Re: bacterial vaginosis

[Guest guest]

I have heard of patients shaking out a probiotic on a tampon, or even dipping it

in yoghurt

J Fidler, MCPP, (RH) AHG

Herbalist

________________________________

To: ukherbal-list

Sent: Tue, February 15, 2011 5:27:40 PM

Subject: bacterial vaginosis

Hello there,

Has anyone treated bacterial vaginosis (BV)?

I have a pt with genital warts which have almost gone but now she has

BV.

It seems to be an infection caused when lactobacillus species are

nudged out of the way by anaerobic bacteria resulting in a raised pH.

Applying a good live yoghurt with a range of lactobacillus species

locally seems an obvious approach as well as patient specific immune

support and gut flora help but I wonder if anyone has any experience

with BV that they might like to share?

best wishes,

Guy

[Guest guest]

Rather than using a tampon, think of using a small sea sponge for

introducing topical medicines to the vagina.

It can be soaked in a strong strained tea, vinegar, diluted yoghurt,

a few drops of essential oil... whatever is prescribed.

And yes, I too have heard of people using probiotic capsules locally,

simply by introducing the capsule itself, which will melt just as it

does on the stomach.

>

>

>I have heard of patients shaking out a probiotic on a tampon, or

>even dipping it

>in yoghurt

> J Fidler, MCPP, (RH) AHG

>Herbalist

[Guest guest]

I saw a couple of studies this year about bacterial vaginosis. The one supports

to the suggestions of yogurt.

Sabra

Sabra Way Medical Herbalist MNIMH

Galen's Watch: A Journal Watch for Integrative Health Professionals

www.galenswatch.com

Am J Obstet Gynecol. 2010 Aug;203(2):120.e1-6.

Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a

double-blind, randomized, placebo-controlled study.

Ya W, Reifer C, LE.

Department of Gynecology, Yuyao/Xinhua Hospital, Shanghai Jiao Tong University

School of Medicine, Shanghai, China.

Abstract

OBJECTIVE: We assessed the effectiveness of vaginal probiotic capsules for

recurrent bacterial vaginosis (BV) prevention.

STUDY DESIGN: One hundred twenty healthy Chinese women with a history of

recurrent BV were assigned randomly to daily vaginal prophylaxis with 1 capsule

(Probaclac Vaginal; Nicar Laboratories, Inc, Blainville, Quebec, Canada) that

contained 8 billion colony-forming units of Lactobacillus rhamnosus, L

acidophilus, and Streptococcus thermophilus (n = 58 women) or 1 placebo capsule

(n = 62 women) for 7 days on, 7 days off, and 7 days on.

RESULTS: Probiotic prophylaxis resulted in lower recurrence rates for BV (15.8%

[9/57 women] vs 45.0% [27/60 women]; P < .001) and Gardnerella vaginalis

incidence through 2 months (3.5% [2/57 women] vs 18.3% [11/60 women]; P = .02).

Between the 2- and 11-month follow-up period, women who received probiotics

reported a lower incidence of BV and G vaginalis. Aside from vaginal discharge

and malodor, no adverse events were reported in either study group.

CONCLUSION: Short-term probiotic prophylaxis is well tolerated and reduces BV

recurrence and G vaginalis risk through 11 months after treatment.

Copyright © 2010 Mosby, Inc. All rights reserved.

PMID: 20659602 [PubMed - indexed for MEDLINE]

Sex Transm Dis. 2010 Feb;37(2):94-9.

Personal hygienic behaviors and bacterial vaginosis.

Klebanoff MA, Nansel TR, Brotman RM, Zhang J, Yu KF, Schwebke JR, s WW.

Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy

Shriver National Institute of Child Health and Human Development, National

Institutes of Health, Department of Health and Human Services, Bethesda, MD

20892-7510, USA. mk90h@...

Abstract

BACKGROUND: Vaginal douching is consistently associated with bacterial vaginosis

(BV), but whether it is a cause or result of BV remains unknown. The association

between BV and other feminine hygienic behaviors is less studied; if BV symptoms

caused behavior change then all hygiene behaviors might be more common among

women with BV. Lack of association between nondouching hygiene behavior and BV

would argue against reverse causation.

METHODS: In the Longitudinal Study of Vaginal Flora 3620 women had 13,517 visits

where BV (Nugent score) was assessed. Associations between hygienic behavior and

BV were assessed by Poisson regression.

RESULTS: After adjusting for demographic and sexual behavior factors, neither

type of underwear (nylon vs. cotton prevalence ratio (PR) 1.05, 95% CI:

0.97-1.13), menstrual protection (tampons vs. pads; PR: 1.04, 95% CI: 0.95-1.12;

pads and tampons vs. pads 1.00, 95% CI: 0.92-1.07), use of pads or panty liners

when not menstruating (PR: 0.99, 95% CI: 0.95-1.05), nor weekly or greater use

of hygiene spray (PR: 1.01, 95% CI: 0.94-1.09), powder (PR: 1.02, 95% CI:

0.96-1.07) or towlettes (PR: 1.03, 95% CI: 0.94-1.13) were strongly associated

with BV. PR for daily versus less than daily bathing and showering were 1.06

(95% CI: 1.02-1.12) and 1.04 (95% CI: 1.00-1.09). Douching remained associated

with BV (PR for weekly or greater vs. never 1.17, 95% CI: 1.09-1.26) and was not

substantially impacted by adjustment for other hygienic behavior.

CONCLUSIONS: Douching, but not other feminine hygiene behaviors, is

significantly associated with BV, providing additional evidence that douching

may be causally associated with BV and is not simply a response to BV symptoms.

PMID: 19823112 [PubMed - indexed for MEDLINE]PMCID: PMC2811217Free PMC Article

[Guest guest]

Hello Guy,

I had one really stubborn case that was recurring and needed

serious antibiotics each time. The final solution was drastic treatment I warned

the patient that it could temporarily interfere with her cycle, it did. However

it stopped the whole thing. I used TCM herbs it was a pattern of dampness which

I presumed that was why so persistent.

My advice would be to identify the causes in your case then go in as hard as

possible it needs vigorous treatment if it's a chronic entrenched pattern with

lots of antibiotic use.

We were able to successfully restart periods again after two months. Client

remained well.

Look at diet and other precipitating factors like oral steroids, pill etc.

Lorraine

Lorraine Hodgkinson MNIMH MRCHM

HERBS AND HELPERS

6, Butts Fold, Cockermouth,

Cumbria, CA13 9HY. UK.

Tel: +44 (0) 1900 826392

Mobile: 07761 489838 (O2)

www.herbalmedicineuk.com

> Hello there,

>

> Has anyone treated bacterial vaginosis (BV)?

> I have a pt with genital warts which have almost gone but now she has

> BV.

> It seems to be an infection caused when lactobacillus species are

> nudged out of the way by anaerobic bacteria resulting in a raised pH.

> Applying a good live yoghurt with a range of lactobacillus species

> locally seems an obvious approach as well as patient specific immune

> support and gut flora help but I wonder if anyone has any experience

> with BV that they might like to share?

>

> best wishes,

>

> Guy

>

>

[Guest guest]

Hi Guy

I did some work on this a while ago when a patient came to me with it.

I intended turning the below into an information sheet for patients so it's a

bit raw and not edited and also has some things that sound almost doctor speak

rather than professional to professional so excuse that.

I'm pasting in my complete notes - some of it is just one word, so come back to

me if anything isn't clear or you can't figure out where I was going with it.

It's actually a pretty common problem - I've seen figures of between 10 and 60%

of women will have it at some stage.

Bacterial Vaginosis is caused by an overgrowth of anaerobic bacteria most often

Gardnerella.

Gardnerella increases, anaerobes increase, as a result the Gardnerella produces

amino acids, the anaerobes have an enzyme that cleaves into amines. The amines

raise the pH in the vagina, that cause the squamous cells to slough and

desquamate and produce discharge characteristic of the disease. Then you have a

cycle of elevated pH which kills more lactobacilli which allows the anaerobes to

increase even more.

Good bacteria outnumbered.

Lactobacillus bacteria are aerobic bacteria, favoring oxygen-rich environment.

Lactobacillus bacteria produce small quantities of lactic acid, which account

for the moderate acidity of normal vaginal secretions. This mildly acidic

environment is thought to play a significant role in immune defense as this

acidity has the effect of inhibiting the growth of many other microorganisms,

which might be introduced within the vagina. Lactobacillus bacteria are also

responsible for producing small quantities of hydrogen peroxide that has an

additional role in protecting the vagina from particular infections.

The exact reasons that bacteria overgrow are not known. BV is not a true

sexually transmitted disease, but it is more common in women with multiple

sexual partners.

Women without bacterial vaginosis had 1 to 6 vaginal bacterial species in each

sample taken from them and lactobacillus species (phylotypes) were the

predominate bacteria.

Women with bacterial vaginosis had greater bacterial diversity with 9 to 17

phylotypes detected per sample. 35 unique bacterial species were detected in the

women with bacterial vaginosis.

Risk factors seem to be

Antibiotics – kill all bacteria

Douching and/ or use of antibacterial wipes or alcohol wipes

Spermicides

Vaginal hygiene products – deodorants, perfumes, douches, scented tampons, etc.

Detergents

Fabric softeners

New sexual partner, multiple sex partners

E. Coli, which is a normal inhabitant of the rectum, can cause BV if it is

spread to the vaginal area.

IntraUterine Device (IUD) for birth control

Unclean sex toys or sex enhancement products that contain sugar or chemicals.

It appears that the presence of a Sexually Transmitted Disease (STD) increases

the risk of BV; up to 64% of women with STDs also have BV, compared with 10-20%

of all women.

getting piercings or tattoos in the vaginal area could also contribute.

Other factors, which may contribute, include hot weather, tight clothing, poor

general health, and poor hygiene.

Hormone factors

Stress

Menstruation

Pregnancy (about 10% to 30% of pregnant women develop BV) – it's not a cause of

BV but BV occurs in many pregnanat women.

The pill

Up to 50% of women diagnosed with Bacterial Vaginosis do not have symptoms.

Some women never know they even have Bacterial Vaginosis because symptoms never

occur.

Normal vaginal secretions have pH of about 4. In Bv it is greater than 4.7.

Semen in neutral, pH 7. So presumably (not an expert here by any means) semen

increases pH of vagina and therefore bacteria can thrive. (Sounds like I'm

turning into some kind of celibacy freak! – but nuns get BV too, so sex is only

one factor. Just smell is usually greater post-sex.

Same is true of blood – so smell increases around menstruation.

Abx – about 30% will have recurrence within 6 months.

Complications include PID, pre-term delivery.

I believe in the USA, some doctors treat all women for BV before having

hysterectomy.

Think of it as a long term disorder rather than an acute problem which is how

it is treated by doctors – Abx. Not their fault, they jus don't have the tools

needed to really address it.

Vitamin B – deficiency can encourage overgrowth of `bad' bacteria.

Treatment: -

Aim at rebalancing and addressing whole health issues.

Vit B supplement and diet rich in B vits (if patient has herpes then that

sounds distinct possibility)

Green leafy veg, sunfloer seeds,

Folic acid supplement – Abx deplete this

Sitz baths with cider vinegar.

Compromised immune system may need addressing

Douche with antimicrobial herbs esp Calendula. Possibly Tea tree oil dilute of

course.

Pessaries with acidophilus in, or you could just use capsules as the casing will

dissolve (advise use of panty liners with pessaries)

I gave acidophilus internally as well

Stellaria helps with itching

Probiotics and prebiotics

Avoid refined carbs – BV more likely to recur – sugar makes body a breeding

ground for BV. Occasional is fine

I sound like a real party pooper! No sex, no chocolate, what is a girl to do!

anyway hope that helps and saves you doing a lot of work.

>

[Guest guest]

Fascinating.

To that regimen, I would add tissue tonics, such as Lamium or

Alchemilla to strengthen the m,embranes and Cimicifuga or Schisandra

to increase normal vaginal lubrication.

Sally Owen

> Hi Guy

>

> I did some work on this a while ago when a patient came to me with it.

> I intended turning the below into an information sheet for patients

> so it's a bit raw and not edited and also has some things that sound

> almost doctor speak rather than professional to professional so

> excuse that.

> I'm pasting in my complete notes - some of it is just one word, so

> come back to me if anything isn't clear or you can't figure out

> where I was going with it.

> It's actually a pretty common problem - I've seen figures of between

> 10 and 60% of women will have it at some stage.

>

>

> Bacterial Vaginosis is caused by an overgrowth of anaerobic bacteria

> most often Gardnerella.

>

> Gardnerella increases, anaerobes increase, as a result the

> Gardnerella produces amino acids, the anaerobes have an enzyme that

> cleaves into amines. The amines raise the pH in the vagina, that

> cause the squamous cells to slough and desquamate and produce

> discharge characteristic of the disease. Then you have a cycle of

> elevated pH which kills more lactobacilli which allows the anaerobes

> to increase even more.

>

> Good bacteria outnumbered.

>

> Lactobacillus bacteria are aerobic bacteria, favoring oxygen-rich

> environment. Lactobacillus bacteria produce small quantities of

> lactic acid, which account for the moderate acidity of normal

> vaginal secretions. This mildly acidic environment is thought to

> play a significant role in immune defense as this acidity has the

> effect of inhibiting the growth of many other microorganisms, which

> might be introduced within the vagina. Lactobacillus bacteria are

> also responsible for producing small quantities of hydrogen peroxide

> that has an additional role in protecting the vagina from particular

> infections.

>

> The exact reasons that bacteria overgrow are not known. BV is not a

> true sexually transmitted disease, but it is more common in women

> with multiple sexual partners.

>

>

> Women without bacterial vaginosis had 1 to 6 vaginal bacterial

> species in each sample taken from them and lactobacillus species

> (phylotypes) were the predominate bacteria.

>

> Women with bacterial vaginosis had greater bacterial diversity with

> 9 to 17 phylotypes detected per sample. 35 unique bacterial species

> were detected in the women with bacterial vaginosis.

>

> Risk factors seem to be

> Antibiotics – kill all bacteria

> Douching and/ or use of antibacterial wipes or alcohol wipes

> Spermicides

> Vaginal hygiene products – deodorants, perfumes, douches, scented

> tampons, etc.

> Detergents

> Fabric softeners

> New sexual partner, multiple sex partners

> E. Coli, which is a normal inhabitant of the rectum, can cause BV if

> it is spread to the vaginal area.

> IntraUterine Device (IUD) for birth control

> Unclean sex toys or sex enhancement products that contain sugar or

> chemicals.

> It appears that the presence of a Sexually Transmitted Disease (STD)

> increases the risk of BV; up to 64% of women with STDs also have BV,

> compared with 10-20% of all women.

> getting piercings or tattoos in the vaginal area could also

> contribute.

> Other factors, which may contribute, include hot weather, tight

> clothing, poor general health, and poor hygiene.

>

> Hormone factors

> Stress

> Menstruation

> Pregnancy (about 10% to 30% of pregnant women develop BV) – it's not

> a cause of BV but BV occurs in many pregnanat women.

> The pill

>

>

> Up to 50% of women diagnosed with Bacterial Vaginosis do not have

> symptoms.

> Some women never know they even have Bacterial Vaginosis because

> symptoms never occur.

> Normal vaginal secretions have pH of about 4. In Bv it is greater

> than 4.7. Semen in neutral, pH 7. So presumably (not an expert here

> by any means) semen increases pH of vagina and therefore bacteria

> can thrive. (Sounds like I'm turning into some kind of celibacy

> freak! – but nuns get BV too, so sex is only one factor. Just smell

> is usually greater post-sex.

>

> Same is true of blood – so smell increases around menstruation.

> Abx – about 30% will have recurrence within 6 months.

> Complications include PID, pre-term delivery.

> I believe in the USA, some doctors treat all women for BV before

> having hysterectomy.

>

> Think of it as a long term disorder rather than an acute problem

> which is how it is treated by doctors – Abx. Not their fault, they

> jus don't have the tools needed to really address it.

>

> Vitamin B – deficiency can encourage overgrowth of `bad' bacteria.

>

> Treatment: -

> Aim at rebalancing and addressing whole health issues.

> Vit B supplement and diet rich in B vits (if patient has herpes

> then that sounds distinct possibility)

> Green leafy veg, sunfloer seeds,

> Folic acid supplement – Abx deplete this

> Sitz baths with cider vinegar.

> Compromised immune system may need addressing

> Douche with antimicrobial herbs esp Calendula. Possibly Tea tree oil

> dilute of course.

> Pessaries with acidophilus in, or you could just use capsules as the

> casing will dissolve (advise use of panty liners with pessaries)

> I gave acidophilus internally as well

> Stellaria helps with itching

> Probiotics and prebiotics

> Avoid refined carbs – BV more likely to recur – sugar makes body a

> breeding ground for BV. Occasional is fine

>

>

> I sound like a real party pooper! No sex, no chocolate, what is a

> girl to do!

> anyway hope that helps and saves you doing a lot of work.

>

>

>

>

>

>

>

>

>

>

>>

>

>

>

>

> ------------------------------------

>

> List Owner: Graham White, MNIMH