In order to prevent transfer of pathogens, sperm, or antibiotic-resistant commensals we will establish a "vaginal fluid bank" in which samples from suitable donors will be kept for future use:

• Donors will be screened using a questionnaire addressing risk factors for potentially transmissible infections, undergo screening for cervico-vaginal infections, cervical cytology screening, and serology analysis for transmittable infections {see detailed screening in Lev-Sagie et al. Nat Med. 2019;25(10):1500-1504. doi: 10.1038/s41591-019-0600-6.}
• The collected samples for VMT will be examined for bacteria,viruses and sperm.

Before transplantation, patients will be treated with intravaginal antibiotics. A frozen specimen will be thawed at room temperature and will be placed in the patient's vagina.

Following VMT, patients will be evaluated every 14 days for the first 2 months, then every month for additional 10 months.

Vaginal fluid of all recipients will be collected before initiation of the study using the same protocol, will be clearly labeled and will be kept frozen in similar conditions. These samples will be used in the placebo arm for autologous vaginal fluid transplantation.

Before transplantation, patients will be treated with intravaginal antibiotic.

Following Placebo, patients will be evaluated every 14 days for the first 2 months, then every month for additional 2-4 months.

After 4-6 months, patients who initially received placebo will be offered a VMT in case they are still symptomatic and fulfill inclusion criteria, in an open-label phase.

Healthy donors vaginal fluid is introduced into recipients' vagina to replace their indigenous disease-associated microbiome

Number of participants reporting disappearance of discharge and odor

Presence or absence of each Amsel criteria (discharge, pH>4.5, positive whiff test and clue cells on microscopy)/

Presence of Lactobacillus-dominant microbiome on microscopy

Characterization of the vaginal microbial community using shotgun analysis and16S rRNA sequencing