Objective - to enhance the efficiency of treatment in perimenopausal patients with bacterial vaginosis. Subjects and methods. The investigation enrolled 66 perimenopausal patients who were diagnosed with bacterial vaginosis according to clinical and laboratory findings. The patients' mean age was 49.6±4.9 years. A random sampling technique was used to form 2 groups of patients whose treatment was performed in 2 steps. At Step 1, the study group patients (n=35) received ornidazole (tiberal) at a dose of 500 mg twice daily per os for 5 days; the comparison group patients (n=31) took metronidazole 500 mg twice daily for 7 days. At Step 2, all the patients received trioginal as one vaginal capsule daily for 14 days. Therapeutic effectiveness was evaluated from clinical and laboratory findings. Results. The clinical and microbiological efficiency of treatment in patients with bacterial vaginosis was 88.6% in the study group and 64.5% in the comparison group. Following 3 months, disease recurrences were noted in 4 (11.4%) and 11 (35.5%) patients in the study and comparison groups, respectively. Conclusion. The two-stepped (tiberal + trioginal) therapy regimen for perimenopausal patients with bacterial vaginosis ensures a high clinical efficiency, the fewest undesirable and side effects, and low rates of late recurrences.