There is no doubt about how frustrating vaginal infections can be, especially if you’ve tried everything – from prescription medication to natural remedies like garlic cloves or tea tree oil. If you’re here, we’re going to go out on a limb and assume you’re dealing with a chronic vaginal infection caused by either BV or yeast (Candida).
So, is there hope? The short answer is yes. But for a more detailed explanation, we are going to look at:
- How to tell if your infection is chronic
- The number of women affected by BV or yeast infections
- Why infections become chronic
- How to treat chronic BV and yeast so they don’t come back
- Tips for maintaining your vaginal health
What Makes an Infection Chronic?
To be considered a chronic infection, your doctor will look for the following criteria before making an official diagnosis:
- Yeast Infections: 3 or more yeast infections within a 12-month period.
- Bacterial Vaginosis: Return of symptoms within a 12-month period following initial treatment.
You are at risk for developing a chronic yeast infection if:You have uncontrolled diabetes: Women with uncontrolled diabetes are more likely to develop chronic yeast infections from the crazy spikes in blood sugar levels. Don’t be surprised if your doctor asks you about diabetes while going over your medical history. You use feminine douching products or scented sprays/soaps: Douches and scented feminine products alter the pH of your vagina, creating a suitable environment for anaerobic bacteria (harmful bacteria) to take over. Your immune system is impaired: If you have a medical condition that affects the health of your immune system (like HIV), you are more likely to suffer from chronic yeast infections, too. Increased estrogen levels: High estrogen levels are associated with chronic yeast infections. This is why yeast infections are so prevalent during pregnancy. Antibiotic usage: Antibiotics are a necessary evil when it comes to treating bacterial infections like strep throat. Not only do antibiotics eliminate dangerous bacteria, they can also reduce the beneficial bacteria in your body, too. You might consider asking for a preventative yeast infection treatment to be taken while you complete your antibiotics.
You are at risk for chronic BV if:You have a new partner or multiple sexual partners: Experts aren’t sure why chronic BV is more prevalent in women with a new sexual partner or multiple sexual partners, but it could be related to the introduction of new bacteria into your vagina’s natural flora.
You don’t use condoms: This point goes with the point above. If you want to reduce your risk of developing chronic BV, you should take preventative measures like using condoms with your sexual partners. You use feminine hygiene products like douches and scented sprays/soaps/etc.: Just like with chronic yeast infections, feminine hygiene products disrupt the pH of your vagina, making the environment favourable for BV.
How Many Women are Affected by Chronic BV/Yeast?
Most women will experience a vaginal infection caused by BV or yeast at least once throughout their lifetime. In fact, according to the CDC, BV is the most common vaginal infection affecting women during their reproductive years (15 years – 44 years of age) with yeast infections following in second place.
Although BV is easily treated, with approximately 90% of women reporting an absence of symptoms following treatment, up to 30% of women will experience another infection within 3 months and more than 50% of women will experience recurrence within the first 12 months following the initial infection.
When it comes to chronic yeast infections, an estimated 138 million women worldwide are affected. It is believed that 75% of women will experience at least one yeast infection in their lifetime with 9% of women experiencing a recurrent infection within 1 year.
What Causes Some Infections to Come Back?
One of the most common reasons a yeast infection or BV returns is that the initial infection wasn’t treated properly or long enough. It’s not unusual to hear about some women stopping treatment because they either felt better, didn’t take the medication consistently, or the treatment simply wasn’t long enough for the severity of the infection. Like with any other infection requiring a prescription, you need to complete the entire treatment unless your doctor tells you otherwise or you experience troublesome side-effects.
If you’re the type to keep your gym clothes on after a workout, you might want to reconsider. Yeast tends to thrive in the warm, moist environment created by wearing damp or non-breathable and/or too tight clothing for a prolonged period. This might explain why you’ve had a yeast infection that you can’t seem to get rid of even after prescription treatment. You should change out of your gym clothes as soon as you can and choose breathable fabrics like cotton or linen. If you have time, a shower will help keep infections at bay.
Occasionally, the infection can be caused by a more drug-resistant strain of yeast. Candida albicans is the strain of yeast behind most yeast infections and is treated using OTC and prescription products. Less common strains like Candida tropicalis or Candida glabrata won’t respond to traditional antifungal medication, so you’ll need to see your doctor to receive the appropriate treatment.
While BV and yeast infections are not considered sexually transmitted infections, sex can cause irritation and make symptoms feel worse. This can also prolong the length of the infection, so you might want to hold off until you feel better.
Finally, there is a chance that the infection you are treating is not caused by any strain of Candida or Bacterial vaginosis and that is why it seems like the infection keeps returning. If you think this might be you, you should make an appointment with your doctor to find the actual source of the infection as soon as possible.
What Impact Does Chronic BV/Yeast Have on Women?
There is no doubt that having a vaginal infection caused by BV or yeast can be uncomfortable, isolating, and embarrassing at times. As you can imagine, these feelings are heightened when the infection becomes chronic.
While some women might feel indifferent, it’s certainly not uncommon to feel self-conscious, ashamed, or “dirty” while dealing with chronic BV and yeast. Many women might avoid sexual activity altogether, and it could take some time until confidence is fully regained following the treatment of chronic infection.
This qualitative study from 2016 took a good look at how everyday women managed their own BV symptoms and their feelings regarding the clinical care they received. Some participants reported feeling frustrated about the stigma surrounding vaginal infections and the lack of knowledge surrounding BV.
How to Treat Chronic BV or Yeast
Once you have confirmed that your chronic BV or yeast is properly diagnosed, you’ll need to get setup with a new treatment plan with your doctor.
If you are dealing with a chronic yeast infection, there are a few options that your doctor might suggest trying to finally kick it to the curb for good.
Long-term Intravaginal Antifungal Treatment
For this type of treatment, your doctor will most likely prescribe a common antifungal treatment, OTC or prescription. The difference is that instead of using the medication for 3 to 7 days, you might use it daily for up to 2 weeks. This is typically followed by a 6-month maintenance treatment where you use the medication once per week.
This study from 2004 looks at the effectiveness of maintenance therapy on vaginal yeast infections. In the test group, there was an overall positive response with over 90% of women symptom free after 6 months following treatment.
Up to 3 Days of Oral Antifungal Medication
If you’d prefer an oral medication treatment instead, your doctor might recommend 2 to 3 dosages of an oral antifungal medication. This is an easy alternative to messy creams and suppositories, but it isn’t safe if you are pregnant.
Boric Acid Suppositories
If traditional medications haven’t worked for you, you might want to consider using boric acid suppositories to treat your chronic BV or yeast infection.
It might sound like a bizarre treatment, especially if you are familiar with how boric acid is used in the insecticide world, but it has been used for over 100 years to treat chronic vaginal infections caused by both BV and yeast.
Don’t worry – intravaginal boric acid capsules are completely safe. They are made with a special pharmaceutical grade boric acid powder, not the stuff you find you at the hardware store!
Here’s OB/GYN Dr. Nita Landry on live TV telling when and why she prescribes Boric Acid:
If you’re interested in using boric acid suppositories, there are a couple of options you can choose from. You can buy your own boric acid powder and size 00 gelatin capsules, but it can get messy so it’s not the safest option if you have little kids or pets running.
The second option is buying premade boric acid suppositories from a reputable source. Buying premade is pricier than making them yourself, but it’s worth it for the security of knowing the product will work and that you are getting the correct dosage. As an important side note, boric acid is toxic when ingested orally, so please store your capsules safely away from children and pets.
The standard recommendation for using boric acid to treat a chronic vaginal infection is one 300 mg – 600 mg capsule inserted into the vagina each night for 14 days. Your doctor might suggest inserting one capsule at the beginning of your menstrual cycle every month for 6 months to help keep the infection from recurring.
Tips for Maintaining a Healthy (and Happy) Vagina
Once you get a handle on your chronic BV or yeast, there is a good chance that you’ll need to make some changes to ensure that the infection doesn’t return. Here are some tips for maintaining the health of your vagina while keeping BV and yeast away for good.
Avoid scented products and strong detergents: Scented soaps, sprays, and deodorants can irritate your vagina and disrupt the natural balance of beneficial and anaerobic bacteria.
Wipe from front-to-back after going to the bathroom: Wiping front-to-back is important for keeping bacteria from your anus away from your vagina.
Change tampons and pads often: It shouldn’t come as a surprise, but it doesn’t take long for your pad or tampon to become laden with harmful bacteria. It’s recommended to change your pad or tampon every 4-6 hours and to use the lowest absorbency you need.
Avoid feminine douching: The vagina is self-cleaning, so it doesn’t need any “help” from feminine douching products. In fact, douching does more harm than good by changing the pH and making you more susceptible to BV or yeast.
Change out of wet clothes: Yeast is known for flourishing in a warm, moist environment. For this reason, it’s best to avoid sitting in wet clothing (including your bathing suit!) for a prolonged amount of time.
Choose underwear made from breathable fabric: To keep heat from being trapped and promote good airflow, choose underwear that is made from breathable fabrics like cotton.
Keep diabetes under control: When your blood sugar is out of control, it tends to leech into other areas of the body including your vagina. Yeast loves sugar, and it won’t take long for your infection to come back if your diabetes is uncontrolled through diet and medication.
Conclusion: Is there Hope? Yes!
Any vaginal infection caused by BV or yeast is a nuisance, but chronic episodes can quickly become a burden affecting your life. They’re uncomfortable, embarrassing, and might even make you feel “dirty” and insecure. Fortunately, there is hope and you don’t have to feel burdened and alone.
Many women have cured their chronic vaginal infections using antifungal medications over a prolonged period and through using alternative treatments like boric acid suppositories.
Whichever treatment you choose, it’s important to consult your doctor beforehand and rule out possible underlying health conditions that could be causing your BV or yeast infection to return.
Sarah Nelson is a nurse with 15 years of experience working with a variety of patients. She has a Masters of Science in Nursing and has spent a large portion of her career working exclusively with women in an OB/GYN setting.
Nursing is a passion for Sarah but she also enjoys writing and sharing her expertise online with people who need helpful information. Treating patients well and helping them learn more about their own bodies is a key essential to a healthy lifestyle that Sarah truly believes in.