Dr. Kate is an OB/GYN at one of the largest teaching hospitals in Boston who lectures nationally on women’s health issues and conducts research on reproductive health.  She regularly (and generously!) answers your medical questions here on EMandLO.com. To ask her your own, click here.

Dr. Kate,

I suffer from Bacterial Vaginosis and it happens when I have unprotected sex. I’m currently in a 2-year relationship. If he ejaculates inside me, I get bacterial vaginosis over and over again, so we have been using condoms for the past 3 months and, since then, no problems. But one time the condom broke and bingo bango: I have BV again. I’m so sick of this and taking Metro Gel and then getting a yeast infection from taking that. I just want a normal healthy sex life with my soon-to-be fiancé. What can I do to help my pH balance? I’m about to start NuvaRing since I’m very fertile. Will this help or hurt my pH balance?  Please help!

— BV

Dear BV,

The vagina can be a mysterious place. Trying to interpret the signals she sends you is like reading tea leaves: Does this discharge mean I have an infection? I can’t tell if that smell is normal or not… And while it’s a good idea to know what is normal for your body, you can go crazy by paying too close attention to your discharge.

First: Recurrent bacterial vaginosis (BV) is unfortunately common. Sometimes it is unprotected intercourse that brings it on; for other women, it’s multiple male or female partners, a new sex partner, douching, or lack of protective bacteria in the vagina. But we really don’t know why some women are prone to the pH imbalances that let the annoying bacteria overgrow. The best treatment for recurrent BV is to go on a prophylactic regimen for a while. After the current case of BV is treated, ask your gyno for a script for Metro-Gel, to use twice weekly for 4-6 months.

Next: I don’t know if you’ve been diagnosed with recurrent BV, or if you’re just noticing more discharge after condom-less intercourse. You’re not doing anything wrong, if it is really coming back (except maybe exposing yourself to STDs without the condoms…). But you should make sure that you really DO have BV coming back – so with the return of your symptoms, return to the gyno. I know coming to see us is a pain in the ass (or more accurately, the vagina – we know how much our patients hate the speculum). But you need to know for sure that it’s really a recurrence of the infection – possibly a change of antibiotic is all you need to knock it out for good.

Last: the NuvaRing won’t affect your pH, or your risk of BV either way. But it very likely WILL increase how much discharge you see. That discharge is healthy – keeps the ring from chafing your vaginal walls – but can be scary if you’re worried about BV. So expect it to come. And it won’t bring on an odor or itching – so if you have those new symptoms, definitely get checked out.

— Dr. Kate

Are you experiencing pain down there? Read:
Dr. Kate’s Sexual Dysfunction Series

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