Treating Recurring Bacterial Vaginosis At Its Root Causes

Many clinical studies have been performed to evaluate the effectiveness of antibiotics in the treatment of bacterial vaginosis (BV)

. Generally, 80-90% of women showed good initial response to the treatments. However, about 15-30% of these women experienced recurring bacterial vaginosis within 3 months after treatment.

A long-term medical study showed that while 48% of women received antibiotic remained free from bacterial vaginosis following treatment, more women (52%) had at least one further episode. Most recurrence cases happened in the first year, and one of the most obvious risk factors was having new sexual partners.

Exactly how recurring bacterial vaginosis occurs remains to be studied. It is still unknown which of these takes place first - a reduction in lactobacilli, an increase in vaginal pH, or an overgrowth of the naturally occuring BV-causing bacteria. Fortunately, there are therapeutic options available to treat recurrent bacterial vaginosis.

1. Bacteria replacement therapy

This method uses harmless bacteria to replace BV-causing bacteria with lactobacilli, and is considered natural and safe. Lactobacilli bacteria are used, either given orally or applied vaginally. Unfortunately, not all strains of lactobacilli are able to adhere well onto the vaginal wall.

The lactobacilli group found in yogurt doesn't seem to stick very well to the vaginal wall. The L crispatus and L jensenii showed better ability to adhere compared with other lactobacilli strains. A clinical study showed that, with a combination of oral and vaginal lactobacilli replacement, normal vaginal flora can be achieved after 60 days. There are now studies to examine the effectiveness of vaginal pessaries containing L crispatus in repopulating the vagina with lactobacilli.

2. Maintaining vaginal pH at 4.5 or less

Before the normal vaginal lactobacilli and other microflora are restored and once again able to maintain the vaginal pH themselves, using external aid to adjust the vaginal pH is important to prevent overgrowth of BV-causing pathogens. In a study that examined the effectiveness of intravaginal lactate gel usage, it was found that 88% of women who were on the vaginal maintenance treatment had their BV cured compared to only 10% of those who didn't.

3. Preventing overgrowth of BV-causing organisms

Bacterial vaginosis recurrences most often take place within the first 7 days of the menstrual cycle, and frequently followed a Candida infection. Experts advise the use of oral metronidazole or intravaginal Metrogel for 3 days at the onset of menstruation for 3-6 months, and add anti-fungal treatment if there is a history of candidiasis.

Using one of the above therapeutic options may help some women to end recurring bacterial vaginosis, but may not cure all cases. A combined approach appears to work better for most women.

From what the medical evidence suggests, the best way to manage recurring bacterial vaginosis is to treat this vaginal disorder at its root causes by replenishing lactobacilli, keeping a vaginal pH of 4.5, and if necessary also adding complementary treatment to control bacteria overgrowth. In fact, many natural cures for bacterial vaginosis practiced today are in line with these medical evidence, and many women are turning to natural remedies as a resort to their BV woes.

by: Serena Loo

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