What Can I Do About Re-occurring Vaginitis?

>> Tuesday, October 22, 2013

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Good morning everyone! Today is a good day, and it is even better when we can share it with those we love. In today's world we have to be so thankful for friends and family, and their health.

Today we will discuss the topic of re-occurring Vaginitis, which includes the most common form -- Bacterial Vaginosis (or BV). As you know from our previous discussions, BV is a condition in women where the normal balance of bacteria in the vagina is disrupted by an overgrowth of bacteria not normally present there except in very small amounts. In fact, there is a flip-flop of the bacterial balance due to a disruption of the pH, which causes the healthy, protective bacteria to be replaced by the unhealthy bacteria.

Because the pH of the vagina is normally on the acidic side of the scale, most bacteria and yeast won't grow in a healthy vagina. That is why the vagina is capable of self-cleansing, and why we emphasize to you over and over not to douche or clean inside your vagina with soaps and chemicals. Most cleansers and soaps are on the opposite side of the pH scale and will flip the pH from acidic to alkaline. So, instead of improving odors and discharge, using them will actually make it worse.

This is frustrating and brings fear to many women that the infection they have is much worse, or that it may even be an STD or cancer. It is amazing how our imagination can scare us like that. BV is not an STD (sexually transmitted disease), but having it can put a woman at higher risk for "catching" one -- such as HIV, Herpes, Chlamydia, Gonorrhea, Warts (Condyloma), HPV -- if she is exposed to it by her sexual partner.
Why is this? Because BV disrupts the normal acidic pH of the vagina that works as a protective barrier against disease. Most bacteria and viruses cannot survive in an acidic environment as they need a normal or more alkaline pH to thrive.

BV is the most common vaginal infection in women of childbearing age in the United States, and any woman can get it. But, the initial cause of BV is not fully understood. There are many unanswered questions about the role that harmful bacteria play in causing BV. We do know that some activities can upset the normal balance of bacteria in the vagina and put women at increased risk including:


  • Having a new sex partner or multiple sex partners
  • Douching
  • Sexual activity in general can increase the incidence of re-occurrence because semen has an alkaline pH and is full of carbohydrates to feed the sperm and keep them healthy for their journey. It can recreate a vaginal environment that feeds the unhealthy bacteria.
  • Note: Women do not get BV from toilet seats, bedding, swimming pools or from touching objects around them.
  • Whether or not a woman has had sexual intercourse or is a virgin does not seem to make a difference in the ability to contract BV.
  • Pregnant women are the most susceptible to BV due to the drastic hormone changes that cause large fluctuations in Vaginal pH. All pregnant women are screened and treated if positive because BV can put them at risk for pre-term labor and early delivery of their baby, resulting in possible complications.

So how do know if your vaginal troubles are normal, caused by BV, or maybe something worse? Well, it can be hard to tell. Even as a Doc, I can't tell by just looking. Many women have no symptoms at all. The concern to me as a doctor is that we know BV can increase a woman's susceptibility to other STDs. Of course, that is dependent on your being exposed to them by your sexual partner.

Women with BV will usually have an abnormal vaginal discharge with an unpleasant, even fishy, odor. Many women will experience an increase in the amount of discharge that requires the use of sanitary pads or panty-liners. The discharge is usually thin, white or gray, and it can burn and itch around the outside. Burning during urination can also occur, possibly as a result of chaffing caused from constant wetness and use of pads.

It can make you feel desperate to get rid of the odor, but nothing works -- shower after shower, cover-up sprays and lotions, but you still have the feeling that everyone around you can smell you. Douching, as we've said, will just destroy and damage the vaginal mucosa and natural bacterial environment that is needed to heal your vagina.

So how does one treat it and get rid of it so it stops coming back over and over again? This usually requires a diagnosis by your doctor and then a special prescription antibiotic (tablet or vaginal cream/gel) to destroy the bad bacteria and allow the healthy bacteria to replenish the vagina.

But how do we keep our vagina healthy so it doesn't re-occur over and over? The best way is to rinse the vagina to remove the semen right after sex. Think about it, what do the guys do? They jump up, go pee and rinse off their penis -- immediately, always. But, that is actually more important for us women to do, because our vagina is like a warm little incubator. After sex, it is full of sweet alkaline fluid that bacteria and yeast thrive upon.

Anything, even period blood, can change the normal healthy vaginal environment. So, if you have re-occurring BV it is essential for you to safely rinse with water. Never put anything, not even lemon juice or vinegar, inside your vagina.

We have talked about WaterWorks and how so many women are using it for just this reason. After your infection is cleared, WaterWorks is simply the best way to keep it away. WaterWorks is FDA cleared to eliminate vaginal odors, and for some of my patients that have struggled year after year with this, this has been the first method that has worked long-term. Plus it requires no chemicals and can be used daily for feminine hygiene maintenance.
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