Over the years I’ve seen many patients who get recurrent BV (Bacterial Vaginosis) Infections and/or Yeast Infections. BV is actually much more common, making up the majority of all vaginal infections. It can be asymptomatic in many cases, but can also result in unusual discharge or a fishy odor. Yeast Infections are an overgrowth of Candida albicans yeast. They make up only 33% of all vaginal infections. The major symptoms are clumpy white discharge, itching, pain and irritation during sex. It is very important that neither type of infection go untreated- both can lead to PID (Pelvic Inflammatory Disease), increased susceptibility to STD’s, and in pregnancy, untreated BV can result in pre-term birth and low birth weight. 

Prevention and Maintenance of Health:

1. First and foremost, eat a healthy diet rich in fruits and vegetables and low in sugar and refined carbohydrates. Studies have shown that yeast and harmful bacteria are more likely to be a problem in people with high sugar diets. One food believed to be particularly helpful is garlic.
2. Support your immune system: reduce stress, get adequate sleep and exercise regularly.
3. Eat plain, probiotic yogurt daily. One study showed that after consuming 150mL yogurt containing L. acidophilus daily for two months, there was a 60% reduction in BV episodes. If you don’t like yogurt, click this link to see a comprehensive list of other food alternatives which contain beneficial bacteria.
4. Take probiotics- they should contain at least 1 billion CFU’s- this is information found on the bottle. Your probiotic should contain species of acidophillus if you are focusing on prevention. In addition, make sure your probiotics also contain “food” for the bacteria- this is usually an ingredient such as cellulose, pectin or inulin. One of these ingredients usually ensures that a greater number of bacteria survive between the time of manufacture and when you consume the capsule.
5. Avoid douching, and if you notice that sex can trigger infections for you, use condoms. For some women who get infections easily, both douching and the alkaline nature of semen can disrupt the vaginal pH.

Why Do These Infections Happen?

The most common causes of imbalance in your vaginal microflora are taking antibiotics, douching, sex (especially without a condom), a poor diet and a compromised immune system. Lactobacilli are the bacteria which are most dominant in a healthy vagina. They produce hydrogen peroxide and lactic acid, which  maintain a healthy, acidic pH (less than 4.5). If the vaginal pH is above 4.5, other types of bacteria are able to flourish and take over, resulting in BV. If yeast proliferate in large numbers, you get a yeast infection.

Another fact worth noting is that healthy bacteria thrive when estrogen is at its highest. This explains why many women experience recurrent infections just before or just after their periods- when estrogen is lowest. You may need to pay extra attention to your diet and use additional preventive measures during that part of your cycle.

The Vicious Cycle…

A common scenario is when a woman gets a BV infection, then takes a broad spectrum antibiotic that kills ALL bacteria- good and bad. This “cures” the BV, but since the beneficial bacteria are wiped out, yeast can grow out of control. You then take an antifungal medication, which cures the yeast, but since nothing has been done to replenish the healthy vaginal bacteria, some bad ones start to multiply again, resulting in another bacterial infection. The cycle repeats itself, and can be very hard to break.

What do I do About it?

If it’s your first time having one of these types of infections, go to your gynecologist to have it properly diagnosed. If you have had one or both of these infections before, keep in mind that BV infections are much more common than yeast. If you aren’t sure which one you have, buy some pH paper at a pharmacy or online. Use it to measure the pH of your vaginal secretions. If the pH is above 4.5, chances are good that you have BV or another type of infection in which the healthy bacteria have been killed off. If it is not above 4.5, it is more likely a yeast infection. Using pH paper is a good way to check and see if your treatment regimen has been successful- after the treatment is over, measure the pH to see if it is around 4.5. If it is still above 4.5, you need to continue treatment more aggressively.

Try one of these remedies for BV and/or Yeast Infections- but if the symptoms persist, consult with your healthcare professional to rule out other causes. Especially if you suffer from recurrent yeast infections, check with your doctor to rule out conditions such as diabetes, Cushing’s Disease, Addison’s disease, thyroid imbalance or leukemia. If you are pregnant, check with your doctor before starting any of these treatments.

Treatment Options:

1. Boric Acid Suppositories (BV). These are primarily used for treating recurring BV infections which have not responded to antibiotics. Vitanica Yeast Arrest is one commercially available product with a small amount of boric acid which is used for both BV and yeast infections, and can be used either for treating an active yeast infection or at the first sign of BV.  It is possible to use Boric Acid as part of a preventive regimen- check with your healthcare provider for specifics on how to safely use it.
2. Probiotics- oral and vaginal. I recommend this probiotic orally, and vaginally there are a few options. Intravaginally, most any basic probiotic containing lactobacillus and acidophilus which is in a gelatin or cellulose capsule will be fine.
3. Chinese Herbs- an individualized formula can be prescribed by your acupuncturist to help both with symptoms and balancing your body’s overall constitution. Please do not go online looking for Chinese Herbs for vaginal infections- this truly is something that should be prescribed by an expert, and purchased from a reliable source (not Amazon). Herbal consultations can be requested through my website.
4. If you are taking antibiotics for BV, you should also insert an intravaginal probiotic capsule containing L. rhamnosus and L. reuteri bacteria nightly. One study showed that this method is more effective than taking antibiotics alone. There is a common misperception that if you take antibiotics, you should wait until after you have finished them to take probiotics. Don’t. Studies have shown that taking them at the same time and continuing for 30 days total can make a difference in curing and preventing recurrence of BV. For BV, make sure the probiotic mixture contains L. rhamnosus and L. reuteri bacteria.
5. Yogurt- soak a tampon in plain, probiotic yogurt and insert twice daily for 2 hours, or use yogurt similar to a douche. This is most commonly used to help with a yeast infection but I have had patients report success with decreasing BV symptoms as well. This could also be a good option for prevention if you know you are prone to infections just before or after your period, or after sex.

Many women have contacted me for specific advice after reading this post- while I am happy to answer questions when possible, most of the time I can’t give advice without knowing your full health history and establishing a formal patient/practitioner relationship. If you are interested in having personalized guidance on what to do, I offer in-person consultations at my office in NYC’s Flatiron/Chelsea neighborhood. Before the meeting, I will ask you to fill out an extensive health history form online. Afterward, I will send you a comprehensive treatment plan including recommendations on diet, supplements, herbs and anything else I feel would help you. The fee for this plan is $130 and includes 30 days of email support. To schedule, you may contact the office at 917-546-4637 or book an herb consultation online.

Sources for all info in this Blog Post:

1. Women’s Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health And Wellness; Tori Hudson, N.D.
2. Cribby S, Taylor M, Reid G. Vaginal Microbiota and the Use of Probiotics. Interdisciplinary Perspectives Infectious Disease. 2009 Mar 29 (link)