At Almond OBGYN, we’re seeing a growing number of patients facing a frustrating and often misunderstood issue: recurrent vaginitis. Whether it’s bacterial vaginosis (BV), yeast infections, or a combination of both, many women experience repeat episodes that never seem to fully resolve—despite multiple courses of treatment.
If this sounds familiar, you’re not alone. And more importantly, you’re not stuck.
At Almond, we're developing a more personalized, science-based approach to treating chronic vaginal infections—one that targets not just the symptoms, but also the underlying biological and microbiological causes of recurrence.
Multiple factors can contribute to recurrent vaginal infections, and all deserve careful attention if we're serious about addressing the root causes of patient suffering. These factors may include a disrupted vaginal microbiome, the microbiomes of sexual partners, repeated antibiotic use for unrelated conditions, and the presence of biofilms—complex bacterial structures that must be eradicated to effectively resolve vaginitis.
What Are BV and Yeast Infections?
Bacterial vaginosis (BV) is caused by an imbalance in the vaginal microbiome, where harmful bacteria—such as Gardnerella vaginalis, Atopobium vaginae, Mobiluncus species, and others—overgrow and displace beneficial, protective strains like Lactobacillus. This disruption often leads to symptoms such as thin, gray discharge and a distinctive fishy odor. While BV is not classified as a traditional sexually transmitted infection (STI), it can be influenced by sexual activity and the microbiomes of sexual partners.
Yeast infections, by contrast, are typically caused by Candida albicans, a fungal organism that’s normally present in small amounts. When something disrupts the vaginal environment—like antibiotics, hormone shifts, dietary changes or immune changes—yeast can multiply and cause thick white discharge, itching, and irritation.
Though different in cause, both BV and yeast infections can become recurrent—especially when deeper contributing factors like biofilms or hormonal pH fluctuations aren't addressed.
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To Do: Get a precise diagnosis before starting treatment. Consider advanced testing that can differentiate between BV, yeast, or mixed infections—and detect underlying microbial imbalances.
Biofilms: The Real Reason It Keeps Coming Back?
A growing body of research shows that biofilms may be the key reason vaginal infections are so hard to treat. These are structured colonies of microorganisms—like bacteria or yeast—that attach to surfaces (in this case, the vaginal lining) and secrete a sticky matrix to protect themselves.
This biofilm barrier acts like a microbial force field, shielding organisms from antibiotics, antifungals, and even the immune system. So even when treatment seems to work temporarily, the organisms can linger—only to flare back up later.
To combat this, we work with a compounding pharmacy to offer customized medications that include metal chelators, which help break down biofilms and allow antimicrobial agents to more effectively eliminate the infection. In addition to targeted treatment, we also recommend a high-potency probiotic supplement containing Acidophilus and Lactobacillus strains to help restore and maintain a healthy balance of vaginal flora. Rebuilding these protective bacteria plays a vital role in preventing future infections and supporting long-term vaginal health.
👉 To Do: Ask your provider about biofilm-targeted treatments and follow with a vaginal-specific probiotic regimen to restore a resilient microbiome.
How Your Menstrual Cycle Affects Vaginal Health
Your menstrual cycle can significantly impact vaginal pH. Normally, the vagina is an acidic environment (pH 3.8–4.5), thanks to Lactobacillus species that produce lactic acid and hydrogen peroxide. But during menstruation, the presence of blood (which is alkaline) temporarily raises pH—disrupting the microbial balance and reducing the protective effects of Lactobacilli.
In women with recurrent BV, studies have found that these protective Lactobacillus species are often significantly reduced, while BV-associated bacteria such as Gardnerella vaginalis, Atopobium vaginae, Mobiluncus, and Prevotella become more dominant. This microbial shift is especially common during or just after menstruation, when the environment becomes more favorable for these harmful strains to thrive.
That’s why many women notice an increase in discharge, odor, or irritation around their period—and why simply treating symptoms isn’t enough to prevent future flare-ups.
👉 To Do: Use pH-balancing support before and after your period—such as a vaginal probiotic containing Lactobacillus acidophilus and Lactobacillus crispatus—to help restore protective bacteria and maintain a healthy vaginal environment during this hormonally vulnerable time.
Partner Treatment: What the NEJM Study Revealed
Recent research published in the New England Journal of Medicine has shown that treating the male partner can significantly reduce recurrence rates in women with BV.
In the study, women who treated their male partners with:
- 500 mg metronidazole tablets
- 2% clindamycin cream
Both twice daily for 7 days, experienced a meaningful drop in recurrence rates. This research supports the idea that BV may be shared between partners—and that reinfection is more likely if only one person is treated.
If you're in a relationship and struggling with recurrent BV, let us know. We can provide prescriptions for your partner as part of a comprehensive treatment strategy designed to break the cycle of reinfection.
Moving Toward Lasting Relief
At Almond OBGYN, we believe recurrent vaginitis deserves more than temporary fixes. By addressing the underlying issues—biofilms, microbiome imbalances, pH fluctuations, and partner transmission—we’re helping patients find meaningful, long-term solutions.
If you’re dealing with recurrent BV or yeast infections and are ready for a more thoughtful, evidence-based approach, reach out to us. We’re here to help you take the next step toward feeling better—for good.
