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Hi Aunt Vadge,
I usually don’t ask the internet for help, but I’ve had BV for over a year now, maybe two — and not from sex, because I wasn’t sexually active. The gyno put me on Flagyl for a week, which did nothing. Then compounded boric acid suppositories — nothing.
I tried vitamin C, then acidophilus, vitamin D, probiotics and folic acid — 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 smells a little sour. No itch or pain.
I was tested and told I had BV; chlamydia and gonorrhoea were negative.
Sincerely,
Baffled
Hi Baffled,
A year or two of ‘BV‘ that shrugs off Flagyl, boric acid, vitamin C and probiotics, with no itch and no pain, makes me want to widen the diagnosis — because that pattern often isn’t really BV, and the details in your letter point somewhere specific.
Thick, cottage-cheese, white-to-yellow discharge with the smell shifting from ammonia to sour, unmoved by everything including all the acidifying things you’ve tried, fits two look-alikes far better than classic BV. One is aerobic vaginitis, which involves different (often gut-type) bacteria, tends to give yellowish, sometimes ammonia-ish discharge, and doesn’t respond to standard BV treatment.
The other is cytolytic vaginosis — an overgrowth of your own protective lactobacilli that turns the vagina too acidic (hence a sour rather than fishy smell) and produces thick white discharge — and crucially, it’s made worse by exactly what you’ve been doing, because boric acid, vitamin C and probiotics all acidify further, so you may have been feeding it.
So the most useful next step is to stop guessing and stop the acidifying onslaught, and find out what’s actually there.
A cheap pH strip is a great first clue — cytolytic vaginosis runs markedly acidic (low), while aerobic vaginitis and BV run alkaline (high) — and a comprehensive vaginal microbiome test (PCR or NGS) will tell you precisely, distinguishing AV, CV and a non-albicans yeast that standard swabs miss.
If it turns out to be cytolytic vaginosis, the treatment is the opposite of everything you’ve tried: gently alkalinise with a baking-soda sitz bath a couple of times a week and let it recover.
This exact ‘BV that won’t clear no matter what’ situation is one of the most common things we untangle, and it almost always turns out to be a mislabelled look-alike, so if you’d like the testing interpreted and a plan built around your result, you can book an appointment.
You’re not stuck — you’ve very likely just been treating the wrong thing.
Warmest regards,
Aunt Vadge
This is general information based on current research and our clinical experience, not a substitute for personalised medical advice.
