Why You Keep Getting BV (and How to Stop the Cycle)

26 Jun

What is Bacterial Vaginosis (BV)?

Many people are surprised to learn that bacterial vaginosis is the most common cause of abnormal vaginal discharge in people of reproductive age (yep, more common than thrush). BV is a significant disruption in the vaginal microbiome, where the balance of bacteria shifts away from protective Lactobacillus species, and towards disruptive species like Gardnerella vaginalis, Prevotella, Atopobium, and others.

Lactobacilli are (generally) the good guys. They dominate a healthy vaginal microbiome and produce lactic acid and hydrogen peroxide to keep the vaginal environment acidic and protected. BV is characterised by a loss of lactobacilli, which makes it all too easy for troublemaking bacteria to set up shop and give you grief.

BV Isn’t Just a Female Problem

Recent research highlights that BV is not just a female problem - if you have a male partner, he could actually be a key player. Recent studies have shown that just by looking at a man’s penile microbiota, they could predict if his partner would develop BV.

That’s huge.

Why Do I Keep Getting BV?!

BV is a complicated beast, and there is no single cause. Instead, let’s discuss some of the well-established risk factors.

Antibiotics: Antibiotic use can wipe out beneficial bacteria. If they don’t recover well, you’re left vulnerable to vaginal infections.
Sex: Sexual activity influences BV risk in a variety of ways. As discussed above, BV microbes could be coming from your partner in a frustrating game of ping pong (this is why condoms are essential during treatment for BV, and partner treatment should also be strongly considered). Oral sex can also increase your risk of vaginal infections by introducing microbes and altering your vaginal pH.
Menstruation: Menstrual blood is slightly alkaline, which can spell trouble for an already compromised vaginal microbiome. On top of this, the heme present in menstrual blood can act as fuel for some BV microbes.
IUDs: IUD use has been shown to increase the risk of BV, particularly where irregular bleeding is also a factor.
Immune function: A weakened immune system increases the risk of vaginal infections because poor immune defences makes it easier for bacteria and yeast to flourish.
Lifestyle factors: Wearing synthetic underwear, tight clothing, some sanitary items, sweating a lot, and washing the vulva with soap can all increase your risk of getting a vaginal infection.
Incorrect diagnosis: What looks like BV can sometimes be vulvovaginal candidiasis, aerobic vaginitis, or cytolytic vaginosis. All very different conditions that require a different approach! This is why I’m big on vaginal microbiome testing.

Treating Recurrent BV

Antibiotics don’t get to the root of the problem. If you’ve had multiple rounds of antibiotics and your symptoms keep coming back, it’s time for a different approach. Restoring and improving the resilience of your vaginal microbiome is essential to truly break the BV cycle - just killing off the offending bacteria isn’t enough.

At Sunday Naturopathy, we take a holistic and comprehensive approach to recurrent BV and other vaginal infections, often starting with in-depth vaginal microbiome testing. I cannot tell you how many women have come to see me after months (or years) of ongoing symptoms, only for us to discover they were treating the wrong condition entirely.

If you’re ready to get answers (and long-term relief), you can book your initial consultation by clicking here. Virtual appointments are available in New Zealand, Australia, and in select locations worldwide.

Appointments are held with our naturopath & nutritionist, Gemma (BNatMed), who has a special interest in hormones, reproductive and vaginal health.