My history is this: 39 yr. old married x4 years/monogamous G2P2 female with IUD for contraception for the past 4 years...I used to be an ob/gyn nurse...I have had (cultured positive) recurrent gardnerella B.V. for the past 8-9 months...i have been treated with Flagyl, metro-gel, clindamycin as directed each time...the symptoms subside during and right after treatment but recur within a week or so...Prior to the iud placement I had maybe 2 total BV (fully symptomatic) infections in the course of previous @ 15 years of being sexually active...I was recently treated with metro-gel for 10 days-twice daily...i was re-cultured about a week or less after treatment and tested positive for gardnerella again. Now, my gynecologist is recommending a 5 day course of metro-gel and to follow up with twice weekly metro- gel for 6 months...I realize that one should not have intercourse during treatment--but it seems i am always being treated...so, it is unrealistic to be fully compliant with that...I am so frustrated and tired of being on medication and my husband seems discouraged as well...My gyne says he does not believe that IUD is part of the problem, so he does not recommend removal. Usually my symptoms are mainly some burning type feeling in the vagina with only occasional classic fishy odor if it's full blown along with some clearish discharge...I am a smoker, so no OCP's for me at this point and we are unsure about sterilization. What are your recommendations???

Thanks so much for your time!

Hi,

I would grab this opportunity and stop smoking (shame !! ); I would improve my oxygen and nutrition delivery everywhere to my body with exercise and other non antibiotic based food and, finally, I would consider avenues to prevent pregnancy other than your unfriendly IUD.

In good health,

Dr. Gian

Hi,

It is possible that you have a enhanced form of what is called "Lacotbacillosis". In young girls and older women the lining of the vagina is only a few cell layers thick. In these women this tissue is therefore quite vulnerable and the balance of the vaginal environment can easily be disturbed. In the vagina (as well as e.g. in the mouth and the bowels) a great many micro-organisms are living in balance with each-other and their hostess. This is called the "vaginal flora". The vaginal flora changes dramatically through life. When a baby girl is born, she still carries her mother's hormones for a short while, and the vaginal flora is dominated by lactobacilli, sometimes called "Döderlein" bacilli. As the maternal hormones decline, the flora changes to resemble the bowel flora. However, with the onset of puberty reproductive hormones are produced, and the lactobacilli return The vagina usually has an acidic environment and a low pH. In fact, Lactobacilli (lactic acid bacteria) are named after their property to produce lactic acid. They largely determine the acidity of the vaginal environment. But.... too many is too much and in some women there may be too many lactobacilli. When this condition is accompanied by complaints that resemble those caused by fungal infections the diagnosis is called "Lactobacillosis". If your situation does not improve you should see a Doctor. For free STD and HIV testing check this website  www.hivtest.org and find a place near you.

Be Well

Dr. Gian