How do I get this infection to go away and stay away?
October 9, 2013 6:02 PM   Subscribe

I have had a recurring bacterial vaginosis and yeast infection for over a year. I treat it, it goes away, and a few months later, it's back. To make matters more complicated, I don't have the typical symptoms. What originally lead me to think something was up is that I have to pee constantly, so I thought I had a UTI (which I have never had before). Turns out, I had a vaginal infection, and no UTI. It's been a year of this and I'm getting really frustrated. I'm seeing my ob/gyn next week about this, so I am not looking to metafilter as a substitute for medical advice. I want to know if there's anything I should be discussing with my doctor that I haven't already, or if I should be pushing for a referral to a specialist. More details and TMI below.

As mentioned above, a year ago I thought I had a UTI because I felt like I had to pee all the time. I had no pain when urinating, no vaginal discharge or discomfort. My doctor diagnosed me with bacterial vaginosis and a yeast infection, and told me my urine was clear. I've never had BV before in my life, and only had a yeast infection once before when taking several weeks of serious antibiotics for something unrelated. I took the antibiotics (metronidazole gel)and the fluconazole she prescribed, and felt better for a little while.

Less than two months later, I was feeling like I had to pee all the time and feeling kind of uncomfortable, so I took another round of fluconazole. A few months later, same thing, except I went back to my ob/gyn who prescribed another round of antibiotics and an fluconazole, and tested me for STDs. Everything was negative except for ureaplasma, which I tested positive for. I've been in a monogamous relationship for seven years, but my doctor told me it's possible I've had this for that long and not been asymptomatic.

After that, my partner and I both took a round of doxycycline (which was miserable), and then I took another round of antibiotic gel and fluconazole. I was tested for ureaplasma afterwards, and tested negative. So, I thought I was out of the woods since the ureaplasma had finally been taken care of. Nope!

Right now, I've got yet another infection. I don't have any discharge or odor, but I have to pee all the time, and I'm uncomfortable. Not necessarily itchy, just uncomfortable. Maybe stupidly, I hoped it was just a yeast infection, so about two weeks ago I bought some Monistat (the three day treatment), however all it did was make me bleed. This was nothing like period blood, this was bright red, and well, pretty much just like normal blood. I've never had that happen to me before.

I called my ob/gyn, who prescribed me yet another round of antiobiotics (metronidazole gel again) and fluconazole. Unfortunately, I have my period now, so I have to wait for it to end so I can get a culture done. My appointment is next week and I'm wondering if there's anything I need to be discussing with my doctor, or if I should be going to a specialist or getting a second opinion at this point.

Alongside the antibiotics and yeast infection medication, I've tried hydrogen peroxide, vinegar, and probiotic supplements (taken orally). I've ordered some boric acid and gel caps, and plan on trying that. I already eat a relatively low-carb diet, because I have polycystic ovary syndrome.

I've never had a BV infection until a year ago, I've been having sex with the same dude for the past seven years, I've been taking the same medications for well over a year. I don't know what else to do at this point, and this has been really frustrating. What else should I do, metafilter?
posted by inertia to Health & Fitness (25 answers total) 7 users marked this as a favorite

I know that this is probably on your duh-obvious lists of fix-its, but just in case: Wear cotton underwear. Not just underwear with a cotton crotch, but cotton underwear. 100% cotton.

I've had a good experience with boric acid. I hope that works for you.
posted by ablazingsaddle at 6:09 PM on October 9, 2013 [2 favorites]

I'd also say stop having sex until this clears up.....I know that sucks, but give it a good month of no sex and that might also help your system right itself.....
posted by zizzle at 6:13 PM on October 9, 2013

Yes, you should see a specialist. Find someone who specializes in vaginitis. If your GYN is just phoning you in a script for Metrogel without doing any further tests or exam on you then I'd be worried they're missing something. There are a lot of reasons for chronic/recurrent vaginitis and a lot of people struggle before getting the right diagnosis in cases similar to yours.

It is a little unclear if you are actually getting vaginitis symptoms (discomfort in the vagina from inflammation) or bladder symptoms, which would be cystitis.

If the discomfort seems to be bladder related rather than vagina-related, and you're getting frequency but your urine isn't testing positive for an infection, consider seeing a urogynecologist to discuss the possibility of interstitial cystitis.
posted by treehorn+bunny at 6:17 PM on October 9, 2013 [3 favorites]

Monostat is evil.

Watch your lube - certain ones contain glycerin which just feeds yeast.

Keep with the probiotics and yoghurt - you've had a lot of antibiotics lately. Some people put yoghurt up in there (freeze it in a nice cube tray first)
posted by St. Peepsburg at 6:19 PM on October 9, 2013 [2 favorites]

Response by poster: I don't mean to threadsit, but I just wanted to add I am already on cotton undies-only and I've been abstaining from sex since I first noticed this most recent infection (and I don't use lube, but if that ever changes I will make sure to avoid ones containing glycerine!)

I am definitely going to ask my doctor about cystitis. I've noticed I have to pee more often when I drink caffeine. I had a coke zero this afternoon, and had to run to the bathroom 4 times in 45 minutes.

Thanks everyone so far, I really appreciate it.
posted by inertia at 6:31 PM on October 9, 2013

Um, have you been tested for diabetes? Peeing all the time and feeling "uncomfortable" may be endocrinological, and have nothing to do with your bladder or reproductive system itself.
posted by aspen1984 at 7:05 PM on October 9, 2013 [5 favorites]

I see that your partner took a round of doxycycline (which you may be aware, BTW, can make yeast infections worse) but has he been treated for yeast? Men can also get genital yeast infections, and they don't necessarily have obvious symptoms.
posted by magicbus at 7:11 PM on October 9, 2013

I had a case of thrush that kept coming back, it turned out my husband was reinfecting me have him rub a generous amount of one of the over the counter creams all over his penis and groin area getting into all the nooks and crannies we did this for a 7 day stretch to be sure. , this is what the Doctor suggested for us after a dose of Diflucam (or however you spell it) each didn't work.

Some other tips I picked up are going naked from the waist down at night while sleeping, and cotton undies don't make a difference if you are wearing tight jeans or yoga pants all day. Air flow is your friend. Oh and make sure you don't wipe back to front. Oh if you use sex toys make sure they get all cleaned really really well too.

I'd also second getting a blood test as Aspen1984 said peeing all the time is one of the signs of diabetes.
posted by wwax at 7:45 PM on October 9, 2013

Nonoxynol 9 (in some spermicides) can sometimes increase frequency of yeast infections.

Nth'ing no underwear at night and limiting tight pant wearing.

I recommend writing down everything that has happened and briefly reviewing it with your doctor when you next visit.

Good luck!
posted by donut_princess at 8:02 PM on October 9, 2013 [1 favorite]

Get tested for diabetes.
posted by oh posey at 8:07 PM on October 9, 2013

I used to get recurrent infections (sinus, ear, etc). I eventually concluded that "recurrent" meant either I was being re-exposed or it never really went away. For things that came from re-exposure, I had to hunt down the source. For those that never really went away, I needed a course of treatment that was both longer and stronger. Taking normal doses of antibiotics that do not clear it out promotes anti-biotic resistent infections.

At this point, I personally would throw out all my underwear, buy new and use panty shields 24/7 until treatment was done.
posted by Michele in California at 8:58 PM on October 9, 2013

This was me - or very similar! UTI's with no bacteria, couldn't find anything, not diabetic, a suspected pelvic infection... I was on all the same, scary, antibiotics too. Also, married, long term partner etc... I was in agony.

I tried all (ALL) the herbs, vitamins, cotton underwear, no underwear, weird diets - EVERYTHING. For the love of god, go see a urogynecologist. I had overactive bladder, which is easily treated with half a 5mg dose of oxybutynin 2x day. Negligible side effects. Nothing else was gonna help/fix that. Ironically, this also helped with the recurrent yeast infections and painful sex and misc. other complaints (not sure why, but not complaining!). I'm talking years of recurrent yeast infections. I will also note that at various times the antibiotics did seem to help - no idea why, and it never lasted long.

The only book I found useful was Ending Female Pain by Isa Herrera.

It also turned out that I have PCOS, probably some endo, and am severely anemic - probably not helping!

In the meantime, try rinsing with cold water after you 'go' - it soothes the nerve endings. Heaven.

MeMail me if you have questions, or just want some sympathy!! Good luck + HUGS.
posted by jrobin276 at 9:56 PM on October 9, 2013 [3 favorites]

This is probably TMI, but this is all the stuff I've learned from personal experience:

Take those cranberry pills -- religiously, at least the recommended amount. That might help your general comfort and help keep new infections from taking hold. Also try to pee every time you touch your genitals and try to not "hold it" any more than completely necessary. Seconding washing with cold water, make sure no soap is involved.

And I n-th that your partner may be reinfecting you, or even getting something on your sheets/towels/washcloths/etc that is reinfecting you.
posted by rue72 at 10:04 PM on October 9, 2013 [1 favorite]

Yeah, don't hold it unless a doctor has talked to you about bladder training.

If it makes you feel less alone, know that I had nights I'd brush my teeth and then sit on the toilet for half an hour, crying in exhaustion while I intermittently squeezed out 1 tsp of urine at a time. Tea is enemy #1, even on meds.

Whatever this is, it CAN be fixed...or at leasta lot better. Hang in there!

oh, and fwiw, pads give me yeast infections, like instantaneously....YMMV.

Also, do not microwave your underwear... elastic is plastic, and melts! ;-)
posted by jrobin276 at 10:17 PM on October 9, 2013

First: get a second opinion: persistent urgency can be a sign of other things that are rare, but more worrisome than the average UTI. Also, have them do a urine C&S with sensitivities: if you do have a bug in your urine, you may be taking an antibiotic that's not effective against it, and just wiping out all of your vag flora.
Second: I'd stop putting stuff in your vagina: monistat, vinegar (especially that!), yogurt, hasn't worked yet, and it seems things have only worsened for you over the past year. Your vaginal flora is pretty delicate and I'd guess that with the antibiotics, vinegar, sex, etc. that have been introduced into your system, you're pretty can take a while to get back up to speed, so proceed slowly and with caution. Similarly, if you have sex, use condoms.
Third: I have heard really good things about femdophilous: it's a very high quality, oral probiotic. A friend had a similar case as you (recurrent BV, yeast, etc.) and she swears by it.
Fourth: I'm sure you know this, but are you using dye/perfume/etc.-free soaps and detergents? Unscented pads, etc.? That can also help a bunch.

Feel better soon and good luck!
posted by stillmoving at 10:58 PM on October 9, 2013

I just realized... oxybutynin is available overthe counter in a patch in the US if you want to test it out. You should still pursue doctors for proper resolution, of course, butit's a slow process, and if it takes the edge off....

I take more than the patch delivers, and found the pills much more effective than the patch, YMMV.
posted by jrobin276 at 11:24 PM on October 9, 2013 [1 favorite]

One of the times I had recurrent infections (slightly different from yours), they went away when I changed my diet. I'd been on a really restrictive diet, and I think I was missing some nutrients. (Maybe this was just correlation not causation. I'm just throwing it out there in case it sounds plausible in your situation.)
posted by salvia at 12:15 AM on October 10, 2013

I've had good experiences with Femdophilus (contains probiotic strains specifically for this issue). As you can see from the comments, many people find them most useful as suppositories.

Also, according to Jarrow it is fine for them to be shipped without refrigeration for a few days -- ignore the comments that insist otherwise.
posted by susanvance at 5:07 AM on October 10, 2013

I also recommend getting tested for diabetes. My mother was a not-well-controlled diabetic and had continually recurring vaginal infections; her doctor said it was part and parcel of uncontrolled diabetes.

A decade or so later, I found myself with recurring yeast infections, and drinking/peeing gallons, my family doc testing for this that and the other gynecological thing, until I said to her, "Um, how about diabetes?" To shut me up, she requisitioned a fasting blood glucose, and yup, that's it.

Please get tested.
posted by angiep at 6:57 AM on October 10, 2013

There's some evidence that cranberry juice helps. Drink lots of cranberry juice and lots of water. Caffeine is a urinary tract irritant so avoid it. Vitamin C helps, too. And Cran and C are pretty harmless, so there's no drawback. Also, make sure that you really empty your bladder. Drink lots of fluids until things are back to normal.
posted by theora55 at 7:38 AM on October 10, 2013

Response by poster: I've had the five hour glucose tolerance test a few years ago, which was normal. My fasting is a bit higher than I would like it to be (it's usually in the 100-110 range), but my GP says my H1AC is normal and neither my GP or my ob/gyn think I should be put on metformin.

I do have a meter and test every now and again, because type 2 runs on both sides of my family and I was diagnosed with PCOS last year.

I'm definitely going to ask for a referral to a urogynecologist, which I didn't even know existed, and for another glucose tolerance test.
posted by inertia at 8:50 AM on October 10, 2013

Can I just add that cranberry juice, although it can help, is usually loaded with sugar. Yeast and infections feed on sugar, so in the meantime stick to cranberry supplements and sugar free diet cranberry juice. It does help a lot, from my experience, but only if you avoid the sugar.
posted by photoexplorer at 9:18 AM on October 10, 2013 [1 favorite]

I have been through the EXACT same trend of recurring BV for a year straight without the typical symptoms ( my BV always felt like a UTI, plus pain during intercourse), and I was able to finally cure it by eventually refusing to take any more antibiotics and finally trying out a few natural remedies:

1. Get Vagisil PH Balance wash - this wash has lacto-probiotic in it, and it has done wonders for me in terms of making me feel much better down there. I apply it externally with my fingers and I use it in the morning, at night, before and after intercourse, and constantly during my period.

2. Use garlic instead of antibiotics. I know this sounds crazy, and my doctor was literally disguested when I told her about it (proving ever more that doctors can be completely unprofessional), but it really works in combination with some other things to get rid of the bacteria that you have down there. I'd peel a garlic clove and cut it once with a knife to open it up a little it, and then push it up there with your finger overnight; take it out in the morning. I'd do this for a couple of nights until symptoms go away. This should be done in conjunction with:

3. Yogurt. Buy some syringes and put greek yogurt up there as well. The yogurt directly places probiotics into the affected area, which helps create balance on the inside as well as on the outside.

4. Drink lots of water, wear cotton underwear, do NOT douche, do NOT use antibacterial soaps down there.

I know this all sounds really gross, but I was seriously able to stop a year-long cycle of recurring BV(twice every month) by doing this instead of using antibiotics.
posted by OnTheWing at 11:21 AM on October 10, 2013 [2 favorites]

Boric acid capsules.
posted by Riverine at 11:47 AM on October 10, 2013

I have interstitial cystitis and all this sounds familiar. I'm glad you're getting the urogynecologist referral. If you're in Los Angeles I can give you a recommendation. If there isn't a urogynecologist in your area, and you have to go to a regular urologist, find a urologist under 50. They are much more tuned in to interstitial cystitis, IME.

The vaginal irritation could be vulvodynia, which I also get. I almost always get it during my period. Sometimes it accompanies an IC flare up at other times of the month.

In addition to this, I am prone to yeast infections and have had BV a couple of times. If you suspect BV (fishy smell, gray discharge) you can test your vaginal pH at home. If it is BV, your pH should be higher than normal. Don't order the special vaginal pH test sticks; they are way overpriced. Get regular pH test strips. Wash your hands, tear about 2 inches of test strip off, loop it over your middle finger and insert into your vagina. Remove after a couple of seconds and compare to the guide on the box. Normal vaginal pH is 3.8 to 4.5. The guide on the strips I linked starts at 4.5. They may also carry these at health food stores if you don't want to order online.

Sounds like you already know the drill about lowering your vaginal pH with hydrogen peroxide, etc. Do you know about RepHresh? Does the same thing, less messy, but more expensive. I've read that taking folic acid can also help (I know this is a woo website, but, hey it's helped me.)

Other things that have helped my urogynecological issues:

1) Take a shower BEFORE sex. Wash your vulva with water and soap up your butt crack. Less bacteria around your vagina and urethra results in less irritations/possible infections, IME.

2) Pee immediately after sex (you probably already know this one.) I lean forward while I pee; seems to help the stream come out more forcefully, thereby flushing out your urethra. Then drink a glass of water and take two cranberry pills.

3) You've got the cotton underwear down. Also wear a pantiliner daily. Change it during the day if you get sweaty or have a lot of discharge. Get the unbleached, crunchy granola kind. The chemicals in conventional brands can cause irritation. I like Natracare. Don't wear underwear to bed.

4) Tampons trigger my vulvodynia and I can only use pads. Consider trying pads if you already use tampons or a menstrual cup. I would recommend disposable, unbleached pads like Natracare. I don't use reusable pads because I don't want to deal with possibly reinfecting myself with something if I don't sanitize them adequately.

5) No baths. Showers only.

6) Blow dry your vulva after showering. This helps prevent yeast infections and non-specific irritation for me.

7) Drink lots of water. No caffeine, no decaf coffee or tea either. I only drink clear sodas, if at all. I avoid anything with added vitamin C (ascorbic acid), with the exception of the cranberry pills. IC can have a lot of different food triggers. Here's a good site.

8) Consider trying condoms if you don't already and you and your partner are open to it. My partner's semen triggers a yeast infections for me and the extra friction of skin on skin causes irritation. A lube that I have had good luck with is Aloe Life.

9) Finally, one of the biggest triggers for IC is stress. I've been taking Zoloft and going to therapy for my anxiety for several months and and added side effect seems to be a reduction in flare ups.

Good luck!
posted by fozzie_bear at 7:23 PM on October 10, 2013 [2 favorites]

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