Table of Contents My story Disclaimer Overview What is Bacteria Vaginosis What it isn t... 10

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1 1 P a g e

2 Table of Contents Table of Contents... 2 My story... 7 Disclaimer... 7 Overview... 9 What is Bacteria Vaginosis... 9 What it isn t Is BV treatable? Curable? How common is BV? BV and race BV and sex BV and age Causes of BV These don t cause BV Symptoms of BV Diagnosing BV BV and HIV Underlying causes of BV Associated conditions for BV Complications for BV BV re-occurrence P a g e

3 How is BV diagnosed Questions Urinary sample Pelvic exam Whiff test Inpatient care Preventing BV Treatment options Medications Additional considerations from the medical viewpoint Antibiotic side-effects How long before relief is felt? Surgical care Activity Consultations with specialists Diet Preventative treatment also known as prophylactic treatment Cost of the medication Follow-up Prognosis P a g e

4 BV and pregnancy Who should be checked for BV How does having BV affect my pregnancy? What are the consequences of BV Treatment for high-risk and low-risk pregnant women with BV Preventing BV during pregnancy Pre-pregnancy Self care options for BV and pregnancy Follow up Natural approaches to BV for pregnant women Lactobacillus products Natural remedies Herbs and extracts Barberry Boric acid Colloidal silver Garlic Gentian violet Grapefruit seed extract Goldenseal P a g e

5 Olive leaf extract Oil of oregano Neem Tea tree Oil Tracheal Homeopathy: Other treatments Hydrogen peroxide Yogurt Douching Boosting your health while treating for BV Healthy diet Supplements Stress free lifestyle Sleep patterns Water Pulling it altogether to be BV free Eliminate bad bacteria Increase the good bacteria Boost the immune system P a g e

6 Avoid re-infection Enjoy a healthy lifestyle Helpful tips and hints Itching Cold compresses Warm baths Clothing Toiletries Summary Bibliography P a g e

7 My story After years of struggling with BV I have to tell you there is nothing as embarrassing, as painful, or as annoying as having a re-occurring Bacteria Vaginosis infection. It s difficult to deal with, difficult to have a sexual relationship with, and almost impossible to live with. I tried everything. From the drugs to the different drugs to the suppositories and even more drugs. Nothing worked. The first round of drugs worked for a week then I started having sex again with my boyfriend and I swear it came back overnight. I hated it and my life for so long. Now I have to tell that my BV is finally gone. Not just gone for a week or two, but gone as in forever! It s such a relief. I can t believe it. My self confidence, heck, I m back! Thank heavens, I have finally found the answer. And you can have it to. Read on for a permanent answer to your BV hell! Disclaimer I am not a medical doctor or healthcare practitioner. While I am comfortable using any and all of the practices mentioned in this book, is it prudent that you discuss any practices you re considering with a qualified healthcare practitioner before use, especially if you re pregnant, nursing or have any pre-existing health conditions. While many people have safely used the medical practices contained within this book, we cannot guarantee the same safety or results with each person. This book is not intended to diagnose, treat, cure, or prevent any disease or medical conditions, nor is it intended to prescribe forms of medical treatment. The authors do not distribute medical advice and are not responsible for use or application of the information contained herein. This book has not been evaluated by the Food and Drug Administration (FDA). We are legally obligated to inform you that this book is to be used as a reference source only. This book is legal property of Yew First Publishing, Inc. and by using this manual you agree that Yew First Publishing is not responsible for the use or misuse of any information contained within this guide. Always consult a medical doctor before starting a new program. 7 P a g e

8 Introduction Traditional or allopathic medical treatments can help some of the women and some of the cases some of the time but they often cause just as many problems as they are trying to solve. Due to the nature of the infection, there is no one answer that fits everyone. However, there are many good answers that have helped thousands of women the world over. This books aims to: 1. Educate you the nature of the problem 2. Show you what happens when you go to a doctor 3. Offer you alternatives to traditional medicines 4. Give you options that WORK 5. And instruct you on how to change your habits and lifestyle so that you can remain Bacteria Vaginosis free. It is possible to be free of this problem that plagues over 2 million women in the US on any given day. Believe it. The answers are here. Try them. You won t be sorry. 8 P a g e

9 Part I Overview In this section of the book, we are going to look at all the different aspects of Bacteria Vaginosis like what exactly BV is and isn t, who it affects, how serious it is and how it is diagnosed. What is Bacteria Vaginosis Simply put, Bacteria Vaginosis or BV for short is a type of vaginal infection. Over the years this condition has been called many things. The Gynecology division of the University of Washington out of Seattle lists the following names the condition has been known by. Some of these will sound familiar to you such as: Nonspecific Vaginitis Haemophilis vaginalis Vaginitis Corynebacyterium vaginalae Vaginitis Gardnerella vaginalis Vaginitis Anaerobic Vaginosis Bacteria Vaginosis 9 P a g e

10 Regardless of the name of the problem, it s important to understand that it is really an overgrowth of the wrong type of bacteria. The healthy vagina is an interesting blend of good bacteria and a little of the more harmful bacteria. When we say good bacteria, we re talking about Lactobacillus. A healthy vagina contains as much as 90 to 95% Lactobacillus in the various bacteria population. This is important because Lactobacillus produces lactic acid which maintains the ph of the vaginal flora in the normal range between 3.8 to 4.5. In this natural ph range several good things happen. The lactic acid: inhibits the growth of bacteria, produces hydrogen peroxide which keeps the healthy vagina acidic produces bacteriocidin There is some scientific thought that Lactobacillus may also influence how the bacterium sticks to the epithelial cells. The problem with a delicate balance of bacteria is that the balance can be easily thrown off allowing the bad bacteria to become the dominant bacteria. What it isn t Bacteria Vaginosis is not technically an STD. That doesn t mean it isn t listed this way on some web sites, including the Center for Disease Control. However, although there are some 10 P a g e

11 apparent links between Bacteria Vaginosis and sexual activity, there are many non-sexual causes of BV. As it is not transmitted sexually, it is not common to treat a woman s sexual partner. It is however, more common in women who are sexually active. It can also appear to be a symptom of a sexually transmitted disease. If you look at the word vaginosis more closely, you ll see that it also means the inflammation of the mucous membranes that line the vagina. Bacteria Vaginosis is only one of two different Vaginosis conditions, with the other being Infectious Vaginosis, which is caused by sexually transmitted diseases. Is BV treatable? Curable? Yes, BV is both treatable and curable but it is possible to contract it again. In fact, recurring BV is a big problem. This stems from several reasons, including: The underlying cause not being addressed The symptoms being masked through various treatments, dropping the population of bad bacterial for a short time only The woman s sex partner is carrying the bacteria The woman s sex partner(s) semen having a ph balance that affects the women s vaginal ph Lowered immune system Unhealthy lifestyle perpetrating the system 11 P a g e

12 How common is BV? Bacteria Vaginosis is the most common infection of all women within childbearing age. It is also common in pregnant women. There are multiple figures giving a percent of occurrence with pregnant women, but the range appears to go from 12-20% of all pregnant women being infected. It s estimated that over 2 million women have BV on any given day in the US. BV and race According to an article published in the February 2010 American Academy of Nurse Practitioners Journal, research has shown that BV occurs more commonly amongst African America women than non-hispanic white women. The research is unable to give a clear reason for this at the time. BV and sex BV is typically a female problem with men rarely developing any problems. It s important to understand however that those men who have sexual relationships with women infected with BV are found to have colonies of the same bacterial strain in their urethras. BV and age BV is known to typically cause problems with women of reproductive age. There are documented cases of BV occurring in girls who have yet to reach puberty and in girls that are still virgins, but the risks are much lower. 12 P a g e

13 Causes of BV Like many medical conditions, experts can t pinpoint the exact causes of BV. But anything that you do that introduces different bacteria into the vagina runs the risk of changing that delicate flora balance. There are certain situations that can contribute to the vaginal flora becoming out of balance. Some of these conditions include: Having multiple sexual partners o There is no clear cut answer as to the cause or the transmission of BV, but experts say that minimizing the number of sexual partners is a step in the right direction. The rates of BV occurrences goes up the more partners a woman has. o Having a new sexual partner. o Not using condoms can increase the chances of developing BV. o Anal sex, manual sex and vaginal intercourse are all at risk of introducing bacteria to the vagina. Sex toys o Sharing sex toys can introduce bacteria to the vagina as well. Lesbian sexual relationships o As BV is a female condition, it is under consideration as a sexually transmitted disease in lesbian relationships. Being a smoker 13 P a g e

14 o Smoking, particularly being a heavy smoker increases your risk for many problems and BV is one of them. If you douche o Douching can upset the delicate balance of the vaginal flora Lacking in vitamin B6 o Deficiencies in certain vitamins and minerals can bring out changes in the body s natural balance Stressful lifestyle o Stress can create many physiological changes in the body Rundown physical condition o When you become physically run down, your body goes through various changes that can open the doorway for infections of all kinds. Poor hygiene o Poor bathroom hygiene, such as improperly wiping after a bowel movement, can lead to bacteria entering the vagina causing many problems Intrauterine device o The use of intrauterine contraceptive devices (IUD) increase the chances of BV Lack of vaginal lactobacilli through other factors o As it is this lack of good bacteria that allows the bad bacteria to grow and develop into BV, anything that reduces these good bacteria is going to cause problems. Recent use of antibiotics 14 P a g e

15 o These are well known to disrupt bacteria balance throughout the body. Lack of sleep o This lowers your resistance to infection. Lack of a healthy diet and lifestyle o This problem lowers your immune system. These don t cause BV There are many different bits of information floating around giving out mis-information. Some of this incorrect information is about the causes of BV. This is where we debunk these rumors. BV is not transmitted or caused by: Sitting on chairs or toilet seats Mattresses, sheets, or blankets Swimming pools Or touching objects around you Symptoms of BV Symptoms vary with this condition but the main ones are usually: Vaginal discharge 15 P a g e o A discharge that is grayish-white or milky in appearance

16 o Thin constituency o May contain small bubbles in the discharge An odor often called 'fishy,' which is particularly noticeable during sexual activity, is primarily due to the bacteria imbalance. The walls of the vagina can be coated with this thin white discharge as well The walls of the vagina can have a wet appearance although there is often no evidence of any inflammation. Less common symptoms occur as well but could be from a secondary condition as they aren t normally associated with BV and these include: Itching or burning sensation in or around the vaginal area A burning sensation during intercourse A burning sensation during urination According to research, approximately half of the woman with BV has no symptoms at all. Keep in mind that other conditions, such as a yeast infection, can show similar symptoms and be easily confused with Bacteria Vaginosis. Because there is room for error, it s important to remove the confusion and get tested properly. Self-diagnosis, unless this is a reoccurring BV situation and you are confident it s the same thing again, choose a treatment that s right for you. Go to a doctor, have him diagnose the condition and then move forward. Make sure he has the lab tests done to prove 16 P a g e

17 it s BV and not an underlying disease, which must be treated before your Bacterial Vaginitis will disappear permanently. Another type of vaginal disorder, to add to the confusion, is atrophic vaginosis. This is predominantly an issue for women that are post menopausal or those women who have undergone surgery to remove their ovaries. It is much less of a problem for women that are premenopausal or currently in menopause. The symptom of this type of vaginal disorder is a very thin, almost watery discharge that will often contain streaks of blood. You will need to go and see your doctor in this case and will likely be told to: Take higher doses of B6 Increase your folic acid intake Use an estrogen ointment What all this means is that you should never assume you have BV. If however, you have the more common BV then you should be able to easily find relief and eventually be free from the condition. This book will address both the traditional method of treating BV as well as may complementary natural remedies as well. Diagnosing BV The correct diagnosis of BV can easily be missed as the symptoms can vary and often women have no symptoms at all. Without symptoms, women are often unaware of the infection. Another problem in arriving at the correct diagnosis stems from women not wanting to be honest about their sexual activity, or embarrassed by the discharge or odor, which delays the 17 P a g e

18 diagnosis. When you go to see your doctor, be sure to answer all the questions as honestly as you can. This isn t the time or place for embarrassment. Get the help that you need. On top of this problem, the symptoms of BV can mimic other conditions like a urinary tract infection and yeast infection as well as sexually transmitted diseases like: Chlamydia, Gonorrhea Genital herpes Trichomoniasis Besides the STD issues, the symptoms can also represent a vaginal irritation causes by soaps, perfumes, bubble baths etc. BV and HIV Many women with HIV wonder if they can receive an effective treatment for BV because of their existing health issues. However, traditional medicine treat women with HIV with an antibiotic treatment the same as a woman not infected with HIV. Underlying causes of BV As the diagnosis can be confusing, one has to consider that there are underlying causes for BV. That s why getting a proper diagnosis right from the start will help you choose the correct treatment. Associated conditions for BV 18 P a g e

19 These types of conditions are ones that appear to be related by haven t been proven to have a cause and effect relationship yet. They aren t known to cause BV - yet with these conditions appear more commonly with people who are dealing with BV. Therefore people with BV are more likely to get these other conditions and the reverse can be true as well. The associated conditions for BV are: Gonorrhea HIV Complications for BV As if it isn t bad enough that you are dealing with the problem of BV in the first place but, you run the risk of greater health issues through complications of having BV. Many times women with BV have no complications, but unfortunately that s not the experience for all women. Complications can be far reaching. Thus far experts appear to conclude that complications of BV include: Infertility issues Pelvic inflammatory disease during pregnancy, abortion, hysterectomy and surgery. Complications from PDI can cause: o Ectopic pregnancy o Uterine infections and ruptured membranes o Premature delivery and low birth weight babies Increase probability of HIV infection and transmission of HIV if exposed to the virus when infected with BV 19 P a g e

20 Increased probability that a woman already infected with HIV can transmit the disease to her partner Increased probability of getting other STDs such as Chlamydia and gonorrhea For those of you hesitant to go to a doctor and get treated, consider that these health effects can result because of BV and are more severe than the side effects that you may receive from using the antibiotics that are used to treat infection. In terms of getting pelvic inflammatory disease (PID), this condition can cause infertility and tubal or ectopic pregnancies. It can also cause problems throughout a healthy appearing pregnancy such as premature deliveries and babies born with a low birth weight. If you are pregnant it is doubly important that you be checked over by your doctor for BV. This ebook will go into BV and pregnancy in greater detail later. BV re-occurrence One of the main problems with BV infections is the problem of it re-occurring. If it is caused by an underlying condition, with BV being either a secondary condition or a symptom of the main condition, then the condition is liable to return. There is no limit to the number of times that the BV infection can occur and re-occur. According to medical research, approximately thirty percent of the women treated with the antibiotic treatment will develop the same symptoms again within three months from completing the treatment. For the close to 10 % of the women with BV that don t respond to the mentioned treatments, there is no standard guideline for how to proceed. Following the steps listed under preventing BV can reduce a women s risk of being reinfected. 20 P a g e

21 How is BV diagnosed When you first go to your doctor and request help with a vaginal discharge problem, the doctor is going to start by asking several questions. Questions The questions will be routine in nature and will help to distinguish BV from other more serious conditions. The questions can include: 1. What are your symptoms? Any symptoms you have will be noted to help separate the issues. Some of these additional symptoms could be: Fever Pelvic pain 2. What are your sexual habits? Do you have a sexual relationship with multiple partners? Have you started a sexual relationship with a new partner? 3. Other questions will be on your health history, to see if you have had sexually transmitted infections in the past. As well as questions like: What type of contraceptive are you using? What medicines are you currently taking? Have you recently finished a course of antibiotics? There will be many other questions asked depending on the types of answers you give as the doctor works his way through the diagnosis. 21 P a g e

22 Urinary sample After the questions, you may be asked to give a urinary sample to see what microorganisms could be present and to test if you have a urinary tract infection. Pelvic exam The pelvic exam is done next to determine: areas of tenderness any signs of infections signs of other more serious issues like Chlamydia or Gonorrhea viruses Internal exam In this part of the exam, the doctor will manually and visually check the vaginal lining and cervix before moving on to checking the uterus and ovaries. Typically the labia, introitus, and cervix appear normal as does the cervical discharge. Usually a sample of the vaginal fluid is taken in order to identify if is excess bacterial growth has occurred and showing the presence of BV clue cells. The ph balance of the vagina will be tested. If the ph level proves to be above 4.5, then it means the good bacteria, the lactobacillus, level is low. This means there is too much of the bad bacteria already present which can now grow even faster. This brings BV on. Any vaginal discharge is also tested for: Yeast vaginitis or Candidiasis this is the much talked about yeast infections so common in women. 22 P a g e

23 Trichomonas this is a sexually transmitted disease caused by a parasite and can show similar symptoms to BV. Whiff test As part of the diagnosis there is what s called the whiff test. In this test, a few drops of potassium hydroxide liquid are added to a small sample of the vaginal discharge fluid. If a strong fish odor develops, this may signal excess BV clue cells. Inpatient care No hospitalization or inpatient care is required for women with BV. Preventing BV One strong indication of the presence of BV is the ph balance of the vaginal fluid being above 4.5. However, this isn t something you can easily find out for yourself. Adding to this is the fact that many women don t know they have it to start with, so they aren t concerned about it. However, some steps can be followed to try and reduce the likelihood of getting this type of bacterial infection. These are: 1. Follow good hygiene practices after using the toilet. a. This means to wipe from the vagina to the anus and not the other way around b. Don t wipe with the same piece of toilet paper more than once in order to not spread the bacteria around c. Avoid using perfumed soaps d. Avoid perfumed bubble bath products if you are prone to this type of problem 23 P a g e

24 e. Some professionals believe you should avoid douching the vagina cavity altogether, even with water, in order to keep the bacteria levels in balance. 2. Follow good sexual practices a. Try to limit the number of sexual partners you actively engage in sex with b. Use condoms all the time as a preventative measure c. Wash your hands thoroughly after masturbation d. Wash sexual toys after each session e. Avoid cross touching from anus to the vagina can help to reduce the risk of infection but will not guarantee it 3. If you suspect, or are worried about, or feel any of the symptoms or even feel discomfort in the vaginal area or when you go to the bathroom, then please go and see your doctor. Make sure you are tested for STDs (Sexually Transmitted Diseases) and STIs (Sexually Transmitted Infections). Having either of these two problems can cause BV infections and will result in constant re-infections if not treated. There is treatment for these conditions and they can help restore the bacterial ph balance in both the vaginal area and the urethra. 4. Avoid smoking. Sounds like an odd connection; however, research has shown that female smokers are at a higher risk for having bacterial issues and imbalances. They have a higher instance of developing BV because smoking causes dysplasia, which is abnormal cell development. 5. If you go to the doctor and are put on a course of antibiotics for a urinary tract infection or BV infection, make sure you complete them as this can reduce the chances of becoming re-infected. If you have a urinary tract infection or BV, by leaving them untreated, the infection can escalate and you can develop further health problems. 24 P a g e

25 6. Don t hide any medications from your doctor. Many medications can impact the bacteria colonies health. 25 P a g e

26 Part II This section of the book looks at the way the medical world views, diagnoses, and treats Bacteria Vaginosis. Treatment options Like any treatment program, treatments for BV work better for some women than for others. The major complaint of traditional treatment for BV is that the infection often returns within weeks to a few months. So the treatment plan is possibly killing that infection but either the underlying cause hasn t been treated or the woman is being re-infected somehow on an irregular basis. Neither is a good choice. Antibiotics shouldn t be taken lightly at any time as they themselves cause an imbalance with the natural flora throughout your system. Let s first take a look at how the medical profession views BV and what your doctor will offer you as a treatment for BV. Medications According to the medical system, antibiotics are currently the most effective way to treat BV. As the condition, if left untreated, can spread and cause more serious infections, making the woman even sicker, the treatment almost always starts here - with antibiotics. They come in either oral form, such as pills, or in a vaginal cream, or as a suppository. There are two common antibiotics used: Metronidazole common name of Flagyl in the US. o Standard dose is 500 mg by mouth twice daily for 7 days 26 P a g e

27 o This is a nitroimidazole medicine that comes as a vaginal gel, topical cream or as a pill. Besides BV, it is commonly given for other anaerobic bacterial infections (these are bacteria that can grow without oxygen), excess Gardnerella bacteria as well as anaerobes (like moviluncus and bacteroides) that can infect cells. o The antibiotic acts on the bacteria that causes the BV. o Once absorbed by the bacteria, it works to regulate the oxidation process, which was reduced by the BV infection, in order to disrupt the bacteria colonization process. o By stunting the growth of the bad bacteria, the good bacteria, lactobacillus, has a chance to regain the population levels needed to reduce the ph level in the vagina. Once the ph balance is restored, the symptoms disappear and the infection clears up. Clindamycin 2% cream also called Cleocin Vaginal Cream o Dose - 5 g intravaginally, at bedtime for 7 days o This is a lincosamide antibiotic o This type of antibiotic works to inhibit the ability of the bad bacteria from multiplying effectively to limit the cell population from growing. o Comes in gel, suppository or tablet. Metronidazole 0.075% gel also known as MetroGel-Vaginal o Dose - 5 g intravaginally once or twice daily for 5 days. Tinidazole another less common antibiotic used for BV Oral or vaginal suppositories 27 P a g e

28 All of the first three have similar success rates. Additional considerations from the medical viewpoint If a woman is having recurrent issues with BV infection, their partner may need to be evaluated for Gardnerella vaginalis colonization and subsequently treated for the woman s condition to finally clear up. o o o o Consider that a woman takes a complete course of antibiotics then resumes sexual activity with her partner and then ends up with the symptoms all over again. It s not that the male partner can be infected but he can carry the bacteria in his urethra. Once he no longer carries the bacteria and the female partner no longer has the bacteria, the problem will be solved. This approach is not widely accepted. In terms of a lesbian relationship, both women would need to be treated as the bacteria do spread between the two women. The medical profession is not a strong proponent of topical or orally administered yogurt/lactobacilli preparation that s used to re-establish the lactobacilli population in the vagina. o They cite inconsistent results as their reason. The medical professional treats BV in pregnant women to reduce the risk of the many potential problems that relate to the pregnancy and a BV infection. It is also recommended to treat BV prior to any type of surgery in the area such as a cesarean delivery, hysterectomy and even the insertion of an IUD in order to minimize the spread of the infection and avoid further complications. 28 P a g e

29 Along with the treatments, common recommendations for women inflicted with BV problems are: o o o o o Minimize douching with the belief that douches can destroy all bacteria, good and bad, throwing the delicate balance off even more Avoid any over-the-counter vaginal hygiene products Avoid any bubble bath Use only hypoallergenic bar soaps or even better, no soap at all. Avoid all liquid soaps and body washes Antibiotic side-effects Like most antibiotics, there are some side effects. They are not experienced by all women, nor will the experience be the same for those women that do end up having them. Still, you should be aware of them prior to starting a course of antibiotics. Metronidazole the side effects of this drug affect close to 1% of the women taking it and can include: o o o o o o o Severe nausea Vomiting Diarrhea Taste of metal Rashes Hypersensitivity Dizziness 29 P a g e

30 o o Flushing Headaches when accompanied by alcohol Metrogel Vaginal - According to FDA, side effects can include: o o o o o Less gastrointestinal side effects than the oral counterpart because less is absorbed into the body Symptoms of candida vaginitis during or shortly after completing treatment for approximately 1 in 16 cases. Vaginal itching occurs in approximately 1 in 70 women Stomach cramps, pain or nausea Metallic taste in the mouth Clindamycin can produce the same side affects and usually in the same percentage of patients Remember to follow the instructions that go along with the antibiotics in terms of what not to eat or drink, such as alcohol, in order to minimize the side effects. How long before relief is felt? After starting a course of antibiotics, you should start to feel better with a couple of days. Some of the symptoms will go away earlier than others, but once started, they should all drop off with a few days to a week or two. The medical profession strongly believes in having a person complete the course of antibiotics and not stopping as soon as you start to feel better. They believe that this will help to prevent a reoccurrence of the BV. Unfortunately, many women will experience a full return of their problem within weeks to months of finishing their antibiotics anyway. 30 P a g e

31 The length of time that you will be required to use the antibiotics will partly depend on what one you are taking and in what form as you use tablets, gels or suppository. Also, the severity of the BV infection could also dictate the length of time you need to take the antibiotics. Surgical care There is no need for surgery in treating BV. Activity There is no need to restrict any activities if you are dealing with the common BV infections. Several of the more serious issues associated with BV could require some restrictions depending on how severe a case you have and the type of illness you are dealing with. Although, restrictions may not be required, many women report being uncomfortable in having any sexual contact while they have BV for the embarrassment, and unsightly look and smell that can occur before and after sex. Consultations with specialists Women that can t seem to resolve the BV problem through antibiotic treatments, or have recurring BV, or even more serious associated infections, such as endometritis, pelvic inflammatory disease, can expect to be referred to an infectious disease specialist or obstetrician/gynecologist for further examination. Diet The medical profession rarely advises on dietary issues and their possible connection to disease. BV is no different. They offer no advice for general diet and they say the studies give conflicting results when women supplement their diet with Lactobacillus in the form of acidophilus. 31 P a g e

32 Preventative treatment also known as prophylactic treatment These same medications, Metronidazole and Clindamycin, can be prescribed as a preventative measure. Preventative treatment of BV is important for women with early signs of Pelvic Inflammatory Disease. These medications are also sometimes prescribed for women that: Have a higher risk of contracting STDs or HIV, Are having an abortion, hysterectomy or pelvic surgery - These women may not have BV yet, and by taking the medications as a preventative it helps to reduce the probability of them having problems with bacteria imbalances, brought on by these procedures, that could cause BV. Women that are post menopause and women that when they are pregnant have anemia problems are often treated preventatively as they are at a higher risk for BV Young girls that are pre-puberty and have problems with strep are also at a higher risk of getting BV and so are often given these medications as a preventative measure. Cost of the medication The oral medications are cheaper than the topical preparations. Of the two oral medications, oral metronidazole is the cheapest. Oral clindamycin is an intermediate cost compared to the other two. Follow-up After the medications have been administered, it s important to follow up to make sure the condition is truly gone. 32 P a g e

33 If the BV does not clear up after one course of treatment, a second course of the same medication may be recommended. There is also the option of switching to the second medicine on the assumption some of the bacteria may respond better from one medication to another. Metronidazole is the preferred course of treatment as it offers a faster return of the good H 2 O 2 producing lactobacilli. Should the second course of treatment not prove effective, other testing may be required. The chances of getting sexually transmitted diseases may be higher with women with BV, depending on various risk factors and the demographics of the situation. The tests commonly done include: N gonorrhoeae C trachomatis Herpes simplex virus Vaginal candidiasis this test may be done as the medications can alter the vaginal flora and bring about a predisposition to this condition. Prognosis Most women will find that the BV will resolve itself through the normal course of treatment, making the prognosis very good. There are other complications and the prognosis for those will depend on many factors that have to be looked at from case to case. This is another reason to go to a doctor for a proper diagnosis - to see exactly what problems you may be dealing with. 33 P a g e

34 BV and pregnancy No woman wants to deal with the embarrassment, mess or smell of having BV at the best of times, but when pregnant it s particularly disturbing as there can be serious complications of having this condition during pregnancy. Some of the problems that have been linked to BV include: Preterm labor, Premature rupture of the water bag, leading to preterm labor Infection of the amniotic fluid, placenta, and the baby during labor. Some experts estimate that as high as 20% of all pregnant women have a BV infection. Who should be checked for BV If you are concerned for any reason, you should mention the problem to your doctor. Treatment should also be considered if you have had: A previous streptococcal vaginal infection during a pregnancy A history of preterm labor A preterm rupture of the membranes in a previous pregnancy Tests and treatment for BV should happen after the first 16 weeks of pregnancy and if Streptococcal Vaginosis is an issue, then testing shouldn t happen until the 35-37th weeks or during the onset of labor. 34 P a g e

35 How does having BV affect my pregnancy? Having BV during your pregnancy puts you at a higher risk for several problems. The links between BV and pregnancy aren t completely clear and not all women who have BV end up with the same problems. There is some speculation that women with a predisposition to other infections or problems that lead to these complications are more likely to have BV. Just because some complications can arise, isn t to say that it will. Not all women will experience these symptoms the same way either. However, in case you do the complications to watch out for include: Preterm birth and therefore the possibility of a having a low birth weight baby Preterm premature rupture of the membranes Uterine infection after the delivery Possible miscarriage in the second-trimester Susceptibility to sexually transmitted infections Susceptibility to pelvic inflammatory disease is rare in pregnant women but it is possible According to some studies approximately half of the BV cases in pregnant women clear up on their own.. What are the consequences of BV The consequences can be severe as mentioned above. Nine studies have shown that BV during pregnancy can bring on any of the above listed consequences. In addition to this, BV infected pregnant women are two to three times for likely to deliver preterm than women who aren t infected with BV. Intrapartum and postpartum infection risks are also much higher for woman infected with BV. 35 P a g e

36 The preterm labor issue can occur if the BV extends from the vagina into the uterus and amniotic fluid and if it s combined with local inflammation around the cervix. Due to these issues, the American College of Obstetricians and Gynecologists recommends that doctors screen for BV in high risk patients. High risk here includes: History of preterm labor Weigh less than 110 pounds prior to your pregnancy Or both conditions Treatment for high-risk and low-risk pregnant women with BV Treatment for pregnant women with BV that are high risk includes: Treatment with oral metronidazole (Flagyl) 250 mg, three times daily for seven days. o Topical treatment doesn t improve the risk of complications such as preterm delivery and are never used on patients with high risk. o The topical forms are acceptable for women in the low risk category, which include women with symptomatic infections but who are not otherwise at risk of a preterm delivery. Other alternatives include Metronidazole (Flagyl), usually at single dose of 2 g orally Clindamycin in a twice daily dose of 300 mg orally for 7 days o Women taking this medication are more prone to experiencing diarrhea than oral Metronidazole. 36 P a g e

37 Preventing BV during pregnancy The best pregnancy is where the expectant mother is healthy to begin with and enters into a pregnancy without complications. That s why preparation and prevention against BV for a healthy pregnancy is an important step. Pre-pregnancy All women who are hoping to conceive in the near future are advised to be tested for BV prior to becoming pregnant. This is particularly important if you have a history of BV or have had previous problems with: Pregnancy loss Problems conceiving Sexually transmitted disease Previous vaginitis Self care options for BV and pregnancy A relatively new field is self care diagnosis for BV. With a German study, the doctors had women use a vaginal ph glove that allowed women to check their vaginal ph twice a week during their pregnancy. As the vaginal ph is a good way to determine BV, as anything over 4.7 is associated with BV. If the ph is high, the women in the study took lactobacillus tablets, which contained normal vaginal bacteria. This helped to reduce premature births and many other complications associated with BV and pregnancy. This vaginal ph glove is now available in the Germany and Chili and possibly online as part of Self-care program. See for more information. 37 P a g e

38 The glove similar to a surgical glove, when worn on the right hand allows the right index finger to be inserted into the vagina and will read the ph of the vaginal fluid on a special ph strip that is embedded into the glove. The tablets containing the lactobacillus that you would place in the vagina to restore the bacteria balance are available from some health food stores and some drug stores. Not all are the same and not all work on all women. Speak with your doctor first. These should only be used for BV infection as any medical substance placed in the vagina on a regular basis is thought to potentially cause changes in the bacteria balance that can lead to an infection. This is the medical reasoning behind not using douches. If you have a good relationship with your doctor, you can see if he ll work with you to check vaginal fluid either before you get pregnant or after 16 weeks of pregnancy. After this point, there is very little chance of getting BV. He can do a microscopic exam or check the vaginal ph. If the results are positive for BV, then you can discuss the options then. If recurring BV is an issue, ask him about the lactobacillus tablets to try and stop the recurring nature of the infection. Regardless of what he says, be sure you don t douche when pregnant and don t douche on a regular basis even if not pregnant. Follow up If you have been tested for BV and have followed the recommended treatment, it s important to do a follow up check and possible retesting in 4 to 6 weeks or earlier. If BV still exists then a second medication may be attempted and possibly a visit with an infectious disease expert depending on the women s medical history. Some studies report that some women, between 3-18%, who initially tested negative for BV early in the pregnancy, have developed BV by 20 to 26 weeks. 38 P a g e

39 Natural approaches to BV for pregnant women Unlike the medical profession, most alternative medical practices look at a person s overall health and lifestyle changes to maximize preventative measures and effect a change in the situation should the woman already have BV. You need to consider lifestyle practices that affect immune function and minimize risks such as: Stress reduction, Nutrition, Tobacco and drug free lifestyle Consider the information presented in Part III of this book and then consult your doctor to find a solution that you are comfortable with. Lactobacillus products There is much discussion as to the effectiveness of the current lactobacilli products available on the market. Even the yogurt and the acidophilus milk that are available widely may not contain the correct lactobacillus species that is required for effecting relief from BV. They may help some women and they may show no effect. A lot will depend on the type of lactobacillus you can find and on your individual case. There are many trials currently underway to determine the effectiveness of these products. Remember, a pregnancy is not the time to test out new products. Speak with your doctor before trying anything. 39 P a g e

40 Part III Natural remedies Natural or alternative medicine looks at the body as a whole. The vagina is considered an ecosystem in itself where both good and bad bacteria live in delicate harmony. When something happens to throw this balance off then the alternative medical world looks at the reasons why and how to solve the problem without disrupting other systems in the body. Natural remedies rarely have nasty side effects like antibiotics, and other over the counter medications do. Instead, natural remedies offer a milder and yet often permanent alternative. There are several reasons to not use antibiotics if not absolutely necessary. It s a well known fact that antibiotics can play havoc with the natural flora in the stomach, kill off both the good and the bad bacteria in the vagina and cause yeast infections. They kill off all the symptoms but don t necessarily address the cause and leave the situation open for constant reoccurrences. In this section, we will discuss the various natural and home remedies for the problem of BV with particular emphasis on getting rid of the problem permanently. Remedies will be split into various types such as herbs, homeopathy and natural remedies, all that work on healing the body as a whole. Remember, many of these remedies can work together as well as be taken along side traditional medicine. Give them a try and find relief, maybe for the first time. Herbs and extracts There are several herbs that work wonders on women health issues, in particular BV. Let s take a closer look. 40 P a g e

41 Barberry Barberry is a great herb that is well known for fighting infections. It is usually mixed into hot water and steeped like a tea. Alternatively, you can take capsules. Note: Barberry is not suggested for pregnant women. Boric acid Boric acid may surprise you but it is a strongly recommended solution for both BV and yeast infections. You can buy the boric capsules or you can make them for much less by buying the boric acid and gelatin capsules and filling them yourself. Be sure to use 100 % Boric Acid. Using an applicator from another vaginal product is the easiest for inserting them into the vagina. Just make sure the applicator is well washed, well rinsed and wait until it is totally dry before using. Put a capsule in the applicator and insert into the vagina. It s helpful to wear a panty liner or mini-pad as there could be discharge over night. There will be no irritation from using these suppositories. Many midwives recommend the following: On the first night - insert 2 capsules into the vagina and leave in overnight For the first week - insert 1 capsule every night and leave in overnight For the second week insert 1 capsule every other night and leave in overnight For the third week insert 1 capsule every three days and leave in overnight For the fourth week insert 1 capsule every 4 days and leave in overnight By the fifth week- you can insert 1-2 capsules inserted per week or as required Colloidal silver Colloidal Silver is a suspension of submicroscopic metallic silver particles in a colloidal base. Many naturopaths believe that it is an all natural antibiotic alternative in the purest form. The presence of colloidal silver near a virus, fungi, bacterium, disables its oxygen-metabolism 41 P a g e

42 enzyme, and when the pathogens suffocates and dies, it is cleared out of the body by the immune and elimination system. If the primary source of BV is from an anaerobic bacteria, then colloidal silver won t have as strong an effect, however, for secondary infections like yeast or another bacteria, it will. There is some controversy around colloidal silver, but they centered on excessive use over a long time period. Garlic Garlic is a great defense against infections. It also contains many antibacterial and antifungal properties making it a great answer for many different types of health problems, but especially BV. If you do decide to take garlic capsules, be sure to find a strong supplement, hopefully around 5,000 micrograms of allium. Allium is the compound in garlic that has infection fighting elements. You should take two tablets twice a day until the problem stops. Gentian violet Gentian violet is a bactericide and an antifungal agent. It is possibility the most important bacterial identification test used today. Gentian violet does not require a doctor s prescription in the US. Gentian violet is primarily used to treat Candida but works for many people in treating BV. It doesn t work for everyone and it can be messy but better messy than a severe bacterial infection. Tampons painted with Gentian violet are used as a vaginal suppository. Grapefruit seed extract Grapefruit seed extract has been used for over thirty years by naturopathic physicians and has been proven to be extremely safe and effective for its broad spectrum antibiotic effect, even in the cases of infections unknown, or misdiagnosed. 42 P a g e

43 This extract is used in a douche. Dilute one teaspoon of grapefruit seed extract with two cups of water before douching. Grapefruit seed extract is strong and should never be applied directly to the sensitive skin of the vagina. Goldenseal Goldenseal is another well known herb. Its reputation is in the area of immune boosting. Goldenseal contains a chemical called barbering, which has been proven to fight off bacteria and Candida fungus that sits in the vaginal mucous membranes. The recommended dose is two 500 mg goldenseal once or twice per day until the symptoms go away. There are also vaginal suppositories available that contain Goldenseal. If you have trouble finding them, you can insert goldenseal capsules instead. Olive leaf extract This lesser known herbal extract also helps to treat and even better, prevent BV from occurring and reoccurring. It s known as a powerful immune booster and free radical fighter. It s been used as a cure all for years, including viruses, flu, fungi, parasites and bacterial infections. It comes in capsules and powder form but the capsules are the easiest. Although the herb has a strong coffee flavor and some women may prefer the powder for that reason. Take the capsules orally, as directed on the bottle, regularly for several weeks. Oil of oregano Oil of Oregano has long been used for its antimicrobial, antibacterial and immune boosting properties. It s also an excellent remedy for colds, influenza, mild fevers, fungal infections and even indigestion. It s extremely strong in taste and some people can take drops straight but many others use one drop in water when they take it as a supplement. Follow the instructions on the bottle for quick improvement. 43 P a g e

44 Neem Neem oil is actually a vegetable oil that s made from an evergreen tree called Neem that grows in India. Neem has antibacterial, anti-viral, antifungal and blood cleansing properties and is often used for detoxifying the body. It can kill off harmful bacteria and leave the good bacteria behind. It helps to fight infections and boost the immune system if the Neem bark extract power is taken internally. Tea tree Oil Tea Tree Oil has been used safely for over sixty years. The most potent tea tree oil comes from New South Wales on the east coast of Australia. It is an excellent antiviral, antibacterial, and antifungal medicine. It also contains immunestimulant properties. It is used as both a first aid remedy and as a treatment for many different kinds of infections. When using it for Bacteria Vaginosis put a few drops of the oil in the warm bath water and spend some time soaking in it. Another option is to dilute the oil with olive oil and apply it to the vagina topically. As a douche, you can mix one teaspoon of tea tree oil in two cups in water. Douches will be discussed in greater detail later. As the oil is strong and can be caustic to the skin, handle it carefully. Tea tree oil suppositories can be inserted into the vagina and left there for up to 6 weeks. These are available in some health food stores Another advantage is the immune-stimulant properties. Tracheal Tracheal is another traditional herb. This one is well known for its ability to eliminate toxins, like parasites and bacteria from your body. This herb helps to restore your normal flow of body fluids. The recommended dose for this herb is one teaspoon of dried tracheal into one 44 P a g e