What Can Happen If You Have Bv For A Long Time
Most often, BV does not cause other health problems.However, if left untreated, BV may increase yourrisk for:
- Sexually transmitted diseases like herpes, chlamydia, gonorrhea, and HIV
- Pelvic inflammatory disease where BV bacteria infect the uterus or fallopian tubes. Pelvic inflammatory disease can cause infertility and increase the risk of ectopic pregnancy.
- An infection after a procedure on the female organs. This includes cesarean section, abortion, and surgery on the cervix or uterus.
- Early labor or birth, if pregnant
If you have BV:
- Always finish antibiotic treatment, even if the signs of BV go away
- Talk to female sex partners about getting BV treatment
Bacterial Vaginosis: Getting To The Real Causes
The mainstay of conventional medical BV treatment is antibiotics, but as youll learn in this article, as my patient Sam did, treatment isnt foolproof theres a high recurrence rate, and on top of this, conventional treatment carries medical risks. Conventional antibiotic treatment is not a long-term solution for BV. Its a bandaid, albeit sometimes necessary in the short run, for whats really going on: disruption in the vaginal microbiome, otherwise known as vaginal dysbiosis.
The medical community is having the wrong conversation about bacterial vaginosis. BV is talked about as an isolated gynecological problem and not as an imbalance in the vaginal microbiome which can be the result of a larger, system-wide imbalance in a womans total ecosystem.But BV is annoying, sometimes uncomfortable, and also carries some risks. So whats a gal to do?
The answer lies in understanding the underlying cause of BV disruption in the vaginal microbiome and removing the triggers and causes of that. These include diet, stress, and what goes in there from toxins in our tampons to who were having sex with and what happens to the greater environment of the body, for example, with antibiotics we might use for infections in general .
Are Vaginal Acetic Acid Treatments An Effective Treatment For Bacterial Vaginosis
Treatment with acetic acid gels aims to keep the vaginal pH at less than 4.5, to encourage lactobacilli to grow, and to discourage anaerobic bacteria from growing. Some studies have suggested that long-term use of vaginal acidifiers of this type reduces recurrences of BV. However, other studies suggest that this treatment, whilst harmless, is not effective.
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Bacterial Vaginosis In Pregnancy
If you develop bacterial vaginosis in pregnancy, there’s a small chance of complications, such as premature birth or miscarriage.
But BV causes no problems in the majority of pregnancies.
Speak to a GP or your midwife if you’re pregnant and your vaginal discharge changes.
Page last reviewed: 22 November 2018 Next review due: 22 November 2021
Does Hydrogen Peroxide Work
One of the popular home remedies for recurring BV is hydrogen peroxide. One study suggests that douching with 30 milliliters of hydrogen peroxide every day for a week eliminated BV symptoms in 89 percent of participants. But what do the experts think?
It was a very small cohort of women in this study, but its worth considering for women who have recurrent BV issues, says One Medicals Beth Pferdihirt, FNP-C. The caveat: 30 ml every evening for a whole week is a lot of hydrogen peroxide. Its probably much easier to just use MetroGel or other vaginal prescriptions first, and discuss this possible treatment with your provider for recurrent issues.
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How Can I Protect Myself If I Am A Female And My Female Partner Has Bv
If your partner has BV, you might be able to lower your risk by using protection during sex.
- Use a dental dam every time you have sex. A dental dam is a thin piece of latex that is placed over the vagina before oral sex.
- Cover sex toys with condoms before use. Remove the condom and replace it with a new one before sharing the toy with your partner.
Treating And Managing Bacterial Vaginosis
Treatment for BV usually involves a course of antibiotics which can be taken by mouth, or in the form of a cream or gel to put in your vagina. You will need to take the full course of antibiotics, even if symptoms go away before the end of the course. Stopping treatment early may increase the risk of the infection coming back.
Because BV can reoccur with sexual contact, its recommended you avoid sexual contact until you have finished taking your medication, and symptoms have gone.
Generally, its not necessary to treat a male sexual partner. However, BV can spread between female sexual partners. If your partner is female, its important she see her doctor to check if she needs treatment.
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How Can I Lower My Risk Of Bacterial Vaginosis
Because bacterial vaginosis isnt fully understood, there are no foolproof ways of avoiding it. These steps may reduce your risk:
- Avoid douching. It changes the natural balance of bacteria in your vagina. Instead, practice healthy vaginal and vulvar care.
- Avoid vaginal contact with anything that has touched your anus. Things like toilet paper and sex toys could transfer bacteria found in your poop to your vagina. Make sure sexual toys are properly cleaned after every use.
- Limit your number of sex partners. Research shows youre more likely to get BV if you have multiple sex partners.
- Use latex condoms or dental dams. Although its unclear why, research indicates that sexual activity is associated with BV.
- Wear cotton or cotton-lined underwear. Bacteria thrive in moist environments. Cotton helps wick away moisture.
How Is It Spread
The vagina contains many different types of bacteria.Normally, there are large numbers of “good” bacteriathat keep the number of “harmful” bacteria very low.Bacterial vaginosis occurs when this balance is upsetand there are more “harmful” bacteria than “good”bacteria. The cause of BV is not fully understood.
The risk of BV is higher if you:
- Have a new sex partner or multiple sex partners
- Douche
- Do not use condoms
- Have a female sexual partner with BV
BV is more common in lesbian and bisexual women than in other women. The reason for this is unknown.
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Risks Of Having Bacterial Vaginosis
BV does need to be taken seriously. Disruption in the natural ecology of the vagina changes the pH and vaginal mucous, the job of which is to protect us against infections. BV reduces our defense mechanisms and makes us more susceptible to contracting sexually-transmitted infections , frighteningly, including HIV. It is also associated with abnormal Pap smears, pelvic inflammatory disease which can cause later fertility problems and ectopic pregnancy, and endometritis .
Bacterial vaginosis can be especially dangerous for pregnant women, who face increased risk of second-trimester miscarriage or preterm labor. After giving birth, women with bacterial vaginosis are at greater risk for postpartum endometritis.
Pregnant women should always seek conventional treatment for BV, though the recommended lifestyle changes can improve treatment outcome and prevent recurrence. If you have persistent infection or abdominal pain with BV, conventional care is the most appropriate for treating acute infection. However, all of the preventative steps in this article still apply and can help prevent recurrence.
What Is The Treatment For Bacterial Vaginosis
Bacterial vaginosis often causes no symptoms, or the symptoms are mild. Also, there is a good chance that BV will gradually clear without treatment. There are various different treatments for bacterial vaginosis . There are also some things which you should avoid doing, which may help the problem to resolve itself.
These include avoiding the use of douches, vaginal deodorants, bath additives and harsh soaps. Refraining from intercourse for a couple of weeks, or using a condom and a water-based lubricant, can be helpful.
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Q: How Can I Prevent Bacterial Vaginosis From Returning
A: Because we dont know exactly what causes BV, it can be difficult to say exactly what will prevent it. However, there are a number of measures that may help:
- Condom use: People who use condoms have a lower risk of BV. Although no one has studied whether starting to use condoms decreases recurrence, using condoms may help.
- Hormonal birth control: People who use hormonal birth control have a lower risk of recurrent BV. Again, no one has studied whether starting these would help reduce recurrences, but we sometimes try this if hormones are a safe option for you.
- Avoid douching: Douching can disrupt your healthy vaginal bacterial community and may increase the likelihood of BV coming back.
- Longer-term antibiotics: If youve had three or more documented episodes of BV a year, using vaginal metronidazole twice a week for four months can decrease the chances of your BV returning.
Can Bv Come Back After Medication
According to research from 2018, a person may develop BV again after a few weeks. About experience symptoms again after 1 year of getting the first infection.
In these cases, a doctor may recommend a different treatment plan.
This research also states that because antibiotics affect all vaginal bacteria, using antibiotics to treat BV may lead to a vaginal yeast infection. This occurs in about of those who take clindamycin or metronidazole.
Symptoms of a yeast infection include lumpy, white vaginal discharge or vaginal itching and redness.
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What If My Bv Comes Back
Itâs common for this infection to come back within a year. If that happens, talk to your doctor about treatments. They may prescribe extended-use metronidazole.
Can Probiotics Treat BV?
You might have considered taking these good bacteria as a way to maintain a healthy balance of bacteria in your vagina.
There are at least seven types of bacteria that grow in the vagina. Lactobacillus is one of them. BV is linked to a decrease of lactobacillus, which is found in yogurt and acidophilus milk. Some studies suggest that eating foods that contain lactobacillus may be beneficial, but more research is needed.
Do not douche with yogurt or any other product. Vaginal douching is a risk factor for BV.
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What Should I Do If Antibiotics Did Not Clear Up My Bacterial Vaginosis
Unfortunately, this is a common problem. Around a third of women who take antibiotic treatment for bacterial vaginosis find that the problem recurs within the next two to three months. Some strains of BV organisms may have resistance to some antibiotics.
You should return to your healthcare provider and describe the problems you are having. The Centers for Disease Control and Prevention advises clinicians on a variety of treatment strategies which can be tried if symptoms recur.
Simply trying another course of the antibiotics you used the first time may be appropriate. Be sure to take all doses of the antibiotic as prescribed and complete the full course — even if your symptoms seem to go away.
Alternatively, your healthcare provider may suggest a course of a different antibiotic, as an alternative to the one you used the first time. You could try antibiotics in a different form, for example as a vaginal gel rather than tablets.
For very persistent cases, the CDC suggests some more intensive regimens — for example, using a vaginal antibiotic gel twice a week for six months, or taking an antibiotic tablet as well as an anti fungal tablet once a month, on an ongoing basis.
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The Unintended Consequences Of Conventional Treatments
The conventional treatment for bacterial vaginosis is the antibiotic metronidazole, which can be taken orally or applied topically to the vagina, or clindamycin.
A sample of the side-effects that can occur with metronidazole include:
- Disturbances of the gut such as diarrhea, nausea, vomiting, or abdominal pain
- Inflamed and sore mouth
- Hallucinations
- Liver disorders
- Disorder of the peripheral nerves called peripheral neuropathy that causes weakness and numbness
- Seizures
If using an antibiotic, I recommend always trying topical treatment first as this is less likely to cause serious medication side-effects.
Metronidazole has an 80 percent cure rate within 4 weeks, but the recurrence rate is disproportionately high: 15 to 50 percent of women who treat BV with metronidazole experience a return of symptoms within 3 months.
One theory about why the recurrence rate is so high after a course of antibiotics is that the drugs kill the bad bacteria, but they dont promote recolonization with good bacteria. Without some encouragement from topical or oral antibiotics, its tough for good bacteria like Lactobacillus to get a foothold and the bad bacteria just take over again.
In my practice, if a patient isnt pregnant or experiencing symptoms of BV complications, for example, abdominal pain, I recommend trying natural treatments first. They are healthier and less likely to cause recurrent infections, though admittedly, they do require a bit more work than just filling a prescription.
Can Vaginosis Be Treated During Pregnancy
Bacterial vaginosis that develops during pregnancy can slightly increase the risk of premature birth. The risk of a late-term miscarriage or stillbirth is also higher. In miscarriage or stillbirth, the child dies while still in the mothers body.
The advantages and disadvantages of antibiotic treatment were analyzed in a systematic review. Researchers analyzed 21 studies involving nearly 8,000 pregnant women. The results show that can lower the risk of late-term miscarriages:
- 2% of women who didn’t take had a late-term miscarriage.
- 0.3% of women who took had a late-term miscarriage.
Antibiotics had no influence on the risk of premature births or on stopping a womans water from breaking sooner. About 2% of the women stopped treatment due to side effects. There is no that used to treat bacterial vaginosis have any long-term side effects or are harmful for the child.
Most study participants experienced no symptoms and their infection was detected during other routine pregnancy tests. If bacterial vaginosis starts causing symptoms during pregnancy, it is usually treated anyway.
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What Is The Treatment For Vaginitis
The treatment for vaginitis depends upon its cause. Infectious vaginitis is treated with antibiotic medications. Bacterial vaginitis is treated with either oral antibiotics, intra-vaginal antibiotic creams, or injections of antibiotics. Treatment guidelines are always updated to reflect the patterns of resistance to antibiotics of circulating bacterial strains.
Eligibility For Study Outcomes
The following definitions will be used to determine participant eligibility for study outcomes and analyses .
Screening failure
Couples who are deemed a screening failure will be ineligible for all study outcomes and not form part of the evaluable population for analyses, including the primary modified intention-to-treat analysis and per protocol analysis. A screening failure occurs if i) a female declines participation to the full trial following screening at a site without an onsite laboratory, ii) a partner declines participation after the female has enrolled, iii) a couple is unable to be contacted for recruitment procedures, iv) the male is ineligible, v) a female has a screening slide subsequently scored as NS=03 when it processed at the Central Co-ordinating site, and vi) female participants requiring or recalled within the first week of enrolment for treatment of PID requiring 14days of metronidazole +/ ceftriaxone.
Protocol violation
Protocol deviation
The following are considered protocol deviations i) if a male participant does not return their day 8 questionnaire, they are not eligible for the safety analysis which measures AEs, or ii) if a female participant does not attend any clinic visits for clinical assessment but returns 1 swab, she is eligible for the Nugent and microbiota secondary endpoints only.
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Latest Women’s Health News
Antibiotics that may be used in the management of bacterial vaginosis include ceftriaxone , erythromycin, metronidazole , and clindamycin , cefixime , doxycycline , and azithromycin .
Antifungal medications are used to treat yeast infections, and antifungal preparations are available over-the-counter for yeast vaginitis. Examples of antifungal medications include fluconazole, terconazole , clotrimazole , miconazole , butoconazole , and Nystatin.
Metronidazole is the drug of choice for treating Trichomonas infections.
Vaginitis due to infections cannot be cured by home remedies. However, many women find that home care strategies can help control unpleasant symptoms. These include allowing air to circulate in the vagina when possible by wearing loose, cotton undergarments and clothing. Removing undergarments at night may also be helpful.
Vaginitis due to thinning and irritation of the vaginal wall as a result of lowered estrogen levels at menopause can be treated with hormonal therapy, either in topical or oral form. Non-hormonal vaginal lubricant products are also available.
Which Tests Diagnose Vaginitis
The symptoms and signs of vaginitis strongly suggest the diagnosis. At the time of diagnosis, a pelvic examination is typically performed that may include the removal of a sample of vaginal discharge. The sample may be viewed under the microscope to look for Trichomonas organisms, or it may be sent to a laboratory for culture or other specialized tests to identify infectious organisms.
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How Do You Get Vaginitis What Causes It
Infectious causes of vaginitis include bacteria, yeast, and Trichomonas.
- Bacterial vaginosis is the most common bacterial infection that causes vaginitis. This condition results from an imbalance in the bacteria normally present in the vagina. It is not clear if sexual activity plays a role in the development of bacterial vaginosis, and some experts believe it can occur in women who have not had sexual contact. The STDs gonorrhea and Chlamydia are other bacterial causes of vaginitis.
- Yeast infections, such as Candida infection, are a common cause of vaginitis. Yeast infections are not considered to be STDs.
- Trichomonas is a parasitic infection that is transmitted through sexual contact.
- Non-infectious causes of vaginitis include physical or chemical irritation, such as:
- Douches, soaps, or fragrances
- Spermicides
- Reduced estrogen levels around the time of menopause
Vaginitis in young girls has also been described and is thought to arise from poor hygiene practices that allow the spread of fecal bacteria from the anal area into the vagina.
