Dear Aunt Vadge,
I’m 26 weeks pregnant and am really struggling with BV, UTIs and yeast, with constant burning, stinging, discharge, redness and urinary frequency and urgency.
I’m in so much pain I can barely walk, and I’m completely exhausted (which I was before pregnancy also, like a 3 out of 10 energy levels). I hardly sleep and am constantly anxious and stressed out, all while being extremely busy.
I’ve tried MANY treatments – Aunt Vadge’s AV Herbal Pessary Blend, milk kefir, probiotics, boric acid, and oral and vaginal antibiotics over and over.
The only thing that has helped a little is Balance Activ Gel, but it only gave slight relief. My vaginal pH is 5. I do have some digestive problems, bloating, gas etc, and before I was pregnant, I would get PMS, irregular cycles, and short clotty periods, if that helps any.
I’d be so grateful for any suggestions you have for me.
Warm regards,
Deeply Suffering
Age 35, UK
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Hi there Deeply Suffering,
First, I’m so sorry you’re going through this! It sounds so stressful and painful, and a real downer on what can be such a lovely time during pregnancy.
Overall, it sounds like you could use a bit more detailed support from a practitioner who can assess your nutrient levels and other factors. The high L. iners is a red flag for nutrient deficiencies, but so is extremely low energy, being awake all night and digestive issues. That’s all without the added stress on your body of being pregnant.
Your microbiome dominated by L. iners is probably why all your vaginal swab tests have come back ‘clear’, but it’s not necessarily a cause of vaginal symptoms by itself. It can be, as it’s not super protective so let’s anybody in, but it sounds like you’ve got something a little bigger going on that is driving the dysbiosis. Check out this article on L. iners to get some more rounded information on that side of things.
Given your symptoms and the fact that your vaginal pH is at 5.0 (which is on the high side), and considering you’re currently pregnant, your options for treatment should be prudent and safe. The Balance Active lactic acid gel has provided some relief, indicating that efforts to acidify your vaginal environment might be beneficial.
In that sense, a once or twice a week lactulose and probiotic treatment could serve you well both for the urinary tract and vagina, and help keep the right sorts of bacteria present for the duration of your pregnancy to help reduce BV and dysbiosis related risks.
Continuing with interventions like probiotics is a good idea, as it can help support healthy vaginal flora, even if it feels like it’s not doing much. It’s better to take them than not to.
Your low energy levels are concerning, particularly as they were present even before pregnancy — this could possibly be due to your high stress levels and poor sleep, both of which can significantly impact energy and overall well-being. Though low energy can be somewhat normal during pregnancy, it’s essential to monitor this with your healthcare provider, as it could also signify certain deficiencies or other health concerns.
Considering the high L. iners, my first suspicion is that you’re running low in certain nutrients, and may benefit from a thorough blood test for iron, thyroid, B12, folate and zinc, but also a full assessment of your nutrient intake and absorption and assimilation. If your digestion isn’t going that well, you might be eating well, but not absorbing what you need, and this could have been happening for a while, contributing to the low energy and high anxiety.
Low B12, for example, will directly lead to low energy and high anxiety, and the minute you correct it, those factors can evaporate into thin air. Anxiety can be treated less as a psychological state, but more of a symptom like a cough or headache, particularly when it is severe or just there all the time whether you’ve earnt it or not.
Keep in mind that folate and B12 serum blood tests are only for stored, not active, forms of these nutrients and having normal or even high levels does not rule out a functional deficiency, particularly in the light of your symptoms. In this case, it might be useful to book in with one of My Vagina’s naturopaths to get a more nuanced perspective of your nutrient levels, and the right tests and interpretation to determine levels.
Considering you’re 26 weeks pregnant, it’s essential to manage these symptoms with the safety of your pregnancy in mind, knowing that BV1 and UTIs can be not just unpleasant, but dangerous also1–5. I would recommend seeing your GP or obstetrician to discuss these symptoms further and get their advice on managing them during the rest of your pregnancy (which I’m sure you’re already doing).
Your doctor may be able to recommend further safe treatments to help alleviate your discomfort, including specific probiotic strains targeted for pregnant individuals that might help outcompete the harmful bacteria causing symptoms. In that sense, you could try the Life-Space Pregnancy and Breastfeeding Probiotic, or adding in a range of fermented foods that are not on the banned-in-pregnancy list.
You’re doing great dealing with so much, these discomforts are really distressing. Pregnancy is a really tough time to have these awful symptoms, because your treatment options are more limited and it is really going to test your mettle!
Your health and the health of your baby are paramount, so always cross-check any treatments or remedies with a healthcare provider who’s familiar with your pregnancy. Here to help as we can, as always.
Best,
Aunt Vadge
References
- 1.Hay PE, Morgan DJ, Ison CA, et al. A longitudinal study of bacterial vaginosis during pregnancy. BJOG. Published online December 1994:1048-1053. doi:10.1111/j.1471-0528.1994.tb13580.x
- 2.Ng BK, Chuah JN, Cheah FC, et al. Maternal and fetal outcomes of pregnant women with bacterial vaginosis. Front Surg. Published online February 13, 2023. doi:10.3389/fsurg.2023.1084867
- 3.Lata I, Pradeep Y, Sujata, Jain A. Estimation of the incidence of bacterial vaginosis and other vaginal infections and its consequences on maternal/fetal outcome in pregnant women attending an antenatal clinic in a tertiary care hospital in North India. Indian J Community Med. Published online 2010:285. doi:10.4103/0970-0218.66855
- 4.Kenfack-Zanguim J, Kenmoe S, Bowo-Ngandji A, et al. Systematic review and meta-analysis of maternal and fetal outcomes among pregnant women with bacterial vaginosis. European Journal of Obstetrics & Gynecology and Reproductive Biology. Published online October 2023:9-18. doi:10.1016/j.ejogrb.2023.08.013
- 5.Balachandran L, Jacob L, Al Awadhi R, et al. Urinary Tract Infection in Pregnancy and Its Effects on Maternal and Perinatal Outcome: A Retrospective Study. Cureus. Published online January 22, 2022. doi:10.7759/cureus.21500
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