Bacterial Vaginosis, Infertility and Pregnancy

Shout Out To The Sleep Deprived


I want to start off this week with a shout out to Jessica. She's my niece and had her second son recently. She wrote to me today that her little guy's a real chow-hound. He's nursing every two hours. She's hitting the wall of sleep deprivation and wonders if anything other than IV caffeine will help. Nope. That's the only thing. IV coffee. The only other cure for life among the vampires is sleep. Good luck with that, honey. I'm certain the only reason the wives of 15th century explorers were willing to put up with their horrid work hours was because they brought back survival gear—coffee beans. I can just hear it, "Fine buddy, you go and discover the new world. Leave me here in this dank castle with all these kids and the village idiot. Just don't come home without some good whole bean coffee. And while you're at it, bring me some biscotti."

Jessica, you will, someday, look back on these groggy, cranky and oh so exhausting days and laugh. Knowing Jessica, she's probably already is having a chuckle or two. Her older son (oh so old—he's three) is a hoot and she's always been able to find the humor among the spit-up, tantrums and overflowing diaper pail. No worries, Jessica, this too shall pass and when it does, you'll wish you could do it all over again.

Now, let's get down to business. Lisa thinks she's facing her second bout with bacterial vaginosis in less than six months. Poor girl. Bacterial Vaginosis (BV) is a vaginal infection caused by an imbalance in the normal bacteria that live "down there." That's right; bacteria are normal and healthy most of the time. With BV, however, one colony of bacteria declares world domination over the others and screws up our ph levels. It's the most common vaginal infection diagnosed. It's not, technically a sexually transmitted disease though it is sometimes associated with having sex (especially if you have a new or more than one partner). Like many other vaginal infections, some women have symptoms and some don't. If you have a weird discharge, itching, pain, burning or odor—get thee to the clinic.

Lisa's concerned about BV messing up her chances of getting pregnant and doing something bad to her baby when she does conceive. The Centers for Disease Control say that anywhere from 10-30% of pregnant women have BV. It's easily diagnosed with a vaginal exam and lab tests and treated with antibiotics. You can get it more than once, however and as in Lisa's case, it sometimes takes more than one antibiotic to cure it.

Lisa's been trying to get pregnant for a couple months and wonders if BV might be preventing pregnancy. Maybe, but it's too soon to tell. While the bacteria themselves don't prevent pregnancy, damage caused by an untreated infection can. When BV goes crazy, it can spread from the vagina up into the uterus and fallopian tubes. This kind of infection is called pelvic inflammatory disease and can, if left untreated, cause damage to the tubes. This can prevent sperm from reaching the egg and cause infertility.

First of all, Lisa, good for you for being clued in to your body and knowing what the symptoms of BV are. Believe me, not everybody does. That's why it spreads—because so many women just don't realize there's a problem down there. Secondly, two months trying isn't enough to start worrying about being infertile. Get treatment for the BV and give it another six months to a year (depending on your age—talk to your doctor about that) of focused "trying." Third, since you know you're prone to getting BV, when you do get pregnant, you and your doctor will be on the lookout and will do proactive screening. BV can mess with pregnancy but doesn't always. It's been connected to increased miscarriages, premature labor and low birth weight babies. The good news: the antibiotics commonly used (metronidazole or clindamycin) for BV are safe to take when pregnant. It's a fairly easy fix. Let me know how it goes, Lisa. I bet you'll be pregnant soon and before you know it, you too will be begging for IV coffee.

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