Frederick R. Jelovsek MD
Possible recurrent bacterial vaginosis
Get The Facts About Vaginal Dysplasia
Last August, I noticed an “odor”… I tried all kinds of things and finally went to the GYN in October. She diagnosed “BV”, bacterial vaginitis, and prescribed metronidazole. I’ve used 8 prescriptions, but… guess what?! It doesn’t go away!
Here it is July and it’s still coming back… every month it seems…in fact, now I have a yellowish discharge that I didn’t have before… why? And why did it start in the first place? My husband and I have been married 15 years and are monogamous. Any suggestions? This is actually depressing…
You are now in a category of having chronic vaginitis rather than just acute vaginitis. It is very important to continue to reconfirm the exact diagnosis. This means when you have symptoms, you need an exam that includes wet prep, cervical culture for gonorrhea and chlamydia (even though you are both monogamous), a vaginal pH measurement, and possibly a yeast culture. While bacterial vaginosis can be recurrent, most of the time there is something else going on.
I just saw a patient recently who had a similar story and the wet prep showed predominantly white cells and no bacterial laden clue cells (to diagnose BV). The pH was 4.0 which is physiologic (should be higher than 4.5 for BV). This patient probably has either cervicitis, allergic vaginitis (due to reaction to lubricant in condoms) or desquamative vaginitis.
Our studies and plan will help figure it out but it isn’t BV even though she has been treated 4 times for it. I won’t deny that it could have started as BV but I hope you see my point about getting it fully diagnosed.