How finding the right treatment can prevent BV recurrence

Written in association with: Mr Mahantesh Karoshi
Published: | Updated: 22/02/2022
Edited by: Karolyn Judge

Bacterial vaginosis (BV) is an unwelcome condition for any woman. When the condition starts to reoccur, it’s frustrating to experience symptoms that just don’t seem to disappear despite antibiotic treatment.

 

On hand to explain just how recurring BV does just that, alongside how it can be prevented by changing the way it is currently treated, is one of the best gynaecologists in London Mr Mahantesh Karoshi.

 

Close up of stressed out woman sat on a sofa with arms wrapped around her knees

 

What is bacterial vaginosis and how common is recurring BV?

Bacterial vaginosis affects 15 to 50 per cent of women of reproductive age, and recurrence is common after treatment with antibiotics. The high incidence of recurrence suggests the need for new, different treatment to prevent recurrent bacterial vaginosis.              

 

 

BV management diagram

 

What causes BV?                                            

The vaginal microbiome of most women is dominated by particular lactobacillus species that play an important role in reproductive health. This is by reducing the risk of urogenital infections and complications during pregnancy.

 

Dysbiosis is a disruption of the vaginal microbial ecosystem with a loss of protective hydrogen peroxide-producing lactobacillus and a marked increase in microbial diversity.  

 

Epidemiological studies have shown that vaginal dysbiosis is associated with Bacterial Vaginosis (BV) and recurrent urinary tract infection (UTIs).

Dysbiosis is also associated with sexually transmitted infections, including HIV, preterm birth and low success rates for in vitro fertilization (IVF).

 

 

How are antibiotics ineffective against BV?

Antibiotics are used to treat urogenital infections, but recurrence is common.  After treatment with an antibiotic agent, about 50 per cent of women have recurrent bacterial vaginosis within three months.

 

Antibiotics kill the bacteria that cause these infections, but they don’t prevent recurrence of infection since they do not restore protective Lactobacillus.  

 

 

How can BV treatment become more effective?

Reconstituting a normal, lactobacillus-predominant vaginal flora remains a challenge to develop a microbial defence.

 

L.crispatus is found naturally in the vaginas of healthy women and is commonly found as a component of the natural human intestinal flora. It is facultative anaerobe that can grow in both the presence or absence of oxygen, homofermentor (produces a fermentation resulting wholly in a single-end product) of lactic acid, fastidious in its growth, and capable of hydrogen peroxide production. 

 

The use of oestrogen-containing contraception may be protective. Combined oral contraception is linked to increased vaginal colonisation with lactobacilli and reduced BV-associated microbiota.

 

 

Mr Mahantesh Karoshi is a highly experienced and skilled consultant gynaecologist who can help you when it comes to treating bacterial vaginosis. Visit his Top Doctors profile today to schedule a consultation with him. 

By Mr Mahantesh Karoshi
Obstetrics & gynaecology

Mr Mahantesh Karoshi is a London-based women’s health expert and consultant gynaecologist, with a special interest in ovarian cysts, heavy menstrual bleeding, infertility, fibroids, and adenomyosis. He is currently one of the most highly-rated gynaecologists in London with a very good reputation amongst his patients and peers.

Mr Karoshi's work is recognised internationally, having volunteered in Ethiopia’s Gimbie Hospital, and later receiving the Bernhard Baron Travelling Fellowship from the Royal College of Obstetricians and Gynaecologists which led to his work in the University of Buenos Aires. Here he worked on the techniques needed to surgically manage morbidly adherent placental disorders - a serious condition that can occur in women with multiple caesarean sections.

He believes in an open doctor-patient relationship, being sure to include the patient and educating them so that they understand their condition better and they can be directly involved in their care and management at every stage. Aside from his clinical work, he is actively involved in research, which together with his experience, has given him the opportunity to publish the first stand-alone textbook on postpartum haemorrhage which was launched by HRH Princess Anne.

At the core of Mr Karoshi's practice is a high standard of professionalism where patients are involved in their treatment and where the latest techniques and advancements are used to provide an extremely high level of care.

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