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How To Get Rid Of Chronic Bv
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How To Prevent Bv (bacterial Vaginosis): 12 Steps (with Pictures)
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Received: April 1, 2022 / Revised: June 17, 2022
Bacterial vaginitis (BV) is a common infection characterized by an imbalance in the vaginal microbiota. Along with extensive research into effective treatments, recommendations for the treatment of BV disease with antibiotics have been developed and are now available. However, BV recurrence is a major challenge given that approximately 60% of women experience a recurrence of BV within six months of initial treatment. In addition, clear guidelines for the treatment of asymptomatic BV during pregnancy or BV co-infections are also lacking. Lactic acid has been proposed as a potential treatment or prophylaxis against BV due to its ability to restore the intestinal microbiota imbalance and promote the disruption of pathogenic bacterial biofilms, which can cause BV recurrence. This review evaluates the clinical evidence for the efficacy and prophylactic potential of lactic acid in BV by searching the systematic literature. Furthermore, a treatment program that includes lactic acid as a stand-alone treatment or in combination with the currently recommended treatments for exercise is recommended, based on these results and adjusted by the severity of BV, pregnancy status and common with vulvovaginal candidosis (VVC) or trichomoniasis.
Role Of Probiotics In Recurrent Bacterial Vaginosis: A Review
Over 560 bacterial species have been identified in the gut microbiome by genomic sequencing [1, 2]. Typically, a healthy gut microbiota is characterized by lactobacilli that provide support in defense against dysbiosis and infections [3, 4, 5, 6, 7, 8]. Disruption of the vaginal microbiota can lead to the development of bacterial vaginosis (BV), a common sexually transmitted disease that affects one third of women of reproductive age in the United States [9, 10, 11]. Although the exact cause of BV is still unknown, the disease is defined by the transformation of lactic acid that produces lactic acid through the presence of many strains of anaerobic bacteria [12, 13, 14, 15]. Furthermore, a significant combination of bacteria associated with BV with the presence of specific lactobacilli species seems to be associated with the development of BV and the development of polybacterial biofilms [16, 17]. The prevalence of BV varies by race and ethnicity and is more common in women who have sex with other women, have new or multiple partners, smoke, bathe, use hormonal contraception, or experience chronic stress [18, 19]. As such, the prevalence of BV in black and Hispanic women in North America is higher (33% and 31%, respectively) compared to white (23%) and Asian (11%) ethnic groups [20, 21, 22]. The economic burden of symptomatic BV is high and has been estimated to be $4.8 billion annually .
Up to 50% of women with BV are asymptomatic, while common symptoms in cases of symptomatic BV include elevated vaginal pH, gray-white vaginal discharge, itching, and a “fishy odor.” [23, 24, 25, 26]. Besides the evaluation of clinical symptoms, the gold standard for confirming the diagnosis of BV is the Nugent score [27, 28]. However, traditional assessment using Nugent’s assessment often requires more time, resources and expertise, which may affect its use in clinical settings . The preferred choice in practice is Amsel’s stain or gram stain [23, 29, 30]. The Amsel scoring system is easy to use and is based on four predictive criteria: (I) the presence of a homogeneous, thin, grayish-white discharge, (II) a background pH above 4.5, (III) a positive whiff-amine test, and (IV) ) > 20% index cells/high power field on cold rock of surgical secretions. However, the important diagnostic tools for BV are phase contrast microscopy and user training [31, 32].
Correct diagnosis of BV is important in the clinic, as these infections allow the transmission of sexually transmitted infections, including human immunodeficiency virus (HIV), Neisseria gonorrhoeae, Chlamydia trachomatis, and herpes simplex virus 2 (HSV-2). , and it can be timeless. childbirth and pregnancy in pregnant women [9, 33, 34, 35, 36, 37, 38, 39]. In the last decades, many treatments have been developed and treatment guidelines for the treatment of BV are publicly available [40, 41]. However, despite these treatment guidelines, BV recurrence rates are high, as evidenced by 30% recurrence in 3 months or 60% in 6 months [3, 42, 43]. The formation of biofilms can be partially responsible for this phenomenon, as the recommended antibiotic treatment with oral metronidazole or obo or clindamycin cannot destroy them [3, 17, 40, 44]. The disinfectant dequalinium chloride, which is also recommended by the World Health Organization / International Union against Sexually Transmitted Diseases (WHO / IUSTI), can dissolve BV-associated Gardnerella biofilms in vitro [41, 45]. In addition, it has been shown that treatment with metronidazole does not lead to the restoration of a healthy surgical microbiome . Therefore, adjunctive and prophylactic treatments after primary treatment, such as probiotics, pH-adjusting drugs and oral or oral lactose, are needed to maintain a healthy monkey microbiome [47, 48, 49, 50, 51 , 52, 53, 54].
Among these therapies, lactic acid has been proposed as a potential candidate for the prevention and treatment of BV . Lactic acid, together with hydrogen peroxide, bacteriocins, anti-adhesive molecules and cytokines, is primarily produced by lactic acid in healthy monkeys and protects the intestinal microbiome against BV-related bacterial strains [56 , 57, 58, 59]. In addition, lactic acid has antiviral properties and can kill C. trachomatis [60, 61, 62, 63].
Preventing & Treating Bacterial Vaginosis (bv) Naturally
This review article reviews the effectiveness and preventive potential of lactic acid as a stand-alone treatment or in combination with antibiotics as a treatment for BV. In addition, BV treatment recommendations have been proposed according to specific patient groups, which differ between first-time BV infection, recurrent BV disease, pregnant women with BV, pregnancy planning, or in BV infections of it mixed. Special emphasis is placed on mixed infections, as there are no recommendations for this patient group.
A systematic review of the literature was conducted by searching the PubMed and Cochrane Library databases from the beginning to 7 May 2021 by 1 reviewer and was independently verified by the authors. Different combinations of terms were requested, including “bacterial inflammation”, “non-specific vaginitis”, “vaginal infection”, “mixed infections”, “lactic acid” and “gellactate”. Articles are accepted if they evaluate intravaginal lactic acid products as a stand-alone treatment for BV or in combination with antibiotics, especially compared with placebo or standard of care. The inclusion of articles in the current review was limited to clinical trials investigating the role of lactic acid in BV. Study populations with first-time and recurrent BV, as well as pregnant study populations, were included in the review. Only articles written in English are considered. In addition, relevant references mentioned in the first studies were monitored. There are no size or date restrictions. We excluded studies if they were conducted on animals or if they were treated with bacteria that produce lactic acid. Unpublished studies, reviews and case studies were not reviewed.
A total of 213 results were retrieved from the literature search, of which 51 abstracts met the predefined inclusion criteria and were further evaluated. Based on the abstracts, 12 full-text articles were then evaluated for selection, of which 7 met the previously defined criteria for evaluating the role of lactic acid in the prevention and treatment of BV. Figure 1 shows a PRISMA flow chart describing the literature search and article selection process. The main reasons for the elimination of the substance after the inclusion criteria are met are endpoints not related to the action of lactic acid , participating in the treatment with Lactobacillus.
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