Ask Dr. Kate: How do I get rid of bacterial vaginosis?

Glamour Magazine

Dear Dr. Kate,

On my last visit to my GYN, my Pap smear was abnormal. I was treated for a yeast infection, which I didn't think I had, and bacterial vaginosis. The next Pap test was normal. I am on birth control so my husband doesn't "pull out." Even though I was treated, the bacterial vaginosis came back pretty quickly. I shower once a day and in the summer twice a day with Dove only. Can my husband be re-infecting me and/or does he also needs to be treated for bacteria?

BV 4EVER?


Dear BV4E,

Your question brings up two important issues. The first is what Pap tests are done for, and what they can incidentally (but not reliably) do. Even though Pap tests are designed to detect abnormalities in your cervix, the pathologists can sometimes also see signs of infection. At the time of the initial diagnosis, did you have symptoms of a yeast infection (usually itching and a cottage-cheesy discharge) and/or vaginosis (usually a foul odor and increased discharge that may be white, yellow or grey)? Pap "detection" of infections isn't always accurate, so many doctors will follow up those findings with better tests.

The second issue is just how commonly bacterial vaginosis, or BV, recurs. If you did have BV, one round of antibiotics doesn't always cure it--30 to 50 percent of women will have another episode of BV within a few months. It doesn't mean your husband has to "pull out," and it DOESN'T mean that you're not keeping yourself clean. (And YAY for Dove, by the way, it's my favorite soap for the vulva!) It also doesn't mean that your husband is re-infecting you. BV is an overgrowth of bacteria that are normally found in the vagina, not something that you get from him. So he doesn't need to be treated: BV likes the vagina and doesn't care for the penis.

When I have patients with a "rebound" BV infection, I give them either a different antibiotic, or the same antibiotic given in a different way (if they used a vaginal gel the first time, I'll try pills next). For the few patients who continually get BV, I'll put them on maintenance therapy, using the vaginal gel once a week for several months
to see if that does the trick.

Have any of you had a hard time banishing BV?


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