Recurrent Bacterial Vaginosis

 

        In my fourth blog, I would like to share information regarding the recurrences of Bacterial Vaginosis.  This infection generally originates in the female genital tract.  It was amazing that this week, I treated four patients daily with recurrent Bacteria Vaginosis (BV).  It is my understanding that the exact cause of the onset of this vaginal infection is still unknown.  The literature suggest that "it is associated with a reduction in lactobacilli (LB) and hydrogen peroxide production, a rise in the vaginal pH, and the overgrowth of BV associated organisms" (Wilson, 2004, p. 8).  Furthermore this infection is known to increase other risk factors like acquiring the Human Immunodeficiency Virus (HIV), associated with complications in pregnancy, and may have a direct connection with the pathogenesis of pelvic inflammatory disease.

        There are many unanswered questions regarding whether recurrent episodes of BV is the outcome of re-infection or due to a relapse.  According to the literature, if the condition is created by re-infection is it due to the type of pathogens and is it associated to behavior of the female or her male sexual partner?  If the infection is due to a relapse than what generates the disturbance of the flora?  As health care providers, we are aware that there are some predisposing factors linked to BV like douching, smoking, the use of an Intrauterine Device, younger age, and black ethnicity but the precise process for the beginning of BV is still a mystery.

        The literature suggests that BV may also be associated with sexual behavior, a recent change of sexual partner, and multiple partners.  Whatever the case maybe it is important to have therapeutic options for the prevention of recurrent BV.  Wilson (2004) suggests that "probably the ideal way of managing recurrent BV would be to tackle all aspects of the interrelation by replacing the lactobacilli, at the same time maintaining the vaginal pH at 4.5, and if necessary also adding in prophylactic treatment to control overgrowth of bacteria" (p. 11).  Hopefully by following these therapeutic options there will be a cure for the recurrences of BV.

 

Reference

Wilson, J. (2004).  Managing recurrent bacterial vaginosis.  Sex Transmitted Infection Journal, 80,

 

        8-11.  doi: 10.1136/sti.2002.002733