Why BV gets worse with your period – it’s not just pH

BV and pH and Periods

One of the reasons that bacterial vaginosis can flare up after or during your period is due to the change in pH that your menstrual blood inflicts on your vaginal flora. But, this isn’t the only reason – in fact, a more important reason may be the availability of iron that your menstrual blood provides to the bacteria in your vagina.

Iron is required by bacteria for many functions, including making biofilms, and having a free-flowing source of iron from menstrual blood may increase bacteria numbers, strengthen the biofilm, and cause a greater propensity for symptoms.

The change in pH, while important, does not provide the full picture when we discuss why menstrual bleeding causes BV symptoms to flare up.

Survival tasks bacteria need iron for:

  • Regulating biochemical, cellular and metabolic functions
  • DNA synthesis
  • Electron transport system
  • Formation of heme
  • Cofactor for enzymes
  • Oxygen transport
  • Synthesis of energy (ATP)
  • Nitrate reduction in nitrate cycle
  • Essential for biofilm development and growth

In a neutral pH and in the presence of oxygen, iron undergoes rapid oxidation if not bound by an iron-chelating molecule. Most iron is not bioavailable, with most microbes requiring a certain level for normal cell performance. For this reason, microbes have developed a collection of iron-chelating (binding) molecules to scavenge iron from the environment, called siderophores.

There are a few different sorts of these enzymes depending on the species of bacteria.

Once the enzymes have been made, they are exported into the area around the microbe so that it can turn the iron into usable iron. This improves the strength of microbes and their biofilms.

Treating biofilms in the presence of menstrual blood

We do not advise trying to treat BV while you have your period. You get the blood-free zone between periods to do your treatments and try to remove the biofilm and kill any planktonic bacteria. Our Killing BV protocol uses specific biofilm busting enzymes to remove systemic biofilms, while also killing planktonic bacteria, and then repopulating your vagina with good bacteria and healthy biofilms.

Anaemia and biofilms – are you anaemic because you have a lot of biofilms?

Some biofilm agents actively block iron for a short period of time, which is why if you are already anaemic, some biofilm enzymes are not best-suited. What this also means is that if you are mysteriously anaemic – for no reason that anyone can determine – it might be because you have extensive biofilms throughout your system, with the bacteria actively scavenging iron from your digestive tract before it can be absorbed.

If you have consistently low iron levels, but eat red meat regularly, and have vaginal infections, you may be due a course of anti-biofilm treatments.

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Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)