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Longer treatment may put end to recurring infection
Q. I have had recurrent bacterial vaginosis for more than two years. I have been treated with both oral and vaginal medicines. As soon as I stop taking them, the infection returns. Will I have to stay on medication for the rest of my life?
A. Bacterial vaginosis is the most common vaginal infection. The population of normal vaginal bacteria becomes displaced by a mixture of troublemaking bacteria. Why it happens is an unanswered question. It has a habit of returning, but why it does so is another unanswered question.
The result of the takeover by the new bacteria gives rise to a profuse, gray to milky-white discharge with a foul odor. The vagina becomes irritated. With a microscopic exam of the discharge and by noting its odor, doctors can make an accurate diagnosis without needing many other tests.
Metronidazole is an antibiotic that can usually put an end to bacterial vaginosis. It comes either in a tablet or in a gel that's applied directly to the vagina.
Such a succession of recurrences as you have had is not usual. How long do you take the medicine? Ordinarily, metronidazole is prescribed for a week. However, you would be better off taking it for two weeks and then going on a maintenance program. During maintenance therapy, you use medicine only twice a week, and you could switch to the gel form so you won't upset your digestive tract with prolonged use of oral medicine.
Another newer medicine applied directly to the vagina is Clindesse cream. It contains the antibiotic clindamycin, which has also long been used in oral form for bacterial vaginosis. If metronidazole fails you, then this might be an option.
It sounds logical to treat a person's partner to avoid reinfection. With bacterial vaginosis, it's been demonstrated that partner treatment doesn't stop recurrences.