Why do so many women repeatedly suffer from Bacterial Vaginosis (BV), even after treatment with antibiotics? Are antibiotics healing or harming? Let’s dive into the antibiotics dilemma and explore why it’s time for an upgrade in the way we approach BV.
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Why do so many women repeatedly suffer from Bacterial Vaginosis (BV), even after treatment with antibiotics? Are antibiotics healing or harming? Let’s dive into the antibiotics dilemma and explore why it’s time for an upgrade in the way we approach BV.
On a not-so-fine day, you discover an unusual discharge in your panties. It smells a bit off and you decide to visit your doctor to figure out what is wrong. After taking a vaginal swab and sending it to the lab for analysis, it’s clear that bacterial vaginosis is what’s causing all the trouble. With a prescription for antibiotics, you start taking the meds, and after a few days, the discomfort disappears, bringing you back to your fine-day self. Seems too good to be true, doesn’t it?
Bacterial vaginosis affects 23-29% of women globally. It occurs when the vaginal microbiome—an ecosystem of microorganisms that maintains a delicate balance —tilts in favor of harmful bacteria. The possibility of disruption of the balance can be increased by many factors like smoking, vaginal douching, stress, estrogen fluctuation during menstrual cycle, intrauterine devices (IUDs), etc. The treatment for BV usually involves antibiotics like metronidazole and clindamycin, typically orally or intravaginally.
But, the effectiveness of antibiotics in treating BV has dropped dramatically. Within a few months of treatment, more than 60% of women experience a recurrence of BV—a pretty steep number.
Nausea, vomiting, and diarrhea, are side effects of antibiotics like metronidazole, and these unpleasant conditions often disrupt women's daily routines, making an already challenging everyday life even harder to manage. When it comes to the broader consequences of women’s vaginal health issues, more research is needed. There are already several statistics highlighting how especially menstrual health and reproductive health, affect workplace attendance. One survey found that menstrual-related symptoms lead to an average of 9.1 days of productivity loss per woman per year, including both absenteeism and reduced effectiveness at work. Consequently, we have started to uncover how much vaginal infections impact the individual woman, but we still need to understand the consequences of vaginal infections on a societal level even better.
There is a vast amount of ongoing research that aims to understand the reasons behind the shortcomings of antibiotics when it comes to treating infections. One of the most well-established reasons for its shortcomings is antibiotic resistance (AMR). Repeated use of antibiotics allows bacteria to develop protective genes, rendering the drugs ineffective. Another way bacteria escape antibiotics is by forming a sheath known as biofilm - a coating over a group of bad bacteria that prevents the penetration of antibiotics, rendering them less effective. Another problem is the fact that antibiotics often kill the protective bacteria, such as lactobacilli, along with the bad ones. This disruption of the natural balance, known as dysbiosis, can lead to the recurrence of bacterial vaginosis (BV) and other complications.
Antibiotics are essential for treating or preventing certain bacterial infections. However, they are not effective against viral infections like the common cold or flu. In the U.S., a staggering 28% of antibiotic prescriptions are unnecessary, and that’s a big deal. When used appropriately, antibiotics can be lifesaving, especially for severe bacterial infections like cellulitis or pneumonia, and for people with conditions such as diabetes, where the risk of complications is higher.
Overuse of antibiotics for mild conditions like bacterial vaginosis (BV) or other non-severe infections not only increases the risk of antibiotic resistance but also disrupts the body’s natural microbiome, leading to secondary complications like recurring infections or yeast overgrowth. In the case of BV, repeated antibiotic use can damage beneficial bacteria, making it harder for the vaginal microbiome to recover and maintain its balance. This creates a cycle of reinfection that is difficult to break.
To combat this, a two-pronged approach is needed: understanding the root causes of infections and ensuring that antibiotics are prescribed only when necessary. For conditions like BV, exploring alternative treatments that target the underlying imbalance without contributing to resistance is key. Responsible use of antibiotics protects individual health and ensures these critical medications remain effective in the fight against life-threatening bacterial infections.
Researchers have explored various alternative treatments to tackle BV recurrence; antiseptics, disinfectants, vaginal acidifying agents, combination therapies, and probiotics (both oral and vaginal). Unfortunately, these options have shown only limited or inconsistent success. Currently, the U.S. Centers for Disease Control and Prevention (CDC) recommends metronidazole and clindamycin as first-line treatments for women with symptomatic BV. When it comes to optimal treatment strategies for recurrent cases, limited data is available. The CDC considers retreating with the same regimen acceptable, but here’s the catch: the benefits often fade once suppressive therapy ends, leaving many women stuck in a frustrating cycle of recurrence and retreatment.
There is still so much we don’t know about women’s vaginal health. Countless pages left unturned and vital information yet to be uncovered. Research in alternative light therapy, including the use of Ultra Violet A (UVA) and Blue light for treatment of chronic BV and thrush, is emerging. Our company, UVISA Health, is actively engaged in advancing this field, and in conducting research. We are developing a light therapy device that can treat sufferers from recurrent episodes of BV and thrush. We believe that women deserve to feel comfortable at all times, and that treatment options should support and help at all times, not be a source of more confusion or fall-backs.
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