Symptom management between treatments in stubborn BV

TL;DR

For those struggling with recurrent bacterial vaginosis (BV), finding relief between treatments can be challenging. This article explores various strategies for symptom management, including the use of 6% hydrogen peroxide douches, probiotic pastes, boric acid, and practical tips for maintaining hygiene and controlling odour. These recommendations aim to provide temporary relief and improve quality of life while addressing the underlying factors of BV.

Not everyone is going to be able to solve their bacterial vaginosis first, second or third go with the Killing BV treatments, and treatment fatigue is a very real thing. You may need to take breaks.

Sometimes there are underlying factors that predispose you to vaginal microflora imbalances that are not readily solvable using our normal methods. You could be impeded by medication, hormonal imbalances, underlying illnesses, or having very hardy, resistant bacteria to overcome.

Whatever the cause, if you need a break, here are some recommendations for controlling your symptoms while you gather your strength for further treatments and testing.

6% hydrogen peroxide douche

Our first recommendation is six per cent hydrogen peroxide. Not three, not 12, but six per cent. Three isn’t strong enough to eliminate the odour properly, and 12 per cent is too strong.

Only use hydrogen peroxide douches if your vagina can handle it – stinging is normal, and disappears quickly, but any swelling or other adverse effects, you should avoid this treatment.

You can use this treatment as often as you like – typically it will give you a clear few days, but it can offer relief from odours and discharge until your pH is disrupted again, by sex or your period.

Hydrogen peroxide is unlikely to solve your problem over the long-term but can provide you with some much-needed relief.

You can have sex, but you’re still contagious so unless it doesn’t matter (i.e. you and your partner have been sharing bugs for ages and you both already have it), use a barrier method and don’t exchange body fluids.

Probiotic-Luvena or probiotic-Multi-Gyn paste

Use Life-Space Women’s Microflora Probiotic powder mixed with Luvena or Multi-Gyn to make a paste, inserted vaginally using an applicator or syringe.

Take a vaginal applicator, put some gel in it, dump the powder contents of the probiotic capsule in, stir it up with a large safety pin or toothpick, and insert it every morning.

If you use Multi-Gyn as the mixing gel, it stays in place all day. This strategy can keep symptoms at bay, particularly distressing odour.

Boric acid

Boric acid keeps the vagina acidic, thus keeping pathogens in check. Boric acid, in our experience, is not a good overall treatment, but can be useful between treatments.

Boric acid fact sheet

Wear underwear

Wear underwear every day. Letting your vagina ‘breathe’ is not only not helpful in this instance, but it can make your discharge go everywhere, and cause the smell to leak out of your clothing more.

Wear a panty liner

A panty liner can be changed when it starts to smell, and they are thin, absorbent, and disposable. Once you have changed the panty liner, wrap it tightly in toilet paper and bin it so the smell doesn’t go through the toilet cubicle. Don’t ever flush panty liners, wipes, or pads.      

Wear a small tampon

Tampons absorb the moisture from your vagina, so can be a good way to keep BV odour escaping the confines of your vagina.

If you need to use a tampon for a short period of time, you should feel free to, though keep in mind that you are perpetuating the bacterial problem by offering a soft loving cushion for the bacteria to thrive on.

IMPORTANT NOTE: Wearing a tampon in the presence of pathogens can result in toxic shock syndrome, so our advice is to use a vaginal probiotic in a vegetable capsule at the same time.

Control sweat

Your vagina doesn’t sweat, but your groin does, and this can spread odours from your vagina around in your underwear and beyond inadvertently.

Controlling sweat might include a change in underwear – so no g-strings, no lace, no lycra.

Look online for specific underwear that holds in odours and sweat (like period undies), but keep in mind that this underwear can harbour pathogens and make problems worse. A panty liner, pad or cotton underwear may be better for you personally.

There are several new sorts of odour-control underwear on the market, and they are not outrageously expensive.



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)
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