By Dr. Chelsea Cole ND
Common Vaginal Health Concerns Addressed by Naturopaths
Many women seek medical advice for vaginal health concerns, including vaginal yeast infections (vulvovaginal candidiasis-VVC) and bacterial vaginosis (BV). Both of these conditions signal a disruption in healthy vaginal ecology, and can present with similar symptoms. However, it is important to differentiate between VVC and BV to insure that you are getting the most appropriate and effective treatment. Naturopathic doctors are able to preform pertinent physical exams, offer testing, and advise on both conventional and naturopathic treatments for BV and VVC.
A Healthy Vaginal Ecology = A Healthy Balance of Vaginal Microbes
A healthy vaginal ecology occurs when a balance is struck between the many different microbes that inhabit the vagina. In particular, the Lactobacillus bacterial species help to maintain a slightly acidic vaginal pH, which stops the growth of potentially harmful bacteria. In addition, some bacteria in this species group help produce a protective barrier along the vaginal walls, which can prohibit infection by other organisms. There are many factors that can disrupt the vaginal microbiome including the following: antibiotic use, personal lubricants, spermicides (nonoxynal-9, in particular), oral contraceptive pills, douching, and hormonal changes.
Bacterial Vaginosis (BV) versus Vulvovaginal Candidiasis (VVC)
BV is the most common vaginal infection in premenopausal women, and of abnormal vaginal discharge and odor. It develops when the protective lactobacilli species are decreased or absent, while other organisms flourish. It is interesting to note that there is not one bacterium that causes BV; rather, BV is caused by a variety of different organisms that can overpopulate the vagina. Typical symptoms include vaginal odor, and abnormal vaginal discharge. BV can be difficult to treat, and commonly reoccurs.
While BV can be caused by a variety of organisms, VVC is almost always caused by Candida albicans. The most common symptom of VVC is vaginal itchiness and burning, especially following intercourse or urination. Vaginal discharge is often present, and patches of redness and swelling of the vulva can occur. VVC can become a recurrent condition, and if this is the case, it is important to look for reasons why this is happening outside of what was discussed above. For example, diabetes and human immunodeficiency virus (HIV) can cause repeated VVC.
A Naturopath ’s Approach to Treating BV & VVC
As both BV and VVC tend to reoccur, prevention is an important aspect of treatment. Improving the health of your whole body, and determining whether an aspect of your lifestyle is contributing to the development of these infections are important first steps. Eating a whole foods diet that avoids sugar and refined carbohydrates, and limits alcohol improves the microbiome of the vagina and digestive system, and bolsters your immune system. This means that your body will be better able to prevent infection from occurring, and fight it if it does occur. It is especially important to avoid sugar if you are struggling with VVC, as yeast feeds off sugar. Identifying and modifying contributing factors like, use of spermicides and repeated antibiotic use, can go a long way in helping stop reoccurrence of these uncomfortable infections.
There are many natural options to help treat an active infection. As lactobacilli species help maintain a healthy vaginal ecology, it makes sense to supplement with these species. A multi-strain lactobacilli probiotic can be inserted vaginally, and taken orally during active infection, and for prevention. In addition to these measures, it may be necessary to take antimicrobial herbs, like garlic, to help kill problematic organisms. Antimicrobial herbs can be taken as vaginal suppositories, where they are working exactly where they are needed. It would be best to discuss this option with a health care provider well versed in botanical medicine. Another component of treatment for BV and VVC includes alleviating bothersome symptoms. These infections can cause local irritation to the vaginal tissue, and there are many helpful herbal medicines, like calendula, that will heal inflammation, thereby soothing itchiness and pain.
In conclusion, the goals of treatment for BV and VVC include: balancing the vaginal microbiome by using antimicrobial agents and supplementing with Lactobacillus species, alleviating uncomfortable symptoms, and preventing reoccurrence. While there is so much that natural medicine can offer, it is important to recognize that conventional therapy, including antibiotic and antifungal medication, is sometimes indicated. If natural therapies are not working, the infection is severe, or if you a pregnant, it may be necessary to take conventional medications.
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