Gardnerella-Tending Tips?
October 5, 2011 7:06 AM   Subscribe

Medical / Sexual Health Question: WTF could be causing these long-term symptoms, and HTF can I take care of them, hopefully once and for all?

I'm a ~40-year-old man who's been in a monogamous relationship with my current girlfriend for almost 7 years.

We were both sexually active before we met each other, and both of us practiced safe sex with previous partners, with a small number unfortunate exceptions (but no diagnoses of STDs other than HPV). We do not and have not practiced anal sex. I rarely give her oral sex, because she isn't a big fan (my loss).

At the beginning of our relationship, she would often complain of vaginitis-like symptoms a day or two after we had unprotected sex. She would complain of yeast-infection-like symptoms (without the characteristic discharge of a yeast infection) and also ended up with a number of bladder infections. At the beginning of our relationship, she used to halfway joke that she must be allergic to me, but the frequency of the symptoms was a real cause for concern.

Early on, I went in for a test (pipette scraping in my urethra) and the only interesting results were an abnormal amount of Gardnerella. The doctor told me it was nothing to worry about, but gave me an oral antibiotic, anyway. She also went in for a simultaneous test, but apparently the same doctor didn't think she needed any sort of treatment. I am not sure, but I don't think she was prescribed any medicine at that time.

I went in, on my own and unbeknownst to my girlfriend, for a follow-up test a few years later, but, if I recall correctly, the doctor (another doctor, this time) didn't see a need to prescribe me anything. I don't remember the exact test results, but I do remember that I wasn't prescribed any medicine.

The problem is that, 6 years later, things still seem to be about the same. I think we've both tried to sort of ignore it, or maybe grown used to the symptoms and, to some degree, accepted them as normal.

Except that we also haven't. I think it's negatively affected our sex lives, if even just on a subconscious level. I think both of us have noticed a drop in sexual desire that, I suppose, may be related to a subconscious desire to avoid the discomfort that often comes after sex.

Although we have lived together for 5 years, due to our work/life situations, we spend several weeks apart from each other a couple of times each year. We also have sex on a very infrequent basis. But what I do notice is that, after an extended period with no sex (say, a period of abstinence that 'just happens' plus several weeks of time away from each other), we both notice these symptoms more after we do have sex for the first time again. That is, it's like we're sort of 'used to' the symptoms if we're having sex semi-regularly, but after some weeks without sex, the symptoms seem to go away, making them much more noticeable when they come back.

My symptoms: increased frequency of the urge to urinate, to the point of mild incontinence. Slight burning or discomfort in my urethra when I urinate. Intermittently, a strong urge to urinate that only produces a few drops of urine. A pressure in my pelvic area that may be related to 'clenching up' in order to delay yet another trip to the bathroom. Additionally, if I have sex and don't take a shower before going to bed, I sometimes notice a strong, almost fishy odor coming from my genito-anal area, and a mild itching or burning 'back there' the next morning.

I've never noticed a discharge, nor had a difficulty actually urinating when I need to - it comes out in a strong, steady stream when I really have to go.

I plan to talk to my current doctor about this, but I thought I'd ask in here, since we've already talked to at least two doctors about it, without clearing up the problem. Maybe I can go in with some ammunition to get him to take this seriously.

I'd also like to know if there's a test that doesn't require scraping my urethra with a sharp glass pipette, since I find that exceedingly uncomfortable. Along those lines, I'd also like to know about testing options, in general. We both tested negative for HIV at the beginning of our relationship, but that's all we've been tested for, and I wouldn't mind having a more thorough test, if that's possible. I'm not in the US, so things may be a little different where I am, regarding testing, etc. It's a modern county with excellent health care, but I sometimes get the feeling that some of the practices aren't as cutting-edge as what I'm used to from the States.

Please hope me!
posted by anonymous to Health & Fitness (11 answers total)

I had this happen with my ex (guy.) After divorce, I was at my normal pap smear with my doctor and mentioned it. She said that some people have different PHs and her best recommendation is to use condoms if I ever encountered it again. (If you're trying to have a baby, get to the baby part, and then go back to condoms when bedtime play is just play.)

posted by doyouknowwhoIam? at 7:12 AM on October 5, 2011

IANAD but I have heard the same thing as the first person who answered. Aside from that, I would encourage her to be tested for Bacterial Vaginosis. Not sure if men can be tested for it, but I know that symptoms (itching, burning, fishy smell) are exacerbated by having sex.
posted by twinA at 7:16 AM on October 5, 2011

IANAD Can you go together to the same doc, and get re-tested? A course of antibiotics for both of you at the same time might make sense.

Spermicidal foam/jelly has mild antibiotic qualities, obviously for sperm, but also bacteria. It also has a lubricating effect that you may or may not think is a plus. Tastes nasty, but not a big concern in your case. You could try using it, even if it's not necessary for birth control.

For an awful lot of urological symptoms, cranberry juice and vitamin C are beneficial, with no risk.
posted by theora55 at 7:27 AM on October 5, 2011

...How's the lube? In your girlfriend's case, that sounds like "honeymoon cystitis", which is aggravated by vigorous and insufficiently-lubricated sex after a long time without. It's a low-level kind of thing, but uncomfortable.

Although, the fact that you're experiencing symptoms as well makes me wonder: have you tested for trich? It's REALLY easy to mistake this for a yeast infection in women, but it takes a really different course of treatment. I'm wondering if maybe your girlfriend wasn't just chalking things up to a yeast infection without seeing her doctor (lots of times we do this) and not getting a confirmation that "oh, wait, this isn't a yeast infection after all".

And yeah, it is not surprising for a case of trich to be going on for years. I got it from an ex shortly after we started dating; I'd had what I thought was a persistent yeast infection and was grumbling about it, and then he said, "you know, it's weird, the last two girlfriends I had also seemed to get a yeast infection right when we started dating too." I had been trying to self-medicate, but that made me think "wait...." and I saw my doctor. He said that those "yeast infections" in my ex's girlfriends had probably been trich as well, and he'd need to be treated too.
posted by EmpressCallipygos at 7:29 AM on October 5, 2011

I am not ANYONE's doctor, but I have heard that partners can "ping-pong" an infection back and forth ad infinitum - as one of them is starting to beat the infection, their co-infected long term partner gives it to them again, and vice versa.
posted by sarling at 8:40 AM on October 5, 2011

Is it possible that she's allergic to your semen?
posted by Leezie at 10:32 AM on October 5, 2011

Please do follow up on this post.
posted by softlord at 4:04 PM on October 5, 2011

Er, also, dried semen + warm, damp area can often lead to fishy odors. doesn't mean anything is wrong.
posted by softlord at 4:05 PM on October 5, 2011

OP, the only info you need info for being taken seriously is the description you posted. "Fishy smell" is a classic descriptor for various bacterial STDs. And even if neither of you had a 5-7 year track record of of this and other symptoms, "Please test each of us for yeast infection, UTI, and STDs" should be the only magic words you need. If your doctor resists at all, go straight to Planned Parenthood. If that first line of tests don't turn up anything, sounds like time to schedule an appt with a urologist for follow-up.

Spermicidal foam/jelly has mild antibiotic qualities, obviously for sperm, but also bacteria.

AFAIK, spermicides have no antibiotic qualities. @theora55, do you have a cite for this?

In the U.S., the active ingredient in all spermicides including gel, foam, films is Nonoxynol-9. It's a powerful detergent. Its major side effect is tissue irritation. So irritating, in fact, that N-9 is no longer recommended by CDC or World Health Organization (WHO) because it has been repeatedly shown to increase vulnerability to STD transmission including HIV. It's also known to increase risk of cystitis.

Spermicide is pretty much a carpet-bomb killer. Much healthy bacteria get laid to waste too. For someone having irritation issues and recurrent infections, discontinuing all spermicide exposure (check your condom label carefully; lubes too) for a while could be good. Several explanations suggested above could fit together. Spermicide -> irritation & discomfort -> enhanced conditions for nasties to flourish -> UTI/cystitis -> discomfort & bad smells & trouble peeing -> avoiding activities associated with unpleasantness.

Meantime, "more lube" (and "longer foreplay") is nearly always a good answer to "how do I make sex hurt less" type questions. In this case, stick to water-based or silicone-based lubes. In women, the close proximity of urethra to vaginal opening makes it easy for lube to migrate northward. Oil traps bacteria, so when an oil-based lube travels it brings alone greater numbers of bacteria.

Once you've successfully dealt with the medical side, expect to spend some time together in consciously re-learning how to associate sex with pleasure. Among other things, a history of painful sex can lead the body to reflexively clench up (vaginismus or ). Which actually makes things hurt worse, setting things on a gradual downward spiral.

And, heck, it could turn out that she's been avoiding oral all these years because someone a long time ago mentioned that her genitals smelled fishy. Many people misunderstand their genitals to be permanently unpleasant rather than recognize it as a cue of temporary infection. Healthy genitals smell good.
posted by nakedcodemonkey at 4:18 PM on October 5, 2011

Whoops, sorry, I meant to include vulvodynia in there too.
posted by nakedcodemonkey at 4:22 PM on October 5, 2011

Oh my goodness, Leezie, thank you for that link! I'm allergic to semen. I became so after some years of having no problems and have been ever since. I had to figure it out myself, most doctors don't seem to have heard of the possibility, and I am *so thrilled* to see an article about it!

I am one of the "thousand needles being stabbed in" people mentioned in the article, and my reaction also takes a couple of days to manifest, like the OP's girlfriend. My husband and I can't use condoms, so I have had to figure out another method. I do not like this method much, but I like screaming pain (sometimes literally) far less. I have to get out of bed shortly after sex (ugh), warm some filtered water to body temperature, and rinse the inside of my vagina with it. (It's not TMI if it's medically useful advice, is it?) I use one of those hair-dye bottles from a beauty-supply shop and sit on the edge of the tub. Admittedly this still diminishes my enjoyment of sex, but a whole lot less than the alternative. Since I figured this method out, I have only had problems a couple of times, and that was when I waited too long to rinse. I've also largely stopped getting the urinary tract infections I have had chronically since about age 6, which is kind of weird but in no way unwelcome.

Douching is generally not a great idea, but in my case it's necessary (if I ever want to have sex, which I do). I haven't spoken to anyone else with a semen allergy about this-- it's not a terribly common affliction-- so I don't know what other answers people have come up with. But it's extremely heartening to see the subject being treated, and also anyone else having any idea that it exists! Because my quality of life would be so much lower if I hadn't figured out what was wrong and how to stop it.

This doesn't explain any symptoms you may be having, OP. But it might be an explanation for hers.
posted by Because at 4:33 AM on October 6, 2011

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