thin white or gray vaginal discharge
- A strong fishy smell, especially after sex
- Burning or itching in the vagina
- Burning when you urinate
Treatment, and when a test is ordered
Symptomatic BV is treated with an antibiotic, as pills or as a vaginal gel or cream, following the CDC treatment guidelines. The doctor chooses the treatment for your case. If you are prescribed one, finish it even if you feel better. BV can come back even after treatment; if it does, book again.
According to the CDC, routine treatment of male sex partners is not recommended. But BV raises the risk of getting chlamydia, gonorrhea and HIV, so the doctor may offer STI testing by lab order, for example for chlamydia.
Itching with thick white discharge and no bad smell points more to a yeast infection. That is why, when the picture is unclear, the doctor orders a test before prescribing.
In pregnancy, untreated BV is linked to preterm birth and low birth weight. If you are pregnant and have symptoms, the doctor coordinates with your OB-GYN.
If you are under 21, a parent or legal guardian must sign the consent, stay on camera for the whole visit and show photo ID.
How to lower your risk
The CDC suggests:
- Don’t douche.
- Limit your number of sex partners.
- Use condoms every time you have sex.
When to go to the ER
These signs are not simple BV. For your safety, go to the emergency room or call 911.
- Severe lower belly pain with fever
- Sudden severe pain, vaginal bleeding or fainting if you could be pregnant
- Pregnancy with leaking fluid, bleeding or early contractions
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Can I get BV treatment online?
Does my partner need treatment too?
Can I drink alcohol during treatment?
Why does BV keep coming back?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (4)
- CDC: Bacterial Vaginosis, STI Treatment Guidelines 2021 (opens in a new tab) (accessed 2026-10-02)
- CDC: About Bacterial Vaginosis (opens in a new tab) (accessed 2026-10-02)
- CDC: Vulvovaginal Candidiasis, STI Treatment Guidelines 2021 (opens in a new tab) (accessed 2026-10-02)
- Ectopic pregnancy (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)