Bacterial Vaginosis Medical Info

One of the natural remedies for bacterial vaginosis is probiotics. But what if you are affected by the condition while you are pregnant? Is it still safe to take probiotic supplements during pregnancy?

Bacterial vaginosis in pregnancy - how is it treated?

Typically bacterial vaginosis during pregnancy is treated with antibiotics, such as metronidazole and clindamycin. There are also more natural ways to achieve bacterial vaginosis relief, including taking probiotic supplements. A paper published in the March issue of the Canadian Family Physician journal reported on the safety of using probiotics in pregnancy.

The authors of the paper wrote that:

"Probiotics have been used for the treatment of acute diarrhea, antibiotic-associated diarrhea, Clostridium difficile, and yeast and bacterial vaginosis... Probiotics administered orally to combat urogenital infections are not systemically absorbed but rather get to the site of action by passage through the gastrointestinal system and ascending into the vagina.

A meta-analysis and systematic review of 8 randomized control trials of probiotic use in more than 1500 pregnant women was published. Most of the women began probiotic treatment between 32 and 36 weeks’ gestation and continued until delivery. The studies included in the meta-analysis compared Lactobacillus spp alone or in combination with Bifidobacterium spp with placebo. There was no increase in the incidence of miscarriages or malformations, which was expected because probiotic use mostly occurred in the third trimester and was therefore unlikely to affect organogenesis."

"Several randomized control trials conducted in pregnant women in the third trimester of pregnancy were published following the meta-analysis. These studies examined Lactobacillus spp and Bifidobacterium spp as monotherapy or in combination. Although not designed to directly evaluate pregnancy outcomes, these studies did not suggest an increase in adverse outcomes related to probiotics. Two observational studies examining the use of lactobacilli in the first trimester of pregnancy reported no increased risk of malformations."

"Because probiotics are rarely systemically absorbed, they are not expected to transfer into breast milk... There are no published data regarding adverse effects in breastfed infants."

The authors concluded that:

"Probiotics do not appear to pose any safety concerns for pregnant and lactating women. Systemic absorption is rare when probiotics are used by healthy individuals, and the current literature does not indicate an increase in adverse pregnancy outcomes."

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Whether you have yeast infection or bacterial vaginosis, both are actually related to the bacteria population residing in the vaginal area. Below is the abstract from the journal paper titled "Vaginal microbiota and the use of probiotics", published in Interdiscip Perspect Infect Dis. 2008;2008:256490, authored by Cribby S, Taylor M, and Reid G.

"The human vagina is inhabited by a range of microbes from a pool of over 50 species. Lactobacilli are the most common, particularly in healthy women. The microbiota can change composition rapidly, for reasons that are not fully clear. This can lead to infection or to a state in which organisms with pathogenic potential coexist with other commensals. The most common urogenital infection in premenopausal women is bacterial vaginosis (BV), a condition characterized by a depletion of lactobacilli population and the presence of Gram-negative anaerobes, or in some cases Gram-positive cocci, and aerobic pathogens.

Treatment of BV traditionally involves the antibiotics metronidazole or clindamycin, however, the recurrence rate remains high, and this treatment is not designed to restore the lactobacilli. In vitro studies have shown that Lactobacillus strains can disrupt BV and yeast biofilms and inhibit the growth of urogenital pathogens. The use of probiotics to populate the vagina and prevent or treat infection has been considered for some time, but only quite recently have data emerged to show efficacy, including supplementation of antimicrobial treatment to improve cure rates and prevent recurrences."

Probiotics for treating imbalanced vaginal microflora are available in capsules, such as Fem-Dophilus capsules.

Apparently one scientific study demonstrated that vitamin C did show some efficacy in curing bacterial vaginosis, a vaginal infection as a result of friendly bacteria (the Lactobacillus species) being replaced by an excessive population of bad bacteria (the aerobic and anaerobic bacteria).

If that's the case, women who suffered from bacterial vaginosis has now another natural remedy for bacterial vaginosis to account on.

Bacterial vaginosis natural treatment with vitamin C

Below is an abstract of the study's methods and results.

Researchers: Petersen EE, Genet M, Caserini M, Palmieri R.
Published in: Arzneimittelforschung. 2011;61(4):260-5.
Title: Efficacy of vitamin C vaginal tablets in the treatment of bacterial vaginosis

A randomised, double blind, parallel groups, placebo controlled clinical trial was conducted to assess the efficacy and safety profile of 250 mg ascorbic acid (Vit. C, Vagi C) in women with bacterial vaginosis (BV).

Overall, 277 out-patients with at least three of the following signs (white discharge that smoothly coats the vaginal walls, pH of vaginal fluid > 4.5, a fishy odor of vaginal discharge before or after addition of 10% KOH and presence of clue cells on microscopic examination) were randomised to apply a tablet deeply into the vagina once daily for 6 days.

The primary efficacy endpoint was the cure rate, defined as the recovery of all inclusion criteria. In the intent-to-treat (ITT) population, cure was achieved by 55.3% of patients with Vit. C (n=141) and by 25.7% of patients with placebo (n=136). The between-group difference was 29.6% (p<0.001).

In the per-protocol (PP) population, cure rate was 66.4% with Vit. C (n=116) and 27.1% with placebo (n = 118), respectively. Between-group difference was 39.3% (p<0.001).

In a subset of patients with centralised evaluation of the vaginal swab, cure in ITT was achieved by 86.3% of patients with Vit. C (n=51) and by 7.6% of patients with placebo (n=53), the between-group difference was 78.7% (p<0.0001). Cure rate in PP was 86.0% with Vit. C (n=50) and 6.1% with placebo (n=49), between-group difference was 79.9% (p<0.0001).

Both Vit. C and placebo were well tolerated and no differences in safety profile were evident between groups. The results support an effective and safe use of silicon-coated Vit. C vaginal tablets in the management of BV.

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From: Infect Dis Obstet Gynecol 2010;2010. pii: 705692.

Abstract:

Multiple-dose metronidazole oral therapy is currently the reference treatment for bacterial vaginosis (BV). This double-blind, double-dummy, noninferiority study compared the efficacy of secnidazole, another nitroimidazole with pharmacokinetics allowing a single dose regimen, to this standard treatment.

A total of 577 patients were randomized to receive metronidazole (500 mg, b.i.d for seven days) or secnidazole (2 g, once). Therapeutic cure at D28 was defined as the resolution of vaginal discharge, positive KOH whiff test, vaginal pH >4.5 and Nugent score >7 on Gram-stained vaginal fluid.

According to this primary endpoint, the single-dose secnidazole regimen was shown to be at least as effective as the multiple-dose metronidazole regimen (60.1 % cured women vs 59.5% , 95% confidence interval with a noninferiority margin of 10%: [-0.082; 0.0094]). Safety profiles were comparable in both groups.

The secnidazole regimen studied represents an effective, convenient therapeutic alternative that clinicians should consider in routine practice.

What about natural cures for bacterial vaginosis? Do they work?

Find out in this 3 days to permanent bacterial vaginosis relief review.