Ask the Nurse

I am 56 years old and had my hysterectomy in 1990, I still have my ovaries and I have been having recurrent bacterial vaginosis. I finished antibiotics, but the BV still re-occurs. I quit smoking cigarettes, but started vaporing. I asked my doctor to prescribe me a low dose estrogen pill, but she will not give it to me because I'm still vaporing. Is it normal for a 56 year old to have recurrent bacterial vaginosis, is this part of going through menopause?

Bacterial Vaginosis (BV) is common in women and is often a result of change in acidity of the vagina. Blood, semen and sweat can raise the vaginal pH, which increases yeast and bacterial overgrowth. Sometimes, women experience BV symptoms after their menstrual cycles, after intercourse, or after antibiotic use (when yeast may overpopulate the vagina). It is important to determine these patterns as it will help guide the best course of treatment for you. If you feel that the current therapy is not clearing your infection, it’s possible that additional cultures with sensitivities need to be obtained in order to ensure that the proper pathogen is being treated.

Your physician may want to check the following:

Women with hysterectomy (even those that smoke) usually benefit from estrogen. Of course, we encourage all nicotine cessation for general health.

Additionally, if you notice that your infection clears while on antibiotics, but recurs, you want to make sure that you have a balanced pH of the vagina. I suggest the following home remedies to help maintain a normal pH:

  1. You can use a product called repHresh, which is over the counter.
  2. Have your partner wash his genitals with plain soap and water before sexual activity.
  3. Avoid wearing pads/liners and thong underwear.
  4. Make sure you are taking adequate Vitamin D supplementation.
  5. Consider taking an oral probiotic.
  6. Eat a yogurt daily.

I also suggest a visit with your women’s health clinican to discuss this further and see if you need to be on chronic suppressive therapy for your recurrent infections. Diabetes and HIV infection are some conditions to consider if you truly have recurrent significant vaginal infections.

All My Best,
Speaking of Women's Health Nurse

April 2, 2019 at 10:14am