Aunt Vadge: I have BV but nothing the doctor gave me works

Hi Aunt Vadge,

I usually don’t ask the internet for help, but I have had BV for over a year now, maybe two. It’s not from sexual activity because I was not sexually active. I went to the gyno and they put me on Flagyl [metronidazole] for a week which did absolutely nothing. Then I got put on compounded boric acid suppositories and nothing. I then went to the store and got vitamin C and I read that those help… and nothing. I got acidophilus, vitamin D, probiotics, and folic acid. It has been over a week and nothing.

I have strong-smelling, thick, elastic, cottage-cheese, creamy white-to-light yellow discharge that used to smell like ammonia, but now it smells a little sour (I can’t put my finger on the exact smell). I don’t have any itch or pain. I don’t know what triggered the BV, but I was tested and the gynaecologist said I had it. I’ve been tested for chlamydia and gonorrhoea, which were negative. 

I’m so emotionally drained and embarrassed and I don’t know what else to do. Is there anything else I could try? Because I’m only 17 and don’t want to change my diet this early on in my life :'( I also don’t want to keep going back to the dr because so far it’s been a waste. Thanks a lot. 

Age: 17
Country/Area: USA

Dear Drained,

Your symptoms really don’t match BV by itself. One of the reasons that BV symptoms are so specific is because of the odour and discharge. Thick, yellowish, elastic, cottage cheese discharge is just not a symptom of BV, and that’s because the bacteria involved in BV actually break down your vaginal fluids with these special enzymes, which makes BV discharge a bit watery and dull. With the fishy odour, these specific bacteria also excrete a substance that has a chemical reaction with something already in your vaginal fluids that causes this very specific smell – the fishy smell.

(Read about why BV causes a fishy odour here.)

You may have aerobic vaginitis, or something else like a fungus (yeast). Your symptoms are atypical of bacterial vaginosis, but it doesn’t mean it’s not lurking in there – you could have many bacteria hanging around helping each other out. This is when BV gets a little more complex. The fact that no antibacterial has helped your symptoms is interesting and useful information, because maybe it’s not bacterial at all.

What I would recommend, if you are not in any kind of massive hurry (these things tend to take a while to get the recipe right on), is you read Killing BV, which is our book on how to get rid of BV, and read everything you can so you understand what you are dealing with, since parts of it will definitely apply. I’m not sure what your access to medical care/testing is, but one of the issues with BV is that doctors only do a limited swab, and do a culture on your vaginal fluids. This means that they put your vaginal fluids in a petri dish and see what grows. Then, the results get sent to your doctor, and you get your diagnosis.

What this method of testing doesn’t account for is that some bacteria in your vagina that can cause these symptoms are really hard to culture – either they grow too slowly or don’t grow very well in petri dishes, so even if you have those bacteria or fungi, they aren’t detected. This is a massive issue with ongoing, recurrent vaginal infections – you are not alone in that you got diagnosed with something, which then doesn’t respond to the treatments, and you are left on your own to figure out the problem.

You will find this occurs a lot in your life, because vulvovaginal health is really not a huge priority, despite so many of us having ongoing seemingly incurable vaginal infections. Antibiotic overuse and resistance is a huge issue here too, since some of these bacteria and fungi (like yeasts) are very antibiotic and antifungal resistant, and with each treatment, they get more so. Doctors have very limited treatment options – antibiotics.

This is another reason why your treatments can fail, as some bacteria and fungi are really hardy and quick to learn. Their aim is to survive, and they are very clever!

One form of testing that can accompany a broad culture is PCR testing, which tests for DNA in a sample, instead of trying to grow the bacteria. This means if the bacteria or fungi or virus is present in the sample, the DNA – dead or alive – can be detected, instead of relying on bacteria being grown. This can be a more useful test for vaginal imbalances and infections.

The other issue is that in some countries, some known BV/AV bacteria are just not tested for routinely with BV or aerobic vaginitis. This means you could have unusual BV-related bacteria that is simply not being tested for.

Read the book (coupon code in email), then we’ll keep talking. Once you’ve read it all cover to cover (don’t worry so much about the treatment section for now), then go through the support section on the site, read everything there, and then we’ll talk more about what the best thing for you to try will be, based on what you can afford and symptoms etc. You’ll have a better idea of what you are trying to achieve then.

Warmest regards,
Aunt Vadge  

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