Bacterial Vaginosis (BV) or Thrush
What are BV and Thrush?
Bacterial vaginosis (BV) and Thrush (also known as a yeast infection- Candida) are common forms of vaginitis. Vaginitis is inflammation of the vagina that can result in discharge, itching and pain 1. This is caused by a disruption of homeostasis of the microorganisms that colonize the vaginal mucos. This ecosystem is dynamic, with changes in structure and composition influenced by age, menarche (onset of the first bleed), stress, time in the menstrual cycle, pregnancy, infections, birth control methods, sexual activity medication and hygiene 2.
Why is this happening?
The vagina is a diverse ecosystem dominated by good bacteria (bacterium Lactobacilli), maintaining the normal vaginal microflora by preventing the overgrowth of pathogenic and opportunistic organisms.
The primary undesirable organisms that cause thrush are an overgrowth of yeasts - fungal organisms such as Candida albicans, Candida tropicalis, Candida krusei.
BV is an overgrowth of anaerobic bacteria such as Gardnerella vaginalis, Mycoplasma hominis, Atopobium vaginae, Prevotella spp., Veillonella spp., Mobiluncus spp 3.
Common triggers?
BV
Are sexually active
Having multiple partners
New sexual partners
Sex without a condom
Can be triggered by sharing toys
Can be triggered by vaginal douching 4
Thrush
Hormonal changes, such as those associated with pregnancy, birth control pills or menopause
Stress
Sexual activity
Having a sexually transmitted infection
Medications, such as antibiotics and steroids
Use of spermicides for birth control
Uncontrolled diabetes
Use of hygiene products such as bubble bath, vaginal spray, vaginal deodorant or douching
Wearing damp tightfitting clothing, especially after a sweaty workout
Using an intrauterine device (IUD) for birth control
Weak immune system 5
Differences and similarities?
BV
Individuals can carry bacteria associated with BV on the penis that may transmit to another partner.
Overgrowth of yeasts
Discharge is usually thin, grey-white or green.
Discharge can be foul-smelling, "fishy"
Thrush
10% of individuals with penis' will get thrush
Overgrowth of anaerobic bacteria
Discharge can be thick, white (resembles cottage cheese).
Redness or swelling of the vagina or vulva 7
Similarities
It affects 75% of individuals with vulvas
Vaginal discomfort
Itching or burning
Redness or swelling of the vagina or vulva
Stinging or burning while urinating or having sex
Splits in the genital skin causing light spotting or bleeding 8
Mainstream treatment for BV
Treatment of BV is a course of antibiotics, or in the form of a cream or gel to put into the vagina. Diagnosis is confirmed by performing a pelvic examination and vaginal swab test. Research shows positive short term effectiveness but poor long term effectiveness 9.
Mainstream treatment for Thrush
Depending on the type and frequency, a GP will usually prescribe a regime of an antifungal cream, ointment, tablet or suppository after confirming a diagnosis by performing a pelvic examination and vaginal swab test. 10
What can Chinese Medicine do?
In Chinese Medicine philosophy, the Spleen and Stomach play essential roles in digestive function. The stomach breaks down what we eat, whilst the Spleen transforms food and fluids into blood and Qi. When this function is impaired fluids can build up, causing multiple health imbalances, including, leaving the body more susceptible to thrush and BV.
Treatment in Chinese Medicine includes Acupuncture, Diet and Herbs. Acupuncture points are chosen that strengthen the digestive function and restores the balance of intestinal flora by regulating the neuroendocrine network system 11 and increasing immune function. A herbal formula is made for your specific constitution and imbalance, these can be used internally to address the root cause and prevent reoccurrence and externally to relieve symptoms 12.
Diet management is an important component in the management of Thrush and BV and it’s important to get a good quality probiotic.
Avoid
Alcohol
Cigarettes
Cold and raw foods are hard to digest and cause digestive dampness.
Mushrooms, black fungus and white fungus
Fermented foods such as tempeh, soy, miso
Sugary foods and drinks (this feeds the yeast), including fruits
All bread, including wheat and rye
Dairy products
Foods to increase
Large amounts of leafy greens, cabbage, artichoke, daikon radish, pumpkin, yam, winter squash, mung beans, barley and kohlrabi, kelps and seaweeds, garlic
According to the research results of pharmacological effects of active TCM, ingredients are immune-enhancement effects, antibacterial or antifungal activity, and estrogen-like effects. Herbal Medicine is essential, especially if you are experiencing recurrent outbreaks 13.
Could it be something else?
Other conditions may present with similar symptoms. These can include sexually transmitted infections (STIs) or Urinary tract infections (UTIs), so best to confirm with your primary care provider. Individuals that have had ovaries removed or are post-menopausal may develop vaginal atrophy (atrophic vaginitis). Vaginal atrophy can be mistaken for BV or thrush. This condition is due to a decrease in oestrogen, causing thinning, drying and inflammation of the vaginal walls that may occur when your body produces less estrogen 14.
Tips
DO book a consult with your Chinese Medicine doctor
DO see a GP if symptoms persist or worsen
DO wear cotton undies or go commando
DO get a good probiotic- lactobacilli, or eat probiotic-rich foods - sauerkraut, kimchi, kefir etc.
DO use proper hygiene after sex
DO be conscious of clean toys, fingers etc., during intercourse as bacteria may be transferred into the vagina
DO wipe from front to back to avoid spreading germs from the anus to the urethra.
DO use 100% cotton tampons or pads
AVOID coffee, alcohol and stimulants during the acute phase
AVOID all bread, including wheat and rye bread
AVOID Dairy products, including cheeses of all kinds
AVOID Fruits, as their sugars fuel the growth of yeast, Sugar, candy, baked goods
AVOID Fermented foods like miso, tempeh, soy sauces for thrush
AVOID Mushrooms, black fungus, and white fungus for thrush
AVOID Cold and raw foods that cause digestive dampness
AVOID sex during an active case if possible or use latex condoms
AVOID hot tubs, pool and spas in an active case
AVOID the use of deodorants, lube, fragrance wipes, douches, fragrant toilet paper as this disturbs the sensitive ecosystem
DON’T participate in anal then vaginal play without appropriate hygiene.
DON'T use antibiotics for thrush, this will worsen symptoms.