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Impact of (recurrent) bacterial vaginosis on quality of life and the need for accessible alternative treatments | BMC Women’s Health

There were 62 respondents to the survey, two thirds of respondents were ages 31–50 with 46.7% white, 22.5% Latina, 14.5% Black and 16.3% other race/ethnicity (Table 1). Most of the respondents were menstruating in the past year (80.6%) and only 32.3% were on hormonal therapy for contraception or other reason.

Table 1 Demographic characteristics of survey participants

The median number of self-diagnosed BV episodes in the past year was 4 (IQR 1–7). The most common symptoms that women experienced were vaginal odor (83.9%), vaginal discharge (82.3%), vaginal irritation/itchiness (67.7%), pain with intercourse (27.4%), spotting between menses (16.1%) and cramping (12.9%). The median number of provider-diagnosed BV episodes in the past year was 2 (IQR 0–4). Most participants were diagnosed by a Family Physician (33.9%) or a Gynecologist (32.3%) and a small proportion were diagnosed at a Family Planning Clinic (17.7%). Forty percent of respondents reported also having one or more non-BV genital tract infection in the past year. Of these, 80% had vaginal candidiasis, 12% trichomonas, 4% herpes, 16% HPV and 4% gonorrhea.

Respondents reported receiving a variety of antimicrobial treatments for BV in the past year including oral metronidazole (77.4%), metronidazole vaginal gel (69.4%) and oral tinidazole (16.1%). More than half of the respondents had used probiotics with oral Lactobacillus sp. (53.2%) and over a third had used vaginal boric acid (37.1%). Of those who tried probiotics most used oral formulations (n = 28) with a fewer reports of intravaginal administration (n = 9). Only 15 (23.8%) women had heard of Lactobacillus crispatus. When asked the preferred route for treatment women were split between oral (45.2%) and vaginal (54.8%). Eight (12.9%) participants reported using a variety of alternative products for BV treatment including folic acid, cranberry juice, raspberry leaf tea, intravaginal probiotics, menstrual cup, cloth pads, ozone, Vagisil, dilute hydrogen peroxide douche, garlic, yogurt, tea tree oil, vinegar, coconut oil, castor oil, oregano, kefir, ACV spray and rephresh gel.

Of 62 participants that responded, 66.1% reported that BV negatively impacted their overall quality of life, 71.0% reported a negative impact on their sexual health, 54.8% on their physical health, 75.8% on their mental health, and 29.0% on their social interactions with other people. Women who were negatively impacted by BV for overall quality of life (p = 0.033), sexual health (p = 0.002), and mental health (p = 0.006), were all more likely to have tried Lactobacillus probiotics than those who did not report negative impact from their BV (Table 2). Boric acid was more likely to be used by women who were negatively impacted by BV for sexual health (p = 0.009). In those negatively impacted by BV using Boric Acid for treatment, no significant difference was reported in physical health, mental health and social interactions.

Table 2 Effects of Bacterial vaginosis on Health by Use of Alternative Treatments

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