Treatments for Recurrent Bacterial Vaginosis
Repeated vaginal itching, burning or pain when urinating, odor and discharge may be signs of recurrent bacterial vaginosis or BV. It results when the harmful bacteria normally found in the vagina gets out of balance and overwhelms the "good" bacteria. Treatment is essential because BV has several associated risks.
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Causes
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According to the Center for Disease Control, BV is commonly found in pregnant women and is the number one vaginal infection in women of childbearing age. It's not clear why women get BV, but douching and having a new partner or multiple partners puts you at greater risk. In rare cases, a woman who is not sexually active will get BV, however. Cases of BV may clear up on their own, but they may recur or even become chronic as a result. That's why it's important to see your physician if you suspect BV.
Risks
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Leaving BV untreated puts you at risk. If you're exposed to HIV while you have BV, you have more chance of getting it, too. Plus, if you already have HIV and develop bacterial vaginosis, your partner has a greater chance of getting HIV from you. If you have BV and undergo a hysterectomy or have an abortion, you are more likely to get an infection. Also, pre-term delivery and other pregnancy complications may result from having BV while pregnant. Finally, if you have BV, you're at greater risk of getting a sexually transmitted disease.
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BV Treatment
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BV usually is treated with one of two prescription antibiotics: metronidazole or clindamycin. Both slow or stop the growth of bacteria that cause infections in the vagina. Like all antibiotics, metronidazole and clindamycin must be taken as directed until they are gone. Even so, BV can recur after treatment. It's important to be attentive and get followup care if symptoms reappear.
Recurrent BV
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Many approaches are being used and studied for treatment of recurrent BV. The National Guideline for the Treatment of Bacterial Vaginosis (2006) lists possible long-term treatment with metronidazole, use of acigel, probiotics therapy and hydrogen peroxide.
Extended Antibiotic Treatment
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Your doctor may prescribe use of metronidazole gel 0.75 percent daily for 10 days, followed by use twice weekly for four to six months. This is called suppressive therapy. Another approach, also using metronidazole, requires that you take a 400mg pill twice daily orally for three days at the beginning and end of menstruation. With this approach, if there is a history of candidiasis (yeast infection), you will also take one 150mg dose of fluconazole.
Combination Therapies
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The Guideline also relays success with using acigel at the time of menstruation following unprotected intercourse, noting the relapse rate was reduced following a course of metronidazole. Still being studied is the use of antibiotics combined with probiotic therapy and hydrogen peroxide.
Considerations
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In any case, if you have recurrent BV, don't douche. If taking a bath, don't use antiseptic agents, shampoo or shower gels. Leave them for the shower. In recurrent cases, your partner should also be checked for BV.
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Resources
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