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I am a 36-year-old healthy woman, but for the past year or so I have been having a recurrent vaginal infection called bacterial vaginosis. My doctor tells me that it is not sexually transmitted. For the past year and a half, I have only had one sex partner, and I only get the infection after having sex with him. I am a bit confused as to why this keeps happening and wonder if there is a treatment that would keep me from getting this infection.
Jan. 7, 2002 -- There are a few preventive measures you might try to help reduce the frequency of your infections. Though medical science has not discovered why some women suffer from recurrent bacterial vaginosis, we have a few clues.
Affecting as many as a quarter of all U.S. women, bacterial vaginosis (BV) is the most common type of vaginal infection. Most women with the infection have no symptoms. When symptoms occur, they may consist of a thin, white or gray vaginal discharge, a fishy or foul-smelling odor, and, sometimes, a sensation of vaginal itching or burning. These symptoms often increase after a menstrual period or sexual intercourse.
Sex can cause symptoms to worsen because it may lead to changes in the amounts of various bacteria that normally live in the vagina. The primary bacteria in a healthy vagina are named Lactobacillus acidophilus. These bacteria produce lactic acid and hydrogen peroxide, substances that acidify the vagina and help keep it healthy. But if an overgrowth occurs of "bad bacteria" -- Gardnerella vaginalis, Mobiluncus species, Mycoplasma hominis, and others that are usually present only in small amounts -- then bacterial vaginosis may begin. The harmful bacteria thrive when there is an abnormally alkaline environment in the vagina.
Women at higher risk for bacterial vaginosis include those who have sex starting at an early age and those with multiple sexual partners. Though BV is not considered a sexually transmitted infection, contracting a urinary tract infection or another sexually transmitted disease -- such as chlamydia, gonorrhea, or syphilis -- increases a woman's risk. Other factors that may encourage a BV infection are pregnancy, frequent douching, or using an intrauterine device (IUD).
Bacterial vaginosis can be diagnosed from a vaginal sample using tests readily available in most medical offices. Upon diagnosis, oral or vaginal antibiotics may be given to kill off the problematic bacteria. Studies have consistently shown that antibiotic treatment of male partners of women with BV does not improve the cure rate.
The problem remains that -- in some women like yourself -- the infection keeps coming back. In these situations it appears that vaginal bacteria, acidity, or other factors have not returned to normal. For women with recurrent BV infections, two preventive measures may sometimes help. These are: (1) Consuming yogurt containing live cultures of Lactobacillus acidophilus, when eaten regularly and for extended periods of time, and (2) Using a prescription of metronidazole (Metrogel) vaginal cream twice weekly to suppress bad bacteria, if recommended by your personal physician.
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