Female Biology is as unique as their fingerprint. The right set of interventions are unique for every female which depends a lot on activities & functions of gut & vaginal microbiome.
Right from chronic diseases, recurrent infections, infertility, preterm births & more, underlying cause for every female is different & symptoms manifest differently.
Vaginal infections are no different. From Menopause to biofilms there are multiple reasons why vaginal infections do not seem to go or at worst keep on coming back.
People with Vagina experience vaginal infections at some point in their lives. Around 75% of females will develop yeast infection while a third of females develop Bacterial Vaginosis.
In about 1/3rd of cases, Bacterial vaginosis reoccur within a month while Yeast Infection reoccur within a year in 30% of the cases.
Why do these infections keep on coming back? Let us deep dive into detail.
- Misdiagnosed by doctors & healthcare practitioners
Vaginal Infections are extremely common & commonly misdiagnosed since the symptoms in different infections are almost similar. For instance abnormal discharge can be indication of yeast infection but it can also arise due to vaginal dysbiosis, cytolytic vaginosis & more.
Misdiagnosis by healthcare practitioners occurs 61% in case of bacterial vaginosis & 77% in case of yeast infection. Overall it occurs 50% of the time.
Why are doctors & healthcare practitioners not able to diagnose correctly? They have missed out studying an important aspect- vaginal microbiome. Understanding activities & functions of the vaginal microbiome can help you decode the underlying cause of developing these infections. Medications based on consultation or filling up online form cannot decode these activities.
2. You are taking wrong drugs
Even if you are being diagnosed correctly, wrong medication which does not neutralize pathogens, can make infection come back/does not go away. For instance, metronidazole has been shown to be less effective than clindamycin for treating gardnerella vaginalis & Atopobium vaginae – the two major pathogens causing bacterial vaginosis while the same is more effective in case of killing Prevotella. However while giving drugs, there are other factors to be considered such as activity of protective bacteria such as those of lactobacillus species.
A number of such drugs even kill protective lactobacillus species, further resulting in vaginal dysbiosis. This is the reason doctors do not recommend clindamycin. However, this drug is least effective in killing pathogens as mentioned above.
If you do not have lactobacillus present or bacteria present are resistant to metronidazole then the whole purpose of taking these drugs are futile.
When it comes to yeast infections, it is really important to decode which species are responsible. Although 80% of yeast infections are caused by Candida Albicans, other species such as non albicans-Candida Tropicalis can also make you develop yeast infection. However most fungal creams & antifungal treatments are not effective on these non albican strains.
3 Sex/Intimacy is leading to vaginal dysbiosis
Certain sexual behavior & conditions can trigger these infections again & again.
Research has found a close association between bacterial vaginosis & having intimate relationship/intercourse with new partners, multiple partners or lack of use of condoms.
4.Harmful Microbes have formed biofilm
Microbes living in our vagina are like us. They are living in your vaginal ecosystem just to survive. One of their survival game plans is to form a biofilm where they attach to the surface of the vaginal environment & form a protective community there. Bacteria living in biofilm have self sustaining structure & it is difficult to neutralize their activities
The capability of microbes causing bacterial vaginosis to form a biofilm explains why bacterial vaginosis keeps on coming back & has high occurrence & recurrence rate . Besides, Candida strains also have the ability to form biofilms making antifungals treatments ineffective.
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5.Imbalanced hormone levels
Changes in hormone levels can impact your vaginal microbiome & make you more vulnerable to vaginal infections. This often boils down to estrogen levels. Estrogen promotes production of sugar- known as glycogen. This glycogen is the main source of food for beneficial lactobacillus species which helps in maintaining a healthy vaginal pH level & keeping pathogens away from vagina microbial ecosystem. When there is less Estrogen present, there is less glycogen to feed lactobacillus & hence provides an opportunity for infection causing pathogens to overgrow
In fact, glycogen is a double edged sword. Glycogen is food for yeast & candida as well. If the level of glycogen is high, it can feed yeast & candida & can lead to yeast infections
As hormone levels change during the month- in situations such as pregnancy, giving birth to child or menopause, risk of bacterial &/or yeast infection changes. This may also occur due to wrong nutrition choices which makes a shift in estrogen levels. If you have consistent & recurrent estrogen changes, you develop a high risk of developing these vaginal infections.
6.Menopause.
A female is said to be under menopause when they have gone through a menstrual cycle for 12 consecutive months. Menstrual cycle plays a key role in regulating reproductive hormones. During menopause, these hormones decline & accordingly risk of onset & progression of vaginal infection increases.
An explanation for menopause- vaginal infection is the level of estrogen. Estrogen feeds beneficial microbes & creates an acidic environment that keeps pathogens away. Lower estrogen levels means less acidic environment & provides an opportunity for pathogens to overgrow.
A lack of estrogen can also cause thinning of the vaginal tissue which can impact the physical structure of the reproductive system, increasing risk of Urinary Tract Infection. When the vaginal environment is disrupted in this way, it provides an opportunity for pathogen- E.coli to overgrow to travel upto urethra & cause vaginal infections
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