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Bacterial Vaginosis: Why Does It Keep Coming Back?
Published: Dec 18, 2023
Bacterial vaginosis (BV) is a common vaginal infection that many women struggle with repeatedly. Let's explore why this pesky problem often returns and what can be done about it.
What Causes Recurrent BV?
Several factors can contribute to BV coming back again and again. These may include inadequate treatment, reinfection from a sexual partner, failure to reestablish healthy vaginal bacteria, or development of antibiotic resistance. Think of your vagina as a delicate ecosystem - when it gets thrown off balance, it can be tricky to restore.
The Biofilm Barrier
One reason BV can be stubborn is the formation of a biofilm - a thin, slimy layer of bacteria that adheres to the vaginal walls. This biofilm acts like a protective shield for the harmful bacteria, making them harder to eliminate with standard treatments. Imagine trying to clean a dirty pot with stuck-on food - sometimes you need extra scrubbing power!
The Role of Sexual Activity
Sexual activity can play a significant role in recurrent BV. Semen can alter the vaginal pH, and bacteria can be exchanged between partners. Using condoms or temporarily abstaining from sex during treatment may help prevent reinfection. It's like trying to keep a clean house - sometimes you need to limit outside 'traffic' while you're getting things back in order.
Hormonal Influences
Hormonal changes throughout your menstrual cycle or due to birth control can affect your vaginal environment. Some studies suggest hormonal contraceptives may actually help prevent BV recurrence. Your hormones are like the thermostat for your vaginal ecosystem - small adjustments can have big effects.
Frequently Asked Questions
Up to 50% of women may experience recurrence within a year of treatment.
Some studies show promise, but more research is needed.
No, but sexual activity can increase risk.
Treatment of male partners isn't routinely recommended.
No, douching can actually increase BV risk.
Breaking the Cycle
While recurrent BV can be frustrating, understanding its causes and working closely with your healthcare provider can help you find an effective management strategy.
References
- Sobel JD, Sobel R. Current and emerging pharmacotherapy for recurrent bacterial vaginosis. Expert Opin Pharmacother 2021; 22:1593.
- Bradshaw CS, et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis 2006; 193:1478.
- Swidsinski A, et al. An adherent Gardnerella vaginalis biofilm persists on the vaginal epithelium after standard therapy with oral metronidazole. Am J Obstet Gynecol 2008; 198:97.e1.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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