What are the treatment options for recurrent bacterial vaginosis?

Question

Hello doctor,

I have been experiencing bleeding, discomfort, and pain after intercourse and masturbation after using a vibrator without penetration for the past few months. Initially, there is minimal blood, but after a few hours and the next day, I notice spotting along with a mixture of normal and period-like blood. The cramping and discomfort start during the activity and last for a few days. I visited a doctor who conducted comprehensive blood tests and swabs. They have ruled out any sexually transmitted diseases. However, I have not undergone a physical examination yet, and my doctor is unsure about the cause of my symptoms. This has been going on for approximately three months. I have been using a Intrauterine device for three and a half years without any previous issues. One month ago, I took swabs that came back clear, but the recent swabs taken one week ago revealed that I have bacterial vaginosis. I tend to develop it occasionally after unprotected intercourse with my long-distance partner. Usually, it lasts for a couple of weeks, and it either goes away on its own or I take antibiotics prescribed by my doctor. The pain and discomfort originate at my clitoris and radiate into my vagina, reaching a significant depth. I also feel the discomfort in my lower abdomen. The type of pain I experience is more dull and achy. Although I have not started taking antibiotics yet, my doctor recently prescribed Metronidazole. I plan to pick up the prescription sometime this weekend. While it may not be directly related, it is worth mentioning that I have ADHD, a history of depression and anxiety, and currently manage them with Venlafaxine (serotonin-norepinephrine reuptake inhibitor) and Methylphenidate. I also take Montelukast and a inhaler containing Budesonide and Formoterol for my asthma. Previously, I was taking Loratadine for hay fever, but I switched to Cetirizine about ten days ago. Additionally, I use Fluticasone propionate nasal spray for hay fever. Two months ago, I underwent surgical removal of four wisdom teeth, although I am uncertain if it is relevant. I have also experienced a significant amount of stress in the past few months, but my doctor does not believe it is likely to be the cause of my symptoms. Kindly help me.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern. Based on the information you provided, It seems you have a vaginal infection or pelvic inflammatory disease (PID), which does not necessarily indicate an sexually transmitted diseases. Treatment with Metronidazole alone may not completely cure the infection. I suggest you undergo a full course of appropriate antibiotics to effectively treat the condition. I also suggest you undergo an abdominal and pelvic ultrasound (USG) scan to evaluate the reproductive organs. To prevent further complications and reduce the risk of spreading the infection, I suggest you abstain from intercourse until the infection is resolved. If intercourse is unavoidable, I suggest you use condoms. Could you please provide information about the antibiotics you have taken? Also, have you undergone a vaginal swab test to identify the specific causative agent? I also suggest you perform Kegel exercises to help strengthen your pelvic muscles and alleviate pain during intercourse. I suggest you use a lubricant during intercourse for some relief. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

What are the treatment options for recurrent bacterial vaginosis?

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