It starts as an itch, sometimes pain or burning in the vagina. You might have a discharge with a foul smell. You go to the hospital, you are treated and you go home.
A month later, the itch is back and so are the other symptoms. The doctor says you have bacterial vaginosis or BV. The treatment does not seem to work and the cycle continues.
Doctors have now raised concerns about the number of women they are treating for BV and why the treatment does not seem to be working. They say despite the drugs developing a mild resistance, people should also watch their sexual behaviour.
Dr Nelly Bosire, a gynaecologist, says the major cause of BV is imbalance in the natural environment of the vaginal canal and this explains the recurrence of the infection.
“The drug resistance could arise if one person is being treated often and not the partner. It is easier once a person has been diagnosed both partners are treated to avoid recurring,” Dr Bosire says. That is why women need to know how to keep a balance.
According to Dr Bosire, consistent and frequent use of antibiotics can externally contribute to the recurrence of BV in women.
“We use antibiotics to treat so many things and once they enter the body, they circulate, killing essential bacteria. Antibiotics might end up killing other sets of bacteria, including the good ones, and a few of the bad ones that do not respond to antibiotics overgrow,” she says.
She adds that there are people with a special immune composition with specific antibodies (IGA) who are prone to BV. The antibodies protect secretory linings and are mostly produced in the reproductive tract (vaginal area).
“Some people have a defect in this particular antibody and its protective nature of keeping the bacteria in check is compromised. These people will always have BV and there is nothing they can do,” Dr Bosire says.
Dr John Ong’ech, a gynaecologist and obstetrician, says: “We are seeing some drugs, for instance, fake Augmentin in the market and once these are used, they can easily develop resistance and this can affect the treatment.”
The doctors say the resistance could be because of late treatment, sexual behaviour or fake drugs in the market.
BV is not a sexually transmitted disease, despite being an infection. However, having several partners puts one at risk of getting the infection more frequently.
The condition is not usually serious, but should be treated because having BV makes women more vulnerable to sexually transmitted and urinary tract infections.
Some of the symptoms of the condition include having thin, grey, white or green vaginal discharge, foul smell vaginal odour, vaginal itching and burning during urination.
However, a team of doctors in the US has introduced a new type of treatment (vaginal transplant) for vaginal infections.
The treatment is aimed at boosting fluids, otherwise produced naturally by the vagina, to cleanse themselves.
It is a radical method, whose target is to boost natural immunity and healing of the vaginal tissues, as opposed to the routine method where antibiotics are administered and fail to work.
The team say this method will seek to address low immunity problems suspected to be caused by continual use of antibacterial and recurrence of the infection. They add that although antibiotics can treat BV, the infection always recurs.
In their study that sampled 20 women, the researchers said they had gained some insights into what might make an “ideal” donor.
Vaginal fluid samples dominated by a bacterium called Lactobacillus crispatus tended to have higher protective lactic acid content and a lower pH, which might be beneficial, they said.
As a precaution, donors were asked to abstain from sex for at least 30 days before giving a sample and were screened for any infections, including HIV, to prevent them from being passed on to a recipient.
The study findings published in the journal Frontier in Cellular and Infection Microbiology revealed that vaginal transplant was the best and ideal way to treat the recurring BV.
Dr Laura Ensign, a researcher, said the donation was a self-collection, “which we know people tend to prefer”.
Treating vaginal irritation at home
● Avoid scented pads or toilet paper, creams, bubble bath, feminine sprays, and douches.
● Use water and a plain, unscented soap to regularly clean your external genital area. But do not wash more than once a day. Doing so can increase dryness.
● Always wipe from front to back after having a bowel movement.
● Wear cotton panties (no synthetic fabrics), and change your underwear every day.
● Do not scratch to avoid further irritating the area.