Anonymous on August 9, 2011

Why won't my bacterial vaginosis infection go away?

I’ve had a bacterial vaginosis infection and a UTI in the last two months. After I finished those medications, I had a sore abdomen and lower back. The doctor said I still had bacteria in my urine so I’m taking more antibiotics...but I don’t feel any different. I’ve been tested for chlamydia, syphilis and gonorrhea but those came back negative. What could be causing these recurring problems?

answered by Lisa Oldson, MD on August 9, 2011

Thanks for your question. I’m sure it must be frustrating to experience so many health issues over the past few months...your doctor will be able to give you the best input on your problem and I encourage you to visit your doctor to get to the bottom of your issue. However I’m happy to offer some points for your consideration.

It is possible to have both a persistent urinary tract infection (UTI) and a persistent bacterial vaginosis (BV) infection. UTI’s and BV are different infections that occur in different parts of the body. UTIs occur when bacteria from other parts of the body, or from an STD, enter the urinary tract through the urethrathe tube that takes urine out of your body. BV occurs when certain bacteria that always live in the vagina overgrow and cause an infection. Usually the infections aren’t related except that both are more likely with sexual activity.

Typically, UTI’s are treated with antibioticsin most cases one or two courses of antibiotics does the trick to wipe out a UTI. However, when a UTI isn’t cured after two courses of antibiotics, it can be cause for concern. It could mean a particular type of bacteria that is somewhat resistant to the usual antibiotics is responsible for the infection. To find out, your physician can do a urine culture to determine the type of bacterial infection you have and to also determine which antibiotic is most likely to cure the infection.

With recurrent UTIs, or urine infections that have spread to the kidneys, typically the course of treatment needs to be extended. And normally a doctor won’t use the same antibiotic again because that antibiotic failed to cure the problem. The fact that you aren’t noticing any improvement after five days of antibiotics is a good clue that you should talk to your doctor about your symptoms again as soon as possible.

It’s very important to speak with your physician because symptoms of back pain and abdominal pain can indicate a kidney infection. Kidney infections usually begin as a UTI that travels up the urethra to the bladder and then the kidneys. A kidney infection requires immediate medical attention and is treated with antibiotics. If the infection isn’t treated quickly, it can lead to permanent kidney don’t delay in checking with your doctor about the symptoms you’re experiencing.

BV is treated with antibiotics too...and when BV meds fail, it’s typically not a big surprise. It’s not uncommon to have a BV again three-to-six months after the first treatment. BV has a high recurrence rate even with effective medications.You’ve taken the best course of action by following up with your doctor...but because you mentioned persistent symptoms, I encourage you to revisit your doctor. Your doctor will determine the best course of action, but typically you would take a different antibiotic either orally or vaginally for at least 7 days.

Also, I want to remind you that it’s very important to take your medicine for the full length of time your doctor prescribes...even if you start feeling better or if you don’t think the medication is making a difference. Why? Because stopping treatment early can make it more likely for BV to occur again.

Are you at risk for STDs? Yes, unfortunately. Women with BV, are more likely to get an STD...whether it’s chlamydia or gonorrhea, herpes, or even HIV. You said you’ve already been tested for chlamydia, gonorrhea and syphilis...that’s a great start. I would also encourage you to speak with your doctor about testing for other STDs as well, especially HIV and herpes, to know your status. I also hope you’ll take some time to learn more about risk factors, symptoms and testing in our Expert Guides to Herpes 1 + 2 and HIV + AIDS.

Bottom line? Talk to your doctor about the symptoms you have that don’t seem to be clearing up. Good luck and I wish you the best of health.

Related info:

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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