Bacterial Vaginosis

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What is it? How can you prevent it? How can you treat it naturally?
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troubled woman
Diana
29 June 2018
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What is Bacterial Vaginosis? In short it is an imbalance of the vaginal flora. It is NOT a sexually transmitted infection.
So how does this happen? There are several ways this could happen. Nutrition, medication, sex and such.

What is Bacterial Vaginosis

The longer version of it is that it is indeed an imbalancemonster bacteria of the vaginal flora, which can be caused by a whole host of influences. You will know that you have Bacterial Vaginosis when you find that you smell (often like fish), that you have the odd itch, or the odd burning sensation, more discharge, and that the discharge grey or white. You can have burning with urination as well. Some women do not have obvious symptoms.

The vaginal flora should have a higher amount of lactobacilli over others. When you have Bacterial Vaginosis, lactobacilli are in the minority. Therefore you do not have the natural slightly acidic environment anymore that you’re supposed to have in your vagina.

What are the consequences

The problem with Bacterial Vaginosis is that it is an imbalance of the naturally occurring vaginal flora and with that you have a higher chance of ending up STI’s. I believe this is because there is already a situation of not being healthy, which can be solved by improving health through diet, supplements and toxin avoidance in general.
The next problem is that when you are pregnant, there is a chance of an early birth or miscarriage. This doesn’t happen to all pregnant women, but women with Bacterial Vaginosis more frequently end up with early births than women who do not have Bacterial Vaginosis. Though the vast majority of women with Bacterial Vaginosis who are pregnant do not have any problems at all. Therefore I wonder whether it is a case of generally not being fit, more than the Bacterial Vaginosis. The fact that someone has Bacterial Vaginosis already shows that health is not as well as it can be. But this can easily be improved.

How do you get “infected”

You don’t really get infected as such. This is because it is an imbalance in the vaginal flora. Now that is not to say that when you are frequently in contact through sex, tampons, or such, with a source that has a very different bacterial set that this won’t have an effect. It actually does, but when your vaginal flora is healthy it will bounce back very quickly. When your vaginal flora isn’t all that great, it will have an effect and can actually be the point where it all goes wrong and you end up with Bacterial Vaginosis.
The only reason for that to happen is because your own flora is already on the brink of imbalance, so it’s just a push in the wrong direction.

Prevention

Prevention of ending up with Bacterial Vaginosis is the best way to go about it. It can be irritating to deal with and a pain to get rid of. But it is fairly easy to prevent.

Nutrition

Probiotic foods and drinks. Another way is to use supplements. Supplements can be used in combination of probiotic foods and drinks. Or supplements can be used until you have wrapped your head round the probiotic foods and drinks.
The best way to prevent Bacterial Vaginosis is the use of probiotic foods and drinks, alternatively you can choose to use supplements. Probiotic foods are sauerkrauts, yoghurts, milk kefir, raw cheeses, water kefir, kombucha and such.
Most can be easily made at home. Sauerkraut is very simple to make. Most sauerkraut available on the market is not raw. The moment a probiotics food or drink is pasteurised it is not probiotic anymore. Therefore raw sauerkraut, live yoghurt and such.

What people seem to forget is that back in the day, before we have refrigerators, people used to ferment their foods to keep it from spoiling. In those days we would get enough fermented foods on a regular basis to keep our bodies healthy, we would replenish what would be lost. These days we don't anymore. But our bodies evolved that way and we need to replenish, like we used to do. This is one of the reasons why illnesses such as Bacterial Vaginosis are so much more prevalent in our modern day and age.  

For some it is difficult to get used to these traditional fermented foods as they haven’t grown up with them and haven’t gotten the taste for it. The taste for it can be acquired though. It takes a bit of effort, but once you learn to appreciate the variety of flavour of fermented foods, you’ll fall in love.
Research (1) has shown that probiotics can have a preventative effect on recurrence.
I think it would be a very good idea to use a probiotic supplement in case you go for the mainstream treatment with antibiotics. Make sure you do not use them at the same time though.

Citrus Fruits (19) are a great source of vitamin C. Vitamin C boosts your immune system. Make sure you eat plenty of foods with vitamin C to prevent illnesses. In case you already have Bacterial Vaginosis, make sure that you get about 2.000 mg a day to help your body in the healing process.

Folate (20) is a very important nutrient for a large amount of body actions. And also for healing. Do make sure you have folate and not folic acid as about 50% of the population cannot metabolise folic acid properly into folate.
Folate is a supportive nutrient to help you heal from Bacterial Vaginosis and also to prevent getting it.

Clothing

Make sure that you wear cotton, breathable underwear. Underwear that keeps the moisture in will create a breeding ground of nasties that you really do not want near your vagina.
Also be careful with thongs. They have a very narrow piece of fabric that can carry all kinds of nasties from the anal area to the vaginal area because it is so short and tight.
Tight trousers also do not help as it creates an environment in which it is difficult to have airflow.

Hygiene

When you have been to the loo, make sure that you wipe from front to back. You do not want to wipe whatever is at the back to the front. This can cause quite some trouble.

Influences

There are several influences in life that can create a good ground for an imbalance to build up from. Some have a higher impact than others.

Diabetes

Women with diabetes are more likely to suffer from Bacterial Vaginosis. The reason is that their blood sugar problems create a situation in which there is more blood sugar in the vaginal area, which feeds the pathogenic bacteria, so they get a chance to overgrow.

Nutrition

When your diet is insufficient, your body doesn’t get all the building blocks it needs to be able to keep everything working smoothly in your body. This also goes for the vaginal flora. One of the most important pieces of nutrition that your body will need to keep the vaginal flora (and the gut flora) in a good shape is fermented foods. The other problem with nutrition is the toxins in the food. These will not help keeping your microbiome healthy. Therefore it is important to eat a diet that doesn’t contain processed foods. The foods should ideally be of organic farming. And fermented foods will help you keep your microbiome healthy.

Douching

Regular douching with commercial douches can cause the normal vaginal flora to become imbalanced. The reason is that most of the ingredients in commercial douches are simply not compatible with the vaginal flora. Therefore it is recommended to not douche. In case you feel you really must, take something like live yoghurt mixed with water.
It is also not a good idea to get soap, shower gel or such near your vagina. Cleaning with plentiful water is enough.
Unless there is a medical reason for douching of course.

Medication

Medication can mess with your microbiome. This can then in turn cause trouble for your gut flora, but also your vaginal flora. It is all linked together. Medications that are well known to cause these kind of problems are antibiotics and the birth control pill. However, most medications have an influence, some just not as bad as others.
Therefore it is important to think well before you take medications. When you need to take medications, do find a way to improve your health, so that you can minimise the amount you use and with that the effect it has on your health. Always make sure that you eat a healthy diet, so that you have the building blocks that you body needs available to your body.

Sex

When you have sex you end up introducing the microbiome of your partner to your microbiome. Then there is also the sperm that is of a very different chemical structure than the vaginal flora. Normally this wouldn’t cause any trouble and the vaginal flora will bounce back fast, but when there is already a difficult situation, this can tip the balance.
Having a female partner is not going to prevent this, as research has shown that women with a female partner have an increased risk of developing Bacterial Vaginosis.

Another point of sex is when sex toys are used. They do need to be kept very clean. The moment you end up not properly cleaning there is a breeding ground created on the toy. This can make the situation much worse.

Condoms, which usually contain spermicide, can also upset the balance of your vaginal flora. (7)
However, this article (6) describes how condoms can prevent getting Bacterial Vaginosis. I guess the jury is likely still out on this and more research is needed to come to a good conclusion.
When you already have a compromised microbiome it’s not going to be nice. Therefore keep them clean.

In one of the pieces that I read it was stated that intact men can be “carriers” because of them keeping the bacteria under their foreskin. This really bugged me as I find this utter nonsense. As far as I know men clean themselves under the foreskin whenever they shower, so this is a non-issue to me. Just like for women, men also need to clean their genitals. It actually pissed me off that Bacterial Vaginosis is also used to keep all the myths against intact going.

It is also possible for someone who is sexually inactive to develop Bacterial Vaginosis.

Period

Your period, which is totally natural to happen, has a bit of a different consistency than your normal vagina does. When your vaginal flora is already compromised, having your period can in fact be the tipping point.
The various period pieces can aggravate this. Tampons tend to contain toxins, which can aggravate. Period pads also contain toxins that can aggravate the situation.
There are also cloth period pads. Be sure to wash them well and make sure you put vinegar in the rinse cycle so that they don’t have any soap left in them.
Cups need to be thoroughly cleaned between and after use. When there is anything left in them, this can tip the balance to Bacterial Vaginosis.

Women after menopause can also be affected. This is not something that only happens to women of childbearing years.

IUD (8)

It is known that women with an IUD are more prone to Bacterial Vaginosis. The reasons for it are however not fully known. The theory is that it could be that there is an increase anaerobic bacteria in the vagina because of the string that is in the vagina hanging down from the IUD. There is also something in the uterus that would normally not be there. What seems to further be a theory is that the periods of women with an IUD are often heavier and longer in days in case they use a copper IUD. All seems plausible to me, so in case you do have recurrent Bacterial Vaginosis, consider another form of birth control that is not an IUD, contains hormones or spermicide.

I recommend going natural and getting to know your cycle, so that you know exactly when you are fertile and can prevent pregnancy that way. It is relatively easy to learn and very safe.

Smoking

Smoking messes with your inner balance. It actually has an anti-estrogenic effect. This throws you hormones out of balance, which can have an influence on Bacterial Vaginosis.
Another point to smoking is that the toxin benzo[a]pyrene diol epoxide in there creates an environment in which the lactobacilli that you so desperately need die off.

Stress

Stress can cause a whole host of problems and will not help with Bacterial Vaginosis either. Try to minimise stress in your life. There are a variety of ways to deal with stress in a positive way. Learn about them and put them into practise. One of the ways that I find very helpful with stress is mindfulness.

How it gets diagnosed

It depends on your GP whether a swab will be used or whether you’ll right away get a prescription. These days many just get a prescription based on symptoms.
When a swab gets done this is usually a swab of the inside mucous of the vagina is taken. This gets tested for the smell, the acidity and the presence of indicatory cells.
The Amsel criteria are usually used to determine whether or not you get the diagnosis.
With the Amsel criteria there are 4 points that are looked at: 1. The discharge, 2. the indicator cells, 3. the PH level higher than 4.5, 4. Fishy smell.

Mainstream treatment

The most common treatment in mainstream medicine is with an antibiotic, such as clindamycin or metronidazole. These antibiotics are considered safe to be used in the second or third trimesters of pregnancy. The problem is though, that with the use of antibiotics the good and the bad gets killed off. This means that there is a high chance that the bacteria you want in the minority get a chance to overgrow again after treatment. Some studies show a 50% recurrence rate. That doesn’t sound like a good option to me.

Natural treatments

There are a whole host of natural treatments, some work faster than others, some are more aggressive than others. Therefore have a read through them and see what suits your needs best.

Yoghurt (19)

Natural yoghurt has lactobacilli in there. This can help improve your vaginal flora. Research hasn’t been consistent in this. So it is a matter of trying and seeing whether it works for you. It would be good to eat yoghurt, daily. It can also help to put yoghurt into your vagina to give your vagina lactobacilli. It may require some weeks to get it all sorted.

Apple Cider Vinegar

The pH in the vagina is not in the right values. Apple Cider Vinegar can help fix that.
The way to use it is to use 2 tablespoons of apple cider vinegar on 250 ml water, rinse twice daily, until symptoms disappear.
 

Boric Acid (5)

Personally I wouldn’t recommend this, as it is toxic. But for some this may be a last resort before going to get antibiotics, so I’ve decided to include it anyway for that reason.
Do not use when pregnant, do not ingest.

It seems that boric acid capsules of 600mg put into the vagina for 2 weeks in the evening.
The article mentioned above explains that they do not know exactly how it works, but that it does work in 98% of the cases, which is a pretty good score.
Before using, please do your own research, I am not confident it is the best way to go.

Hydrogen peroxide (3)

The study on Hydrogen peroxide really looks like that could be a very good idea. The study was done with women who had recurrent Bacterial Vaginosis, so they had already been treated with antibiotics before. The study showed that the treatment was very good. They used 3% hydrogen peroxide, for 1 week, daily in the evening.
The results at the 3 months follow- up were the same as with the commonly prescribed antibiotics. But without the negative effects of the antibiotics because hydrogen peroxide facilitates the restoration of the normal vaginal flora in 100% of the cases and the normal pH of <4.5 in 98% of the cases. Now that is really good news. It also helps with the disappearance of the cells and pathogenic flora that we don’t want in the vagina in 100% of the cases.
I think hydrogen peroxide sounds very good, from all that I have read, I think this would be my favourite to try. Likely together with increasing fermented foods and maybe a probiotic supplement to make sure I’d be done with it long term.

Coconut oil

Coconut oil is antiviral, antibacterial and antifungal. Can’t go wrong with coconut oil. Coconut oil is said to contain 30%-40% Lauric Acid. Lauric Acid is very good for you. It strengthens the immune system and that is what makes Coconut oil so helpful. Combined with some tea tree essential oil, this can be a very good solution.
Do add coconut oil to your diet, it is healthy in all kinds of ways.
In case you would prefer not to use tea tree oil, so you can also put coconut oil in your vagina on it’s own. Some recommend soaking a tampon in it and putting that inside. I think just a teaspoon will do just as well.

Herbs

There are several herbs that have shown to be beneficial with regards to the treatment of Bacterial Vaginosis.

Aloe Vera (14)

Aloe Vera is a very nice soothing plant. You take the gel that is inside the leaves and apply this. Do this for about 2 weeks. Aloe Vera has been shown to have antibacterial properties.

Black Walnut (15) (16)

The green hulls of the black walnuts are known to be antifungal, antibacterial, and antiparasitic. Therefore the hulls can be ground into a powder to be used medicinally. The powder helps with infections such as Bacterial Vaginosis. This comes mostly in the form of a tincture. So you will need to apply some drops of the tincture to your genital area. As many tinctures are made with alcohol, it may burn. You can also try to find a non-alcoholic tincture. Use until you have no symptoms anymore.

Calendula Officinalis (11)

Calendula is well known for its antiviral and antibacterial properties. It is used both in herbology and homeopathy for various complaints.  
Calendula cream is often used for nappy rash.
For Bacterial Vaginosis, you can also use Calendula to help with the irritation and red skin. You make a Calendula tea by taking 2 tablespoons of dried Calendula flowers, add 250 ml boiling water. Leave it to cool down, soak a cloth in it and put that on your genital area.

Chamomile (24)

The study referenced here shows that chamomile has an amazing antioxidant, antimicrobial, anti-inflammatory, and anti-diabetic effect. This is really cool to know. I do love chamomile for various reasons in healing. It helps with so many things from cold to Bacterial Vaginosis.
You can use this in combination with the other options that I mention here.
Take 2 tablespoons of dried flowers. Pour 250 ml of boiling water over it. Let it steep for 15 minutes. Strain and drink.
You can use this tea as a douche as well.

Echinacea (17)

This herb is known to boost your immune system. So whichever other method of curing your Bacterial Vaginosis you choose, always use Echinacea as well to help your body.

Use as is indicated on the packaging.

Fenugreek

Fenugreek boosts the immune system and it helps the vagina maintain the right pH level.
Fenugreek can be used as an infusion. 1 teaspoon of Fenugreek seeds in 250 ml water. Leave it to soak overnight and drink it in the morning before breakfast. Use this for about a week. Alternatively make a tea, by pouring 250 ml hot water over 1 teaspoon of Fenugreek seeds. Let it steep for 10 minutes, strain and drink. You can sweeten it. You can drink the tea 2 to 3 times a day.
Another way for taking Fenugreek is to use a teaspoon of Fenugreek powder in yoghurt or so and eat that daily until the Bacterial Vaginosis has cleared up.

Garlic (2) (19)

Garlic has antibacterial properties, research shown that. I read a study of July 2014. In this study they used garlic tablets orally. The conclusion of this study was that garlic could be a suitable alternative to the metronidazole antibiotic. Both the garlic tablets and the antibiotics were orally administered in this study.
From what I have learned over the year is that garlic is much more potent when it is used raw and fresh. I have read that there are quite some women out there who put a raw garlic clove up their vagina with great success. I would recommend trying that, as that would be a very natural way to do it.

Goldenseal (18)

Goldenseal is known to be antibacterial. This is because one of its compounds is berberine. Berberine also strengthens the immune system by activating white blood cells. This means that the body helps itself much better.
The same as goes for Echinacea goes for Goldenseal. When choosing to use any other method of curing your Bacterial Vaginosis, do add this one as well, as your body will do much better at healing this way.
Use as is indicated on the packaging.

Neem (9) & (10)

Neem is a herb often used ayurvedic healing. It is known to be antiviral, antibacterial and antifungal. Research has found that neem is a good remedy for various vaginal and other infections, such as viral, bacterial & fungal / yeast.

You can use it by mixing the powder with some water, making a paste. That you can apply around and slightly inside the vagina.

Sage / Salvia Officinalis (21)

You can use a tea of Sage for Bacterial Vaginosis. Take a handful of sage, put that in a mug, add 250 ml boiling water, let it steep for 15 minutes. Strain and drink. Do this 3x a day. It will decrease irritation, redness, discharge and the burning feeling.
Furthermore try rinsing your vagina with the tea.

Essential oils

I have a love for essential oils. I have been educated in the use of essential oils many years ago, so it is often my go-to remedy.
I was therefore hoping to find that essential oils also have their place in the treatment of Bacterial Vaginosis and yes, there are options.
In case you feel like mixing a few of the essential oils mentioned below. Use a maximum of 10 drops total in the 30 grams of coconut oil.
Lavender has a strengthening effect on the oils that you use, therefore you can always add a few drops of lavender to any mix you make.

Clove oil (22)

Clove oil is an antibacterial essential oil. Use it by taking 30 grams of coconut oil, melt it on low heat, add 5 to 10 drops of clove oil, stir well, let it cool down. Apply to your vagina. It will melt and spread around on its own.

Lemongrass (23)

Lemongrass oil is an antibacterial essential oil. Use it by taking 30 grams of coconut oil, melt it on low heat, add 5 to 10 drops of lemongrass oil, stir well, let it cool down. Apply to your vagina. It will melt and spread around on its own.

Oregano oil (12) (13)

Oregano oil is an antiviral, antibacterial and antifungal essential oil. Research has shown that oregano oil works well. It also shows that the chances of recurring are minimised by the use of oregano oil.
Take 30 grams of coconut oil, melt that on very low heat. Add 5 to 10 drops of oregano oil, stir well and keep it off the heat.
Check whether you react to oregano oil, just like with the tea tree oil mentioned above before use.
When you’re good to go take a small spoon full and put that into your vagina, It will melt and spread around on its own.

Sage oil / Salvia Officinalis (21)

Sage oil is an antibacterial essential oil. Use it by taking 30 grams of coconut oil, melt it on low heat, add 5 to 10 drops of sage oil, stir well, let it cool down. Apply to your vagina. It will melt and spread around on its own.

Tea tree oil (4)

This study shows that tea tree oil in a carrier oil, preferably coconut oil, has a very good effect. I recommend that you take 30 grams of coconut oil and melt that on very low heat. Add 5 to 10 drops of tea tree oil, stir well and keep it off the heat.
Do make sure you do not react to tea tree oil. It is rare, but it does happen, as with anything else. Test it on the inside of your wrist or elbow. Wait 48 hours and when you do not see an obvious reaction, you’re good to go.
When you buy tea tree oil, make sure it is 100% essential oil. There are many rubbish brands out there, so make sure you look into it well, before purchasing.
I have read several recommendations online. One mentioning soaking a tampon in pure tea tree oil and then putting it in your vagina. Please do not do that. Essential oils are much to strong for that.
The best way to go about it is have the mix that I mentioned above in the fridge and take a teaspoon of that and quickly put that in your vagina, before it melts, at bedtime. It will then melt in your vagina and do it’s work while you sleep.

Thyme / Thymus Officinalis  (21)

Thyme is an antibacterial essential oil. Use it by taking 30 grams of coconut oil, melt it on low heat, add 5 to 10 drops of thyme oil, stir well, let it cool down. Apply to your vagina. It will melt and spread around on its own.
 

Homeopathy

It depends on your symptoms which homeopathic remedy you can get prescribed. There are quite a few that could be used. Such as: Belladonna, Caladium, Calcarea carbonica, Cannabis sativa, Cantharis, Helonias, Hydrastis, Kreosotum, Medorrhinum, Thuja, Sepia, Staphisagria, Pulsatilla, Platina and some others.
The 4 most commonly used ones are Kreosotum, Pulsatilla, Sepia, and Calcarea.

Calcarea carbonica

Calcarea carbonica is the remedy when the discharge is white. It is a remedy for women, young and old. The profile of Calcarea carbonica is of a woman with chronic, milky discharge, accompanied by itching. The type of woman is usually a plump, weak-muscled, sweaty, passive but stubborn type.

Kreosotum

Kreosotum is the remedy most often indicated when Trichomonas is suspected. When the vagina is red, raw, and irritated. And the external genitalia are as well due to the vaginal discharge that damages the surface of the skin. With this remedy there is always a unpleasant clear smell.

Pulsatilla

Pulsatilla is a mother and baby remedy. Many problems that are typical for mothers and babies are easily resolved with Pulsatilla, provided that the symptoms are the ones that Pulsatilla is indicated for.
The symptoms of Pulsatilla are changeable moods, weepiness, desire for affection, thirstlessness, and aggravation in a warm room. The discharge for Pulsatilla is thick and  creamy. Pulsatilla is also used for thrush in mother and baby.

Sepia

Sepia is also a specific remedy for women, including young women. The discharge is yellow or green. Itchiness and a smell are usually also the case.
A very specific symptom for Sepia is the feeling of “bearing down”. When this is not there, then Sepia is not indicated. The symptoms are usually worse mid-cycle to pre-menstrual. So this is basically the last half of the cycle.
 

References:
https://www.nhs.uk/conditions/bacterial-vaginosis/

https://en.wikipedia.org/wiki/Bacterial_vaginosis

(1) https://www.ncbi.nlm.nih.gov/pubmed/24299970

(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166107/

(3) https://www.ncbi.nlm.nih.gov/pubmed/14676737

(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC89050/

(5) https://www.livestrong.com/article/148414-boric-acid-for-vaginitis/

(6) https://www.womenshealth.gov/a-z-topics/bacterial-vaginosis

(7) https://academic.oup.com/jid/article/181/2/595/822542

(8) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285477/

(9) https://www.nap.edu/read/1924/chapter/2

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761146/

(11) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841996/

(12) https://lib.dr.iastate.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=4973&context=etd

(13) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876125/

(14) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763764/

(15) http://ctl.w3.uvm.edu/omeka/exhibits/show/uvmtrees/bw_intro/black_walnut_medicinal_ethnobo

(16) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3856033/

(17) https://www.ncbi.nlm.nih.gov/pubmed/15035888

(18) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100400/

(19) https://www.unh.edu/healthyunh/blog/nutrition/2017/01/5-immune-boosting-foods

(20) http://d-scholarship.pitt.edu/8043/

(21) http://citeseerx.ist.psu.edu/viewdoc/download;jsessionid=2EA2C898C48676AE5BC0414924561147?doi=10.1.1.410.4008&rep=rep1&type=pdf

(22) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769004/

(23) http://eprints.manipal.edu/2041/1/7396-20360-1-PB.pdf

(24) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074766/


 

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