For a couple of years in her late 30s, Nicole Donnelly went to walk-in clinics and saw doctors, returning again and again with the same problem and leaving without answers.
One doctor told her there was nothing wrong and questioned why she had even come in. Others had little to offer beyond advice to wear cotton underwear and avoid scented soaps.
“I went to so many doctors, so many times,” she said. “There was never anything they said that I could do about it.”
Donnelly, a Vancouver resident now in her late 40s, is one of many women who have dealt with bacterial vaginosis, or BV — the most common vaginal infection among women of reproductive age. Researchers estimate it affects about one in four women globally, yet scientists still do not fully understand what causes it or how to reliably prevent it from returning.
BV happens when the normal balance of bacteria in the vagina shifts and certain bacteria begin to overgrow. Some women experience discharge or a strong fishy odour, while others have no symptoms at all.
Left untreated, BV has been linked to complications including pelvic inflammatory disease, increased susceptibility to sexually transmitted infections and, during pregnancy, preterm birth.
Donnelly estimates she spent about $500 trying different remedies on her own.
“I tried the regular over-the-counter douches. I made suppositories using coconut oil. I used garlic, I used all the things,” she said.
None of those worked. At one point, she said, the condition contributed to the end of a relationship.
‘They didn’t help me’
BV is typically treated with prescribed antibiotics, according to HealthLink BC . Donnelly said she was never prescribed antibiotics. Instead, she started searching online and came across suggestions about diluted hydrogen peroxide. She tried it and found it helped ease her symptoms.
“They didn't help me out,” she said. “I had to help me out.”
Even when antibiotic treatment is prescribed, relief is often temporary. Studies show that BV returns in 50 to 80 per cent of cases within a year of antibiotic treatment. Antibiotic treatment can also trigger yeast infections by wiping out the good bacteria alongside the bad.
Nicole Pasquino, registered nurse and clinical director at Options for Sexual Health, estimates that roughly 30 to 40 per cent of people treated for BV end up with a secondary yeast infection as a result.
“It ends up being like an unfortunate cycle of trying to manage the BV versus the yeast, especially with people who have recurrence,” Pasquino said.
Another Vancouver resident, Julia Goudkova, said she spent close to two decades dealing with recurring yeast infections, sometimes needing medication almost every month.
“It would change my lifestyle,” she said. “I would have to think twice — am I going to go on a bike ride or not?”
It was only when she saw a gynecologist for an unrelated issue that boric acid treatment was mentioned, she said.
Boric acid works as a mild antiseptic by restoring vaginal pH and creating an environment less hospitable to the bacteria and fungi associated with both BV and yeast infections. Research supports its use for recurrent cases.
“I was so pissed,” Goudkova said. “It costs pennies. It's so much cheaper than over-the-counter medication and it’s much more effective.”
Tanisha, a Black Vancouver woman whose name has been changed to protect her privacy, has been dealing with vaginal infections since she was 15. She is now 32.
Black and Hispanic women in North America experience BV at significantly higher rates than other groups. Tanisha believes racial bias affected how seriously some doctors treated her concerns.
Left to her own devices, Tanisha also pursued alternative treatments that research showed held promise. She has treated her infections with boric acid, lactic acid, ascorbic acid and hydrogen peroxide, and paid privately for vaginal microbiome testing because the standard testing available through her doctors was not giving her clear answers.
“I got so sick of wasting days at a time trying to get a diagnosis and medication that I just bought a microscope,” she said.
She said she eventually started making folders with all the documents to track her symptoms and doctor visits.
“I've even made so many graphs and timelines to consolidate everything into one document so that I can print it out and take it to appointments,” Tanisha told The Tyee via email.
Self-diagnosing helped with yeast infections, she said, because medication for them is available over the counter. But BV has been more difficult.
Getting a BV diagnosis in B.C. usually starts with a clinic visit. A doctor orders a swab and sends a sample to the lab. Patients wait for results and followup treatment. Tanisha said that for her, that last step has never happened.
“I have literally never been called back or offered treatment when I've tested positive,” she said.
And so the process would start over: another appointment, another swab, another wait…
Read the full article at The Tyee →
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