Vaginal Health and Healing from Bacterial Vaginosis and Thrush

Have you experienced the struggles of vaginal dysbiosis in the form of infections such as Bacterial Vaginosis or Candida overgrowth/Thrush?

Believe me, if the answer is yes, you are certainly not alone!

These conditions are actually more common than anyone would believe, though because of the sensitive nature of the topic, and the shame shrouding any sort of vagina-related ailment, not many women are too keen on talking openly about it. Fancy that!

With attitudes and connotations surrounding even a healthy vagina often straying into the territory of 'gross', 'unclean', 'smelly', and 'shameful', it is no wonder we women are reluctant to let on when things aren't quite right down there.

I, myself, had a long battle with vaginal dysbiosis, manifesting in alternating Thrush and BV infections for years! It's hell, and I know from my own experience that it severely affects your self-confidence, sexual expression and desire, and your relationship with your body suffers heavily.

So I get it. Oh, boy, do I get it!

And this ongoing struggle with my own vagina, led me on a path of research and healing that has resulted in me having quite a bit of information on the topic that I'd like to share with you. I am now a Yoni Mapping Therapist and Holistic Sexuality Coach, and I'm passionate about helping you get out of the vicious cycle of vaginal dysbiosis!

Why Can Bacterial Vaginosis and Thrush Occur?

Now this article is not the be-all and end-all, and there are MANY things you can do to ensure a happy little vag-emite (only the Aussies will get that one, and I seriously won't blame you if you don't approve!). It's a crazy complex issue, and the research available is scant, and often still inconclusive or not significant enough to draw any solid conclusions about all of this.

I've written a big ol' checklist of several more day-to-day 'Vagina Care' measures in another post that you can read HERE. I'd highly recommend you check that out too as vaginal health needs to be approached holistically on many fronts.

But for now, let's get specific about vaginal dysbiosis.

Studies have worked out that some of the known risk factors that predispose you to BV include:

• Smoking
• IUD contraception
• Douching
• Multiple sexual partners
• A recent change in sexual partners (there's an increase in BV occurrence in women with a new sexual partner, meaning new bacteria)

But the main thing I'd like to discuss in this post is the importance of the GUT in vaginal health.

The gut microbiome is extremely important to all manner of things when it comes to general health and balance in the body, and it also has an effect on the vagina's microbiome too.

Yes, your vagina has it's own little microbiota, or vaginal community of beneficial bacteria, that prefers to exist in harmony with just the right balance of each of the many bacterial strains that coexist in there.

It's inhabited by a range of microbes from a pool of over 50 species.

Lactobacilli are the most common, particularly in healthy women.

Vaginal microbiota form a mutually beneficial relationship with their host and have a major impact on health and disease.

When this bacterial balance is tipped in favour of some of the harmful bacteria, Bacterial Vaginosis (BV) can result. And when other members of the vaginal village - such as yeasts - that are perfectly normal, happy little guys in the right amounts, are allowed to flourish a bit too much, they overthrow the protective bacteria and turn into a real problem - as in the case of candida overgrowth resulting in vaginal thrush.

When the vaginal microbiota is a touch too diverse, the friendly and essential hoard of lactobacillus are edged out of their homes and unable to hold down the fort like they normally do to maintain a nice acidic pH and keep yeast at harmless levels.

This tip of the balance in the wrong direction is often what has happened in the case of BV, which is the most common urogenital infection among women of reproductive age.

In half the cases of BV, the infection is asymptomatic, so you may not know you even have it. This is a little scary because having BV can increase the risk of preterm labor and low birth weight, pelvic inflammatory disease, urinary tract infection (UTI), and increased susceptibility to sexually transmitted disease, including HIV.

The reason I mention this is because it's all about having the right balance of bacteria to maintain a healthy environment within the body. And the gut microbiome can affect the vaginal one through bacteria from the digestive tract 'trans-locating' (ie. migrating) to an area where it is not supposed to be! In other words, any pathogenic strains of bacteria that are present in the gut, can therefore infect the vaginal tract and disrupt the delicate balance of flora there and this could lead to BV or Thrush.

So looking after the gut is of the utmost importance, not only for the health of the rest of the body, mind, and soul (I mean, heck, the gut manufactures 90% of the body's serotonin - If that's not reason enough to take better care of it, I don't know what is!) but for creating and maintaining vaginal health and balance.

A tricky thing about BV and it's causation is that there's a bit of a chicken-and-the-egg situation...

It's clear that the acidic pH is a huge factor, since if the pH isn't acidic enough (under 4.5) then the BV causing organisms are able to flourish and take over, suppressing the lactobacilli.

However, the lactobacilli are the ones who produce hydrogen peroxide and therefore contribute to the acidic environment, which acts as a protective factor against BV causing organisms to thrive. It's unclear which is affecting which the most.

There are experiments being done with gels that make the vagina more acidic and all sorts of methods to keep the pH at a level that makes the vagina an inhospitable environment for pathogens, but nothing has surfaced as an effective and safe treatment in the mainstream yet.

As with so much in the realm of women's sexual health, there isn't enough research (or funding) yet to really know what's going on here, but I will outline some of the main avenues for treatment below.

What Sort of Treatment is Available?

The most common treatment for BV typically includes antibiotics such as metronidazole.

This is very effective at the time of treatment but the recurrence rates of BV are really high, and often once women have gotten rid of the infection for the first time, they will continue to suffer and struggle with re-appearing symptoms intermittently on an ongoing basis for years. Not to mention the effects of months of treatment with antibiotics on the gut AND vaginal microbial balance, wiping out much of the good bacteria, along with the bad, in one fell swoop.

Therefore it is common for the BV to go away for the moment, but chronic yeast infections become a problem almost immediately, with women then see-sawing between the two versions of vaginal dysbiosis indefinitely. It's very common for BV and Thrush to occur one after the other. Over-the-counter treatments for thrush are similarly short-lived in their effectiveness, with a huge recurrence rate, and an increasing resistance to the drugs in these medications as a result of such frequent use.

Clearly the available medical treatment of these infections needs some work!

So, if you absolutely have to use antibiotics - and by all means, do your darndest to avoid this if at all possible! - clever use of probiotics is essential to re-populate the vagina (and gut) with helpful, protective and healthy bacteria that belong there in abundance.

Several scientific studies have shown that the use of antibiotics to get rid of the bad bacteria coupled with probiotic supplements to populate the vaginal tract with the right sort of organisms is the most effective if not successful treatment - much more effective than just antibiotics alone.

To get a tad nerdy on you for a second...(as if I hadn't already!) When looking into probiotics, the two most beneficial strains of lactobacillus for the vagina specifically are L. rhamnos

GR-1 and L. reuter RC-14, which have been shown to have the best success at adhering to the epithelium as well as colonising the area and lasting the distance well after treatment has ceased.

Studies have tested both direct vaginal and oral methods of administering probiotics. Interestingly, the oral method seems to be just as, if not more, effective than vaginal suppositories. I often suggest doing both at the same time though for good measure!

A good Nutritional Medicine Doc or Naturopath will be able to supply you with the right vag-specific probiotics and supplements to take, as they're generally not available on the shelves.

A lesser known treatment that many doctors swear by, and that studies have begun to support, is Boric Acid suppositories. Boric acid is a natural antifungal and antiseptic, and studies have shown that it inhibits the growth of Candida albicans, the strain of yeast behind most cases of vaginal yeast infections, as well as other kinds, such as Candida glabrata, an increasingly common cause of infection that tends to be more resistant to other treatments.

The powder, an irritant, should never be applied directly; suppositories are designed for this reason and can be directly inserted inside the vaginal tract for 5 to 7 days. There're no definitive studies that can conclude firmly whether this is an effective route though.

Another possible treatment for Thrush that is supported by some interesting new research is the use of Saccharomyces boulardii. This little guy has been shown to be helpful in the treatment and prevention of vaginal thrush as it inhibits the adhesive and biofilm forming abilities of Candida Albicans (the main culprit of thrush infections). S. Boulardii is interesting as it is actually a tropical species of yeast, but it functions in the body like a probiotic!

This is pretty cool stuff, and a great start, however there is not enough research data in this field to make a definitive conclusion about whether it is an effective treatment for thrush, and probiotics and dietary factors are still the leading approach for any vaginal dysbiosis.

But watch this space!

How I Tackled Chronic BV and Thrush:

The medications and typical Western Medical treatment pathways that were offered to me were helpful at times but by no means formed a complete and effective avenue for curing my vaginal dysbiosis.

I used a holistic approach, as I now instruct my clients to do, where I used many different resources and made several changes to my lifestyle and diet that all contributed to rehabilitating my gut health and vaginal health over time by going to the root of it rather than relying on antibiotic treatment or thrush tablets as a band-aid solution that only ever gave me temporary respite.

I would recommend getting onside a Naturopath and/or Nutritional Medicine Doctor who can help you with the supplement/treatment side of things, while implementing the lifestyle and dietary strategies outlined in this article. 

There's always an emotional and energetic component to every ailment or imbalance in the body too, so finding a practitioner in this realm who can help you work through any emotional issues, trauma, shame and guilt surrounding your femininity or sexuality, etc can be very helpful as part of your approach to overcoming this. You may find that once you've dealt with the underlying beliefs or emotional wounds around this part of your body, that the issues with thrush and BV clear up on their own and its natural balance is restored.

So, there you go! The lowdown on your down low! I hope this information was helpful, and if you're left wanting more tangible action steps to take, you can read this article on additional Yoni Care tips, or get in touch with me if you want to work on the emotional side of things.

_References:

• _{Managing Recurrent Bacterial Vaginosis: J Wilson, Department of Genitourinary Medicine, The General Infirmary at Leeds, Great George Street, Leeds, LS1 3 EX, UK; (https://sti.bmj.com/content/80/1/8)}
• _{Cook RL, Redondo-Lopez V, Schmitt C, et al. Clinical, microbiological and biochemical factors in recurrent bacterial vaginosis. J Clin Microbiol1992;30:870–7.Abstract/FREE Full TextGoogle Scholar}
• _{Hay PE, Ugwumada A, Chowns J. Sex, thrush and bacterial vaginosis. Int J STD AIDS1997;8:603–8.Abstract/FREE Full TextGoogle Scholar}
• _{Larsson P-G. Treatment of bacterial vaginosis. Int J STD AIDS1992;3:239–47.PubMedWeb of ScienceGoogle Scholar}
• _{Hawes SE, Hillier SL, Benedetti J, et al. Hydrogen peroxide-producing lactobacilli and acquisition of vaginal infections. J Infect Dis1996;174:1053–63.Google Scholar}
• _{Avonts D, Sercu M, Heyerick P, et al. Incidence of uncomplicated genital infections in women using oral contraception or an intrauterine device: a prospective study. Sex Transm Dis1990;17:23–9.PubMed}
• _{Nillson U, Hellberg D, Shoubnikova M, et al. Sexual risk behaviour associated with bacterial vaginosis and Chlamydia trachomatis infection. Sex Transm Dis1997;24:241–6.PubMed}
• _{Rosenstein IJ, Fontaine EA, Morgan DJ, et al. Relationship between hydrogen peroxide-producing strains of lactobacilli and vaginal-associated bacterial species in pregnant women. Eur J Clin Microbiol Infect Dis1997;16:517–22.CrossRefPubMedWeb of ScienceGoogle Scholar}
• _{Boskey ER, Telsch KM, Whaley KJ, et al. Acid production by vaginal flora in vitro is consistent with the rate and extent of vaginal acidification. Infect Immun1999;67:5170–5.Abstract/FREE Full TextGoogle Scholar}
• _{McClean NW, McGroarty JA. Growth inhibition of metronidazole-susceptible and metronidazole-resistant strains of Gardnerella vaginalis by lactobacilli in vitro. Appl Environ Microbiol1996;62:1089–92.Abstract/FREE Full Text}
• _{Reid G, Millsap K, Bruce AW. Implantation of Lactobacillus casei var rhamnosus into vagina. Lancet1994;344:1229.CrossRefPubMedWeb of ScienceGoogle Scholar}
• _{Reid G, Charbonneau D, Erb J, et al. Oral use of Lactobacillus rhamnosus GR-1 and L fermentum RC-14 significantly alters vaginal flora: randomized placebo-controlled trial in 64 healthy women. FEMS Immunol Med Microbiol2003;35:131–4.CrossRefPubMedWeb of ScienceGoogle Scholar}
• _{Andreeva P, Slavchev B, Kovachev S, et al. Treatment of bacterial vaginosis with high dosage metronidazole and lactic acid. Akusherstvo i ginekologiia2002;41:36–9.Google Scholar}
• _{Joesoef MR, Schmid GP, Hillier SL. Bacterial vaginosis: review of treatment options and potential clinical indications for therapy. Clin Infect Dis1999;28(Suppl 1):S57–65.Google Scholar}