infection

Dear Doctor,

I have been treated for bacterial vaginosis 9 months ago with clyndamicine, the infection reoccured 6 months after the treatment and the doc prescribed a week of flagyl and after the antibiotics diflucan because i developed yeast. It is important to mention that i have been sexually active with the same and only man, and STD free, been tested the first and the second time when i got the treatment. Now three months after the treatment i am having the same symptoms that are horrible vaginal burning without urination which gets worse after urination. From the last treatment i have abstained from sex but however i got the symtopms again and today i began again flagyl. I am very worried and want an opinion from you, why do i keep getting BV so offen? We are planing to have a family, but i am scared to have sex as in my mind sex=BV. Now that i got the symptoms again however i have abstained, it makes me really confused on what to do or not do to be vaginal burning and BV free??? Is there dangerous to try to be pregnant? This is the third time in 9 months that i am having horrible vaginal burning and this time im scared in case flagyl will help or not. I got the first dose but i do feel the same or worse,,,hoping it works. Your advice is very much appreciated.
Thank you

[Elaine Brown, MD]

HI!
Normally there are a lot of lactobacilli or "good" bacteria present in the vagina, and these bacteria keep other bacteria and yeast from causing symptoms of infection.  It is important to keep the "good" bacteria healthy so that they can fight the "bad" ones like the ones that cause BV (gardnarella, etc). You can do this by taking probiotics and also live culture yogurt.
BV is not really a sexually transmitted disease, and won't harm a developing baby.  There is some evidence that links BV to preterm birth however, so it is good to clear it up if at all possible.  Antibiotics kill the "good" and also the "bad" bacteria, so that can be a reason that some people keep getting BV-yeast-BV over an over again.
If you can, use Metrogel or Cleocin ovules for the BV and take diflucan for yeast.
For symptoms of itching and burning, you can use vegetable shortening topically.
It is cheap, no prescription needed, and works pretty well without causing any additional inflammation.  One other thing to try is a strong anti-inflammatory cream such as clobetasole--your MD will have to prescribe this one.
I hope this helps!
Dr B