Pre-Screening Inclusion Criteria:

• Women 18-40 years of age at the time of screening
• Willingness to be screened for bacterial vaginosis (BV)
• Willing to self-collect two Q-tip like vaginal swabs

Screening Inclusion Criteria:

• Women 18-40 years of age at the time of screening
• Diagnosed with BV, clinically, by one of the clinician co-investigators of the protocol
• Willing to be screened for HSV-2 using a rapid, FDA approved test
• Using an effective method of birth control (examples of effective methods of birth control are: women practicing abstinence, hormonal birth control, consistent condom use, bilateral tubal ligation, partner with a vasectomy)

Enrollment Inclusion Criteria:

• Women 18-40 Years of age at the time of screening

• Women who meet the following Amsel (by investigator assessment) and Nugent Criteria for the diagnosis of BV 3 or more Amsel criteria

  1. Homogenous vaginal discharge
  2. Vaginal discharge pH greater than or equal to 4.7
  3. Clue cells greater than or equal to 20% of vaginal epithelial cells on saline wet mount examination of vaginal discharge
  4. Positive amine (whiff) test upon addition of potassium hydroxide to vaginal discharge

Nugent criteria:

1. Vaginal gram stain score greater than or equal to 4 Subjects will be enrolled based on the Amsel criteria alone. Nugent scores will be performed to confirm the diagnosis of BV. Women whose gram stain is less than 4 will be replaced.

• HSV-2 seropositive as determined by rapid HSV-2 testing
• Willing to avoid use of any intravaginal products during study period
• Willing to refrain from ingestion of any alcoholic beverage within 8 hours of starting study medications and willing to refrain from alcohol ingestion during course of metronidazole therapy and for 24 hours following completion
• Capable of providing written informed consent
• Capable of cooperating to the extent and degree required by this protocol

Pre-screening Exclusion Criteria:

• Pregnant or nursing mother
• Use of any antimicrobial agents (vaginal or systemic) for the treatment of any condition within 7 days
• Presence of any intrauterine device

Screening Exclusion Criteria:

• Pregnant or nursing mother
• Use of any antimicrobial agents (vaginal or systemic) for the treatment of any condition within 7 days
• Presence of any intrauterine device
• Allergy or hypersensitivity to metronidazole or valacyclovir

Enrollment Exclusion Criteria:

• Pregnancy (all women will have a urine pregnancy test prior to randomization and treatment)
• Women not practicing an effective method of birth control (examples of effective methods of birth control are: women practicing abstinence, hormonal birth control, consistent condom use, bilateral tubal ligation, partner with a vasectomy)
• nursing mother
• Menopausal women
• Presence of concomitant symptomatic yeast vaginitis
• Presence of concomitant Trichomonas vaginalis infection
• Use of any antimicrobial agents (vaginal or systemic) for the treatment of any condition within 7 days of study enrollment
• Significant medical disorder that precludes accurate evaluation of a participants condition
• Known immunocompromised state
• History of significant hepatic or renal impairment
• Sensitivity/allergy to valacyclovir or nucleoside analogues
• history of acyclovir resistant HSV infection
• Participation in a study using an investigational product in the past 30 days