Aunt Vadge: post-antibiotic fissures – what can I do?

Hi Aunt Vadge,

I have been experiencing pain from vaginal fissures for about a week now. I’ve just finished a round of antibiotics for a UTI. My vagina was itchy and sore after day two of starting the antibiotics, and finally on day five I had a yeast infection-like discharge. I treated the discharge with an oral antifungal and am no longer experiencing the itching and no discharge is present.

However, I do still have a tear on each side of my vagina, on the inner part of the lips, a bit deeper inside. My vagina also feels much dryer than normal (I’m usually extremely lubricated at any given time.) Please help me.

Is there anything I can do to speed up healing? At what point should I go and see my doctor? Would anything besides yeast be causing this? Also, I do have HSV2 but this is very different to an outbreak.

Thanks,
Natasha
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Dear Natasha,

I’m sorry to hear you have a painful vagina. It sounds a very uncomfortable situation indeed.

It seems that your vagina might still be suffering from the after-effects of the antibiotic-driven yeast infection. It is imperative to always take a high-quality refrigerated probiotic (two per day, morning and night with food for two weeks) after taking antibiotics and antifungals to recolonise your gut and vagina with friendly bacteria. This applies no matter what the reason for the antibiotics was.

These friendly bacteria normally live in the vagina, but antibiotics kill all of them (usually as intended, especially for a UTI). This means you need to replace them so they can recolonise your vaginal walls and resume their position as the saviours of your vagina.

When you don’t have enough friendly bacteria your vagina can really suffer, as it is left defenceless. It leaves your raw mucous membranes (the inside of the vagina) open to tears and infection from a variety of sources. Further infections might be urinary tract infections (as you’ve just had), yeast infections and if exposed, it can make you more susceptible to sexually transmitted infections – you need your good bacteria to fight for you, keep your vaginal flesh healthy, and prevent dryness, itching and tears caused by imbalance.

To speed up healing, eat plenty of fermented foods and take a high-quality refrigerated probiotic twice daily for two weeks away from other medication and with food. Don’t have sex, masturbate, use tampons or otherwise irritate the vagina until it has healed.

Additionally, in the name of healthy bacterial balance, make sure your bowels are moving easily at least once per day by eating enough high-fibre foods (all vegetables, fruits and legumes contain fibre). Women are advised to get a about 30 grams / one ounce per day. See our article on healthy bowels for healthy vaginas. 

Regularly-moving bowels ensure ‘bad’ bacteria doesn’t have a chance to overgrow in your intestine, causing proliferation and the potential to spread more easily to your vagina (the perineum is short!) – most UTI infections are in fact caused by bacteria from the anus (E. coli).

You should see a doctor if you are in ongoing pain, have non-menstrual bleeding or the fissures don’t seem to be healing on their own.

Sincerely,
Aunt Vadge

How to keep your vagina microflora healthy