Some women get Bacterial Vaginosis (BV) (a vaginal infection that causes vaginal discharge and odor) over and over again. It seems like as soon as it gets better, it comes right back. Why does this happen, and how do you keep it from happening? If this happens to you, read on for the answers…
What exactly happens that causes BV?
Our vagina has good bacteria called lactobacillus that are normal and keep everything balanced and healthy. Sometimes these good bacteria are replaced by bacteria that are not supposed to be there, and this causes BV. Usually this happens when the pH of our vagina gets “off” or if the good bacteria are washed away. Here are some of the common culprits:
Douching: Douching washes away the good bacteria and increases the risk of bacterial infections, especially BV. You should NEVER douche!!
Feminine washes, deodorants, and wipes: There is a whole aisle at the store dedicated to selling us on the lie that our vagina should smell like strawberries and bananas or whatever, but vaginas should smell like vaginas. If you do not have an infection, then your own natural smell is normal. Using feminine washes, deodorants, and wipes can also change the pH of your vagina and wash away the good bacteria increasing your risk of infections. It is best to use only water to clean your vaginal/labial area. If you really need to, use a mild soap like Dove, but only on hair bearing areas (not inside the vagina or in between your lips).
New sexual partner: Women are more susceptible to BV when they have a new sexual partner. However, some women do report repeated infections related to each time they have sex. This is because semen has a higher pH than our vagina usually has and this change in pH can increase the risk of BV.
Same sex female partners: Lesbian women have a two times higher risk of BV than heterosexual women. The reason is not quite understood, but women with same-sex partners who have BV are at higher risk of getting BV. However, studies show that monogamous homosexual women have lower rates of BV after about 6 months with the same partner (by then, most same-sex female partners who are monogamous have similar microbiomes or sets of bacteria in their vaginas that are mostly the normal healthy type).
Should my male partner be treated?
Although BV may be somewhat sexually transmitted, multiple studies have shown that treating a male partner of a female with BV does increase cure rates (the chance that a medicine will make the infection go away) or reduce recurrence rates (the chance that the infection will come back). Men cannot get BV, so there is no reason for your male partner to be treated.
What can I do to reduce my risk of BV coming back?
If you think you may have BV due to vaginal discharge or vaginal odor, be sure to contact your doctor. If your symptoms do not resolve with treatment or resolve and then come back, be sure to let your doctor know! Here are some tips to decrease the chance that your infection will come back:
Vulvar/Vaginal Hygiene: Your vagina is meant to clean itself! Use only water in the shower and avoid soaps when cleaning this area. DO NOT DOUCHE! Skip the feminine wash aisle!
Use Condoms: If your BV tends to occur in close proximity to intercourse, try using condoms. Although this may not be your or your partner’s favorite, it will keep semen out of the vagina which keeps your pH normal preventing recurrent BV.
Think about hormonal birth control: Some women find that they have fewer BV infections when they are on the pill.
Probiotics: Studies are mixed on whether or not probiotics decrease the risk of BV infections. However, some women find them helpful. If you choose to try these, be sure you try one that is labeled “for women” or “for vaginal health” as these contain the specific species of lactobacillus that keeps our vagina healthy.
I’ve done all of those things, and it is still coming back… Now what?
For patients who continue to get BV despite conservative measures, there are preventative medical treatments.
This means you take medication even when you don’t have an infection to prevent the infection from coming back.
This is successful for most patients. However, some patients still get recurrent infections if they stop therapy.
What Should I Do Now?
If you are struggling with recurrent vaginal infections, you should see your gynecologist. I am accepting patients in my virtual clinic who live in states where I am licensed and would love to see you.
Have a question for me or an idea for my blog?
You can email me at drjacquelynstone@gmail.com.
Jackie Stone, MD
Comments