Persistent Bacterial Vaginosis

Q: Persistent Bacterial Vaginosis
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Dr. Natalie Metz
Message 1 of 8 , Jun 11 2:59 PM
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Greetings,

I have a patient with persistent bacterial vaginosis (>1 year).

I first saw her for a Pap and pelvic exam last year when I noticed copious discharge, elevated pH, mild odor, and upon questioning, patient reported mild pelvic discomfort with sexual activity. Initial testing showed positive for Gardnerella only.

She continued to test positive for Gardnerella, and negative for Chlamydia, Trich, Gonorrhea, Candida, Mycoplasma and Ureaplasma upon further testing as discharge persisted after a round of Tx with diet, immune boosting herbs, probiotics, and vaginal Boric acid suppositories followed by Lactobacillus suppositories. She later self-treated with a round of Wise Woman #1 suppositories (nightly x 1 month), Diflucan at some point, and eventually did an extended Vaginosis panel from Doctor's Data which revealed clue cells and growth of the following:

2+ Lactobacillus spp.

2+ Enterococcus spp

2+ Gardnerella vaginalis

2+ Staphylococcus spp not aureus

2+ Corynebacterium spp

Possibly Mobiluncus as well per written report....

She has recently done another round of Boric acid and is currently on Lactobacillus suppositories and adding in 1mg estriol this week with Lactobacillus as she is now perimenopausal with some atrophic signs. We just retested this week (there was white foamy discharge with pH ~4.5 upon exam) and are awaiting results. Patient is an ND and we are both a bit stumped after so many attempts, awareness of diet/emotions/ND perspectives/etc....

I welcome any help!!!

Thank you!

Dr. Natalie Metz
Oakland, CA




Anne Van Couvering, ND
Message 2 of 8 , Jun 11 7:10 PM
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I recently had a case very similar to this, been treated for BV for quite some time, with no relief.  Looked through my beautiful gyn notes (thank you Dr. Windstar) and read up on cytolitic vaginitis, an overgrowth of lactobacillus causing lysis of the epithelial cells and discharge and "false clue cells." on a wet prep.  Three days of baking soda douches "put out the fire" that had been going on for months.

Perhaps it's that?


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--
Anne Van Couvering, ND, LMT
Hamptons Naturopathic




Heidi Peterson
Message 3 of 8 , Jun 12 4:53 AM
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I do not think that boric acid works well for BV or other bacterial infections/ bacterial overgrowth  ( I love it for candida).  Likewise, diflucan only works for fungal infections.

I would recommend vaginal vitamin C ( 250 mg), vitanica bacteria arrest,  vaginal colloidal silver or vaginal ozonated olive oil.   ( my favorite product phyto-asceptic is back ordered)  If she wanted a drug then she would want to consider cleocin ovules.  I generally wait to use the estriol until I have cultured and know the bacteria are gone.   I have seen the estriol flare bacterial overgrowth.

You might also consider some stool testing as GI tract can be the seeding the vagina.


Heidi Peterson, ND

Portland, OR




erikakrumbeck
Message 4 of 8 , Jun 12 8:03 AM
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Is she completely resistant to conventional medicine?  Is there a reason why she was given Nystatin but not metronidazole?

Vitanica's Bacteria Arrest has been renamed "V Fresh."  I have used their Yeast Arrest suppositories with some success with BV (since they have antimicrobial herbs in them).   Also consider Vag Pack suppositories (only 1 per week, though)

Erika Krumbeck, ND
Montana Whole Health
Missoula, MT




drmeekheart
Jun 5 8:38 PM
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Hi Hiedi,
Could you tell me where to find phytoasceptic, and a Vit C 250mg tab-i primarily order through emerson/natural partners and the tabs are all 500-1000
If you use V-fresh supp. do you use them on different days than the Vit C
Where do you find ozonated olive leaf?
Thank you for all your suggestions- just had someone with BV come in with 15 yrs history, and no help.
Kathleen Knights, ND
St. J VT




Heidi Peterson
Message 6 of 8 , Today at 10:41 AM
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Sadly phtoascetic is off the market.

I think the 250 mg tab is ok.

The ozonated olive oil is from Lonegivity in Canada.




Deborah Schokking-Phair
Message 7 of 8 , Today at 12:21 PM
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Ozone Services in BC also has ozonated olive oil in jars or sticks that can be cut into suppositories. (No affiliation)
866-460-2581
Info@...

Deborah Phair ND
Prince George, BC





clarknd
Message 8 of 8 , Today at 1:58 PM
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I have seen Suppositories no. 1 from wise woman work well for persistent BV cases.

Denise Clark, ND
Boulder CO