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February 13, 2010 6:24 PM   Subscribe

Why does Bacterial Vaginosis keep coming back?

I'd had this forever! I've been on antibiotics time after time to treat it, but every time within a week it'll come back. It will usually go away around the time of my period but will always come back. Doctors haven't given much of an explanation, only antibiotics. I thought it might be coming back due to unprotected sex, but bf and didn't have sex during or after antibiotic for a couple weeks and still it came back as strong as ever.

I get thick yellow discharged, cloudiness in pee, occasionally with a a reddish tint like blood is in it, frequent bladder/yeast infections which I'm pretty sure is also due to the BV. Also I have been suffering from infertility for the last 3 years. I'm told that has nothing to do with BV which makes me wonder that it might be something else. I've questioned it even being BV many times but each time the tests come back as it being BV. Is it possible the tests could be missing something? It's absolutely frustrating in so many ways! I've tried everything I could possibly find online to fight against it, like folic acid pills, acidophillis pills, avoiding bathes, body sprays or anything scented, including body washes and shampoos to no prevail. I'm absolutely desperate to get rid of this BV. But it seems like with everything I try it fights back, because it always comes back worst than before.

I mostly want to find out if there is anyone else here that knows anything about BV. I know there are people out there that know more about it than I do, so I'm hoping someone can offer suggestions, something I should be doing differently or anything I should try. Maybe even something I can mention to the doctor for me to try out. Also if anyone knows a lot about BV what exactly causes this and what would cause it to come back, maybe an explanation in more medical terms but broken down for a layperson to understand? Any help would be greatly appreciated.
posted by lwclec072 to Health & Fitness (8 answers total) 6 users marked this as a favorite
For me, the only recurrent bouts of BV I've experienced ended up being diagnosed as a sensitivity to my partner's semen. I had never had a problem with previous partners, so I thought this was a bit curious, but the theory was that his semen was too basic or I was too acidic, so he was throwing off my pH enough to cause infection. After we started using condoms again or even just pulling out, I didn't come down with it again.

I hope you find something that helps you, I know how miserable BV can be.
posted by sunshinesky at 6:41 PM on February 13, 2010 [1 favorite]

Any chance you could be diabetic? Or have PCOS, which is often treated with the diabetic medication metformin? I'm a type 2 diabetic with PCOS and for a few years before I was diagnosed it seemed like I was constantly battling recurrent BV. Once I got on metformin and cut down on sugar and carbs it seemed to help a lot.

A few things to try (not all tried and true by me personally, but just stuff I heard of while researching for my own issues:)

Tea tree oil suppositories (I've used these and found them to be fairly effective)

Probiotic pills

Rephresh vaginal gel (supposed to adjust the ph of the vagina to be less hospitable to bacteria)

Douching with hydrogen peroxide (research this on your own and use with caution, I have no idea how safe it is. But I did read that the reason acidophilus helps with BV is that the good bacteria produces hydrogen peroxide in the vagina which kills the BV. Check with your doctor on this one! I just mention it as something different to try.)

Extra-careful hygiene: wipe front to back to keep germs from your "taint" from getting into your vagina; don't use sex toys made from porous materials (like "jelly" or "cyberskin",) use ones made from silicone, glass or stainless steel which are sterilizable; don't ever let toys, fingers or penis go from your ass into your vagina without being thoroughly washed; don't use lubes that contain glycerin.

Those are a few things I can think of off the top of my head. Good luck with this, I sure hope you can find something that works for you. BV can be incredibly persistant and frustrating.
posted by Serene Empress Dork at 9:03 PM on February 13, 2010

Have you discussed having both you and your partner go on antibiotics simultaneously? If you have a transmittable form of BV and you keep getting reinfected, maybe ask your doctor if it makes sense to treat both of you together.

(that doesn't mean you need to approach it like OMG STD, just extra sexual hygiene)
posted by slow graffiti at 9:20 PM on February 13, 2010

Have you tried boric acid suppositories?

You might want to read the livejournal vaginapagina boric acid information.

BV can lead to infertility. Why do your doctors think that they are not connected?
posted by medusa at 9:32 PM on February 13, 2010 [1 favorite]

Here's a bit more information: boric acid can work because it makes your vagina more acidic. This helps suppress the growth of both bacteria and yeast. Some women tend to have a pH that makes it easier for bacteria to grow, and this can contribute to recurrent BV. If this is true for you, then the boric acid suppositories will help enormously. Many women find that they work like magic on chronic yeast infections or BV.

Despite its goofy name the livejournal vaginapagina pages have a lot of information about this, and a lot of women discuss their experiences and what has worked for them. You may find it helpful.
posted by medusa at 9:38 PM on February 13, 2010

Cotton underwear?
posted by bunny hugger at 6:59 AM on February 14, 2010

Here's some medical journal stuff that might help you -- a gyn is still you're best bet but here's a summary of the most recent studies:

Treatment of nonpregnant women

* Treatment of symptomatic women with bacterial vaginosis is indicated to reduce vaginal discharge and odor. We recommend metronidazole or clindamycin (Grade 1A). (See 'Treatment of nonpregnant women' above.) Options include:

* - Metronidazole 500 mg (twice daily orally for seven days)
* - Metronidazole gel 0.75 percent (5 g once daily vaginally for five days)
* - Clindamycin bioadhesive cream (Clindesse) 2 percent (a single vaginal dose of 5 g of cream containing 100 mg of clindamycin phosphate).

* We suggest treatment of asymptomatic women who are to undergo pregnancy termination or hysterectomy (Grade 2B). Preoperative treatment decreases the frequency of postoperative infectious complications. (See 'Gynecologic procedures' above.)

* We recommend not treating sexual partners of women with BV (Grade 1B). (See 'Sexual partners' above.)

* Approximately 30 percent of patients with an initial response to therapy have a recurrence of symptoms within three months and more than 50 percent experience a recurrence within 12 months. We treat symptomatic relapse with a longer course of therapy, using a different antibiotic than that used for the initial episode. For women who prefer preventive therapy instead of treatment of frequent episodes of BV, we recommend suppressive therapy with metronidazole gel 0.75 percent for 10 days followed by twice weekly applications for three to six months

So, recurrence is possible, and you might need the antimicrobial gel. Also, try peeing after intercourse, I remember that being said to work someplace -- that's more for urinary tract infections though.

As for other causes, here's a list to guide your gyn:

* Vaginal discharge and symptoms of vulvovaginal discomfort can be caused by irritants (eg, scented panty liners, spermicides, povidone-iodine, soaps and perfumes, and some topical drugs) and allergens (eg, latex condoms, topical antifungal agents, seminal fluid, chemical preservatives) that produce immunologic acute and chronic hypersensitivity reactions, including contact dermatitis. Identifying and eliminating the offending agent is generally adequate treatment. (See 'Irritants and allergens' above.)

* Desquamative inflammatory vaginitis is a rare cause of chronic vaginal discharge. (usually worked up after excluded BV)

* Structural cervical or vaginal lesions, such as warts, polyps, granulation tissue, ectropion, fistulas, and neoplasia, and foreign bodies can cause vaginal discharge. These lesions can be seen on speculum examination. Treatment is by ablation or excision, or removal of the foreign body. (See 'Cervical and vaginal lesions' above and 'Fistula' above and 'Condyloma acuminata' above and 'Foreign bodies' above.)

* Vestibulodynia should be considered if pain is a prominent symptom. (See 'Vestibulodynia' above.)

* Cervicitis can present with vaginal discharge that may be confused with vaginitis. Neisseria gonorrhoeae and Chlamydia trachomatis are the two most common causes, followed by herpes simplex virus (get worked up for such causes if you feel it's something other than BV).

Still, BV is a pretty clear, direct diagnosis, so you might be having recurrences of it and require the appopriate treatment for that.

Re: the infertility since it's greater than a year, you should got to a reproductive specialist -- try the antimicrobial gel first though.

Couple more things, make sure they get your vaginal pH checked out -- should be greater than 4.5 for BV to occur -- though studies state that acidifying stuff does not work. Refrain from douching also. But, see a specialist about this stuff.
posted by skepticallypleased at 9:39 AM on February 14, 2010

Seconding Boric Acid.
posted by jrichards at 6:21 AM on February 15, 2010

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