September 01, 2021

WHY Your BV, YEAST, and UTIs Keep Coming Back

Why your BV and Yeast and UTI keep coming back. 

BV, or yeast infections or UTI’s you want to know why they keep coming back. I had two lovely ladies ask me to talk to them about biofilm and so this is for you!  Theres one thing that all these annoying infections have in common and thats something called a biofilm. 


I warn you this is a bit of a data dump- but please stick with me on this one because I think its very valuable info. 


Formation of biofilm is a survival mechanism for fungus and bacteria. Under the protection of their biofilm, microbes can become resistant to antibiotics and the immune response which makes them very difficult to treat and a real challenge for doctors to deal with. 


Many studies have indicated very clearly that antibiotic treatment on its own, in most cases doesn’t get rid of biofilm infections. Thats why many people take a round of treatment, symptoms go away and then shortly after it comes back. 
Effectively treating biofilm requires a multi prong approach, and I want to talk about a few of the ways you can do this for vaginal infections. 


Biofilms are often the reason behind chronic strep throat, sinus infections, irritable bowel issues, and you guessed it...vaginal infections. 


It is incredibly frustrating to deal with also because there just hasn't been a ton of good research in women who suffer recurrent vaginal infections. 


Why does biofilm develop…. Biofilm happens when bacteria adheres strongly to the vaginal epithelium. Antibiotic resistance can also happen with the Inappropriate use of antibiotics, not using antibiotics for the full recommended duration, having multiple recurrences of infection 


Bacteria growing IN a biofilm can be up to 1000 times more resistant to antibiotics than bacteria just floating around your body. So this is a pretty big deal, especially for those of us who struggle with infections that just keep coming back over and over again. 


Bv is the most common vaginal infection in women ….. And even after an initial response to treatment almost 50% of women will get BV again. And we know this is because its associated with biofilm

But heres the issue if you're still taking oral antibiotics right. Over time antibiotics do a number on your gut health, your microflora, your yeast/bacteria balance, and can cause real issues down the road. 
I have always thought going directly to the source was better and so if given the choice between oral antibiotics or vaginal, I like vaginal treatments way better. I can protect my gut with systemic oral supplementation if I feel its right and I can treat whats going on vaginally. I was on an oral anti-fungal for chronic yeast infections for years and they really were hard on my liver and my gut and I was super careful about following the protocol of doctors, not drinking alcohol, not eating a ton of sugar or carbohydrates, getting my bloodwork checked regularly while I was on medication and so I could see what was happening in the long term with some of these things. I really feel for people who have to be on medication long term because you have to take care of yourself the best you can and sometimes its unavoidable, we have to take the prescriptions but if there are other ways of treating the vagina locally I like that first. 
I mean vaginal suppositories and vaginal antibiotics while supporting my immune system with other supplements and there are some good herbal supplements especially traditional Chinese medicine and herbs that can help with biofilm as well and thats what were going to get into. 
For BV- remember when I said the data tells us that combination therapy is more effective than single antibiotics. A combination of antibiotics can work or many gynecologists recommend treating with an antibiotic in addition to boric acid suppositories. I know you know I like boric acid, especially for recurrent issues and this is one area that the research tells us boric acid can really help. 
Boric acid in combination with metronidazole or another antibiotic has been shown to be more effective at reducing bv and keeping it away. 
And then theres some data that says Could then follow with vaginal probiotics to try and get your good lactobacillus counts up. 
Goal is to first reduce the burden on the body with antibiotics, then to get rid of biofilm with boric acid and then hopefully recolonize good lactic acid producing bacteria with a vaginal probiotic. 
It's interesting that clinical studies have shown that some antibiotics like azithromycin in combination with ginseng and garlic significant improved the immune systems ability to clear biofilms. Theres a lot of literature for other areas of the body developing biofilms and unfortunately just not a lot for the vagina. 
Ive also told you I like herbs and supplements that have clinical data and so I like garlic, I like ginseng, I like curcumin some citrus seed extracts and something called Lactoferrin. 
I've also struggled with sinus infections throughout adulthood and I noticed an improvement after I started taking a high dose ginseng with echinacea. Lactoferrin also has data associated with it, and thats an interesting supplement because lactoferrin is already part of the innate immune system. I can link some lactoferrin supplements below. It is expensive but its good stuff. And really lactoferrin….

The other big supplement I want to talk about regardless of what kind of infection you have  is something called NAC. NAC stands for N- acetyl Cysteinethis has been recommended to me by a few practitioners and so Ive been taking NAC quite a bit over the last two years. At first I took it because I was taking an anti-fungal everyday for a long course and so I wanted to help my body out a little bit with processing that . and it is an antioxidant that has a lot of really cool properties. Its a natural product I guess. It's an amino acid but it works so well it has been used in hospitals and by physicians for patients who have to take certain medications or undergo certain treatments. It's used when patients undergo some chemotherapy. NAC is a precursor to glutathione. And glutathione really supports the liver, kidneys, and does a whole host of great things for the body. It has antibacterial properties but really it helps to detach biofilms and I think its definitely a product to keep at the top of the list because it has some good data especially for infection.  


Like BV biofilm, candida biofilm can also reduce the effectiveness of anti-fungals. Yeast can be aggressive but Its a different infection and it doesnt recur the same way as BV unless there is an underlying issue. Effective biofilm inhibitors for yeast also include boric acid. My gynecologists over the years always recommended boric acid for yeast infections when oral antifungals didnt really work. You can always get a heavy duty vaginal antifungal like terconazole or ketoconazole, but you have to work with your gynecologist on those ones. 


There is an old school treatment that I did with my gynecologist but I know some women have done this at home, and thats gentian violet painting. Essentially I went into my gynos office and she would paint the inside of my vagina with a bright purple solution called gentian violet. And this stuff works for yeast. Oh man it works...but it is so messy. And it literally dyes everything it touches a dark purple. Some women actually soak tampons in a 1% solution of boric acid and then insert that for a few hours to treat yeast infections. But seriously i died my floor purple permanently, my bathtub, my underwear, clothes, my hands. It's intense stuff. 


I also do a lot of TCM, and I work with an acupuncturist who is a master herbalist and I do and have done many asian herbs that work beautifully for yeast and candida. Acupuncture is great for the immune system. Clearing Damp Heat, yin energy, hot flashes, vaginal dryness. I love acupuncture for many reasons, and I have been doing it for years. I have found it incredible for sleep, anxiety energy and ive noticed improvements in my sex drive, libido, itching skin, vaginal dryness and redness. Everything is just way more juicy and healthy when I get acupuncture. I work with my TCM quite closely and I choose to do my herbal remedy as tea. I find it better for my system to have him make up custom formulas using the herbs and I take it 3 x a day.


The last area that I think is really important to talk about when we discuss by biofilm formation is in chronic UTI’s. Recurrent cystitis. Really frustrating for many women. 


D-mannose. D mannose is a simple sugar basically and it prevents bacteria from adhering to the urothelium of the urinary tract. It binds to e-coli and theres decent randomized clinical trials that show it helps to treat and prevent UTI’s. You can find d mannose alone or in combination with cranberry extract. Just make sure your finding the right strength and dose of each.. Ill link some resources below for you. 


There is an interesting ingredient i've been reading a lot more on lately that I want to talk about in addition to things like cranberry and thats Morinda centrifolia (noni fruit). 

It has gotten some attention over the years because its proven antioxidant effect and anti inflammatory benefits and like cranberry can be used to assist with UTI prevention. 
They looked at a trial in women undergoing chemotherapy for breast cancer who had chronic cystitis due to hormone depletion. And in that trial they used a combination of NAC with d-mannose and noni fruit during their chemo and they found a significant reduction of infections compared to antibiotics. I like that combo because NAC has the ability to disrupt the pathogen polymicrobial biofilm and Morinda citrifolia fruit extract is a natural strong anti-inflammatory, immunostimulating, antimicrobial and cancer chemopreventive phytotherapeutic product.
What Im saying is there are many things you can explore if you're struggling with infections. it's not one size fits all, its not natural vs pharmaceutical when it comes to getting rid of chronic infections. I wish you could watch this video and I could tell you theres a magical natural treatment that will make it all go away. There is a lot of trial and error unfortunately. And i think in really stubborn cases you need to look at both approaches together. The combinations of alternative therapies can enhance antibiotic treatment, and combination therapies can work better for in bacterial biofilm infections. It's really promising and I really hope more work is done in this area because its so essential.