Bv Won T Go Away

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Bv Won T Go Away
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BV that just won’t go away is one of the most difficult-to-treat women’s health conditions.
Ask a woman for the most frustrating and uncomfortable health condition she’s ever dealt with down there, and bacterial vaginosis (BV) likely tops the list. And, if you keep getting BV, it’s understandable to wonder how to stop recurring BV infections permanently.
It’s important to point out that what’s happening down there isn’t your fault. Rather, it’s a reflection of the complex and ever-changing balance of bacteria inside the vagina.
“During evolution, the vagina developed a careful equilibrium of different bacteria that can help keep harmful microbes away from the vaginal microbiome,” says Anke Hemmerling, M.D., Ph.D., M.P.H. , a women’s health researcher and project director of the UCSF Bixby Center for Global Reproductive Health. “These ‘healthy’ bacteria such as lactobacilli produce acids and acidify the vaginal pH to below 4.5, which creates an environment unfavorable for genital infections to thrive in.”
Whether you keep getting bacterial vaginosis, think you might have the condition, or are just curious, it’s understandable to have questions. Doctors break it down.
Bacterial vaginosis is what happens when the amount of ‘good’ bacteria like lactobacilli and ‘bad’ bacteria known as anaerobes is disturbed. With lower lactobacilli counts, the vaginal pH goes up, allowing ‘bad’ bacteria to take hold and cause an overgrowth of pathogens or disease-causing microorganisms like viruses.
Research suggests up to a third of women who have sex with people who have penises and around up to half of women who have sex with people who have vaginas develop BV at some point in their lives, making it the most common vaginal infection in existence. Variations in vaginal pH—and in turn a greater susceptibility to developing BV—seem to be linked to many different factors such as your diet, geography, genetics, race, or ethnicity.
“Furthermore, the vaginal microbiome fluctuates throughout the menstrual cycle, when using contraception such as birth control pills or intrauterine devices , during pregnancy, with exposure to semen, shared sex toys, and douching,” says Dr. Hemmerling. All of the above can increase your risk of developing BV, but what exactly causes it remains a mystery.
If you’re in the midst of a battle with BV, you know the process: Hit the self-checkout line with over-the-counter suppositories, take a break from sex, sleep without underwear, and avoid hot baths. When that doesn’t work, a trip to your doc for antibiotics such as metronidazole or clindamycin in the form of oral pills or a vaginal gel can sometimes do the trick, despite common side effects like nausea and spin-off yeast infections . However, 80% of women who go in for treatment end up with another infection within three months, according to a 2020 review published in the European Journal of Obstetrics & Gynecology and Reproductive Biology.
“Many women experience an endless cycle of BV episodes.”
“For decades, bacterial vaginosis has been treated with antibiotics to eliminate the harmful bacteria, but often this does not fix the underlying problem of an imbalanced vaginal microbiome, and many women experience an endless cycle of BV episodes,” Dr. Hemmerling says. Recurrent BV might happen when the infection isn’t fully treated, something messes up the balance of your bacteria again, or a layer of microorganisms known as a biofilm forms to protect BV-causing bacteria.
Besides disrupting your work and sex life, recurrent BV can also lead to serious complications. “Once the imbalanced vaginal microbiome is overpowered as a line of defense and bacterial vaginosis sets in, other bacteria and viruses can grow,” says Dr. Hemmerling.
A lot of people with BV don’t have any symptoms, according to the Centers for Disease Control and Prevention (CDC). However, if you do develop signs of the condition, you might notice the following:
Recurrent BV simply means that you keep dealing with the condition, says women's health expert Jessica Shepherd , M.D., an ob/gyn in Texas. Even if you don’t have any major symptoms of BV, this isn’t something that you want to let slide.
It really depends. “Bacterial vaginosis occurs when the pH balance in the vagina is tipped, resulting in the overgrowth of bacteria,” explains women’s health expert Jennifer Wider , M.D. This can happen when you have multiple sex partners or simply from your body not producing enough lactobacilli to keep your vagina’s pH in check, she says.
Even shifts in your hormones can tip you into recurrent BV territory, Dr. Shepherd says.
Women living with recurrent BV have a higher chance of developing other vaginal and uterine infections (especially after surgeries like a hysterectomy or dilation and curettage), contracting STIs like gonorrhea and chlamydia , and acquiring and transmitting HIV .
During pregnancy, BV also increases the risk of miscarriage , pre-term delivery, and low birth weight. The burden of bacterial vaginosis is especially high for women in marginalized communities, as African American, Hispanic, and Native American women are affected more than white women, and low-income women are affected more than women who have higher incomes.
New approaches to treating BV are currently under investigation in clinical studies designed to meet safety and effectiveness criteria set by the U.S. Food and Drug Administration (FDA) for approving medication, Dr. Hemmerling notes.
But in the meantime, it’s understandable if you feel like finding a cure for your recurrent BV is something you have to take into your own hands. Many women are frustrated with their experiences in the doctor’s office, particularly when they visit primary care physicians rather than sexual health physicians for recurrent BV, due to what they describe as healthcare providers’ insensitivity and dismissals.
According to a 2015 study published in Plos One , women suffering from recurrent BV reported that their doctors had told them it will “just resolve itself” or it’s “just a woman’s thing,” or they admitted that they didn’t know what causes it or how to cure it themselves.
Keep in mind: Some of the most popular home remedies you’ll find on Instagram like vaginal washes or gels, perfumed douching agents, deodorants, or steaming procedures should never be used. “These remedies can negatively impact the vaginal microbiome further or cause damage to the protective cell layers of the vagina,” Dr. Hemmerling explains. Case in point: A Vagisil Feminine Moisturizer gel actually halted the growth of beneficial bacteria in the vagina, per a 2013 study published in Microbial Ecology in Health and Disease .
So, what can you do? We asked real women to share what finally worked for them and had women’s health experts weigh in on why each one might be worth trying if you can’t end your recurrent BV episodes.
For some women, introducing carefully-measured acidifiers such as boric acid—yes, the same stuff used as roach poison!—could help maintain a low vaginal pH and in turn potentially ward off bacterial vaginosis, says Alyssa Dweck, M.D. , a board-certified gynecologist in Westchester County, New York. Obviously, a substance capable of knocking out pests is very strong, and concentrations of powerful acids like boric acid can be harmful to vaginal tissue . As such, it’s important to check in with a healthcare provider for their guidance and never try this home remedy on your own. After that, only put in boric acid inside your vagina in the form of suppositories which are encased in a gelatin capsule that dissolves in the correct doses and avoid applying to broken skin.
An older study found that seven days of antibiotics followed by three weeks of 600 milligram boric acid suppositories per day had a cure rate of 87%, 78%, and 65% at 12, 16, and 28-week follow-ups. Still, researchers say more studies are needed on the efficacy of boric acid as a solution for recurrent BV and pregnant women should not use it due to a lack of information on safety and potential side effects.
If you decide to give it a try, be sure to follow the instructions on the label, avoid going over the recommended dosage, and never take boric acid by mouth as it is toxic if ingested. If you notice burning, discharge, irritation, redness, a rash or hives, stop using boric acid immediately and call a doctor, says Dr. Dweck. In the case that your BV returns after a boric acid treatment, consult with your healthcare provider before trying it again.
Much of current research into BV treatments focuses on how to replenish stores of good bacteria. So far, the most promising seem to be those that are native to the human vagina like Lactobacillus crispatus, L. jensenii, and L. gasseri. In particular, the L. crispatus strain is found in LACTIN-V, a live biotherapeutic product inserted with a vaginal applicator that’s currently undergoing clinical trials after a successful trial study led by Dr. Hemmerling. Of the women who were given LACTIN-V after initial antibiotic treatment, only 30% had a recurrence within 12 weeks compared to 45% of those who received a placebo.
It could be years until a BV treatment like LACTIN-V is available on the market. However, a few studies have shown non-native probiotics like L. acidophilus, L. rhamnosus GR-1, and L. fermentum RC-14 may help return the vaginal microbiome to normal. That said, it’s still unclear if these probiotics can prevent BV recurrences or might just help treat them when they arise. Often, these probiotics were successfully taken by study participants at the same time as antibiotics and during the menstrual cycle (since menstrual blood can shift vaginal pH).
Dr. Hemmerling says that non-native strains of probiotics like those found in yogurt douches derived from cow’s milk tend to not grow well in the vagina or produce acid to shift pH as effectively as native strains. But some women say they’ve been helpful in keeping their recurrent BV at bay.
While there’s not strong data to prove a direct correlation between non-native probiotics and changes in the vaginal microbiome, they’re not harmful either, and a healthy gut microbiome is linked to overall health benefits, Dr. Shepherd says. Whole foods that contain lactobacilli like yogurt and kefir, probiotic suppositories, or probiotic supplements like Happy V are completely fine to try out after consulting with a healthcare provider, she says.
If you have penis-in-vagina sex and you haven’t been using protection, condoms might help protect you from recurrent BV as well as unintended pregnancy and STIs. In fact, research suggests condoms could be just as beneficial for stopping BV recurrence as abstaining from sex altogether thanks to the protective barrier they create between you and your sex partner.
Switching up your choice of birth control to a method that contains estrogen may also be helpful, especially if you’ve noticed that your BV tends to recur when you’re on your period. Because menstrual blood has a very high pH, it increases your overall vaginal pH and causes counts of lactobacilli to tank, says Dr. Hemmerling. For this reason, getting your period or experiencing heavier-than-usual periods could increase your risk of recurrent BV if your body struggles to recover healthy amounts of lactobacilli afterwards. In fact, having a copper IUD (Paragard) has been linked to recurrent BV, likely due to the common side effect of increased menstrual bleeding, per a 2020 study in Clinical Infectious Diseases.
Think this might be the case for you? Talk to a healthcare provider about hormonal birth control methods. A couple studies show opting for a type of BC that lightens your period or stops it completely might do the trick for recurrent BV.
There are a few vaginal health habits that are important to keep in mind all the time, but they’re especially crucial if you have recurrent BV. Experts recommend taking a pass on these if you keep struggling with the condition.
In case you’re not familiar with it, douching is washing out your vagina with a mixture of fluids. Women usually douche to try to combat an odor—which, again, can happen when you have BV. However, doctors say this is a really bad idea. “Douche removes the layer or amount of good bacteria in the vaginal canal,” Dr. Shepherd says. This, she adds, “leads to less defense to offset infections.” Worth noting: A Vagisil Feminine Moisturizer gel actually halted the growth of beneficial bacteria in the vagina, per a 2013 study published in Microbial Ecology in Health and Disease. Meaning, you could actually be making your recurrent BV worse or more likely to happen again if you go this route.
It’s understandable to want to search online for recurrent BV remedies you can do at home, but vaginal steaming—where you place your exposed vagina over a steam bath—is not the way to go, no matter what you read. “This can harm the lining of the vagina, potentially with heat,” Dr. Shepherd says. “But it also disrupts the physiological ecosystem of the vaginal lining.” There’s also this to consider, per Dr. Wider: “Vaginal steaming can cause burns and inflammation as well.” And none of that will help you clear up recurrent BV infections.
Again, BV is not something that you want to just let go. “Leaving BV untreated can increase complications in a pregnancy if you get pregnant,” Dr. Wider says. “It can also make a person more susceptible to other infections like chlamydia, gonorrhea, HIV, and pelvic inflammatory disease.” Also, you can end up being really uncomfortable when help is available.
If you suspect that you have BV, see your doctor. “A trip to the doctor is warranted with a full history and physical to uncover potential causes and risk factors,” Dr. Wider says. And, if you keep getting BV, it’s important to go back for repeat care until the problem is solved. “Extended use treatment with the antibiotic metronidazole may be necessary, along with recommendations to increase lactobacillus in the body,” Dr. Wider says. But, it’s important to remember, your doctor can’t help if they don’t know what’s going on.


Posted on May 19, 2016 September 1, 2020 Last reviewed September 1, 2020


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I have been battling recurring BV ( Gardenerella vagnialis ) for months! Went on several rounds of metro gel, metro pill and antibiotic to try and clear up.
Without fail, when I would quit the medicine, issue would return; irritation, discharge, smell. I even had my IUD taken out after reading about biofilm and how it is a safe harbor… decided to do my own research further when this failed to rectify the problem completely, and started using boric acid suppositories and probiotics.
Again, as long as using something symptoms start to go away. Irritation and discharge are still present but different now. I’m wondering if I’m overdoing the probiotics… How do I just balance out at this point? So over it!!
Yours truly,
Fed Up
Age: 37
Country: US
You have the typical presentation of recurrent BV, which is hard to get rid of, but not impossible, since the biofilm is not being destroyed by the antibiotics or probiotics. The antibiotics are just killing the planktonic bacteria. You need a dedicated treatment program to get rid of the biofilm, because just getting rid of your IUD won’t solve the problem – that stuff gets everywhere (all over your vaginal cells), and is notoriously hard to break down with typical treatments, but with the right ingredients, definitely doable.
You have not ‘overdone’ the probiotics, but they are not strong enough to kill off the biofilm alone. It’s good that they make a dent in your symptoms, but your vagina needs more. A lot of antibiotics also kills off your good bacteria, so your vagina is probably not in great microbial shape right now. This needs to change.
One of the things we do very well here at All Things Vagina is BV – we’ve written swathes of information on it, which we put into a lovely little book called Killing BV . I suggest you buy it – not because I don’t want to tell you what to do, but because it really explains what your problem is in detail, so you understand the treatment plan we provide – it’s important that you understand the true nature of the problem before you start your treatment, otherwise you’ll find yourself in the frustrating cycle of thinking you’ve solved the problem, but then it just comes back.
We also provide free email support, plus access to exclusive BV content in our support section. Check out the Bacterial Vaginosis page – there is a lot of
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