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<\/a><\/p>\nOnly if the humans who read them support them. And here comes AI.<\/p>\n
CONTEST: Win Tickets to the Vancouver Folk Music Festival<\/a> One lucky Tyee reader will receive a pair of weekend passes valued at $500.<\/p>\n One doctor told her there was nothing wrong and questioned why she had even come in. Others had little to offer beyond advice to wear cotton underwear and avoid scented soaps.<\/p>\n \u201cI went to so many doctors, so many times,\u201d she said. \u201cThere was never anything they said that I could do about it.\u201d<\/p>\n Donnelly, a Vancouver resident now in her late 40s, is one of many women who have dealt with bacterial vaginosis, or BV \u2014 the most common vaginal infection among women of reproductive age. Researchers estimate it affects<\/a> about one in four women globally, yet scientists still do not fully understand what causes it or how to reliably prevent it from returning.<\/p>\n
BV happens when the normal balance of bacteria in the vagina shifts and certain bacteria begin to overgrow. Some women experience discharge or a strong fishy odour, while others have no symptoms at all.<\/p>\n Left untreated, BV has been linked to complications including pelvic inflammatory disease, increased susceptibility to sexually transmitted infections and, during pregnancy, preterm birth.<\/p>\n Donnelly estimates she spent about $500 trying different remedies on her own. <\/p>\n \u201cI tried the regular over-the-counter douches. I made suppositories using coconut oil. I used garlic, I used all the things,\u201d she said.<\/p>\n None of those worked. At one point, she said, the condition contributed to the end of a relationship.<\/p>\n \u2018They didn\u2019t help me\u2019<\/p>\n BV is typically treated with prescribed antibiotics, according to HealthLink BC<\/a>. Donnelly said she was never prescribed antibiotics. Instead, she started searching online and came across suggestions about diluted hydrogen peroxide. She tried it and found it helped ease her symptoms. <\/p>\n \u201cThey didn’t help me out,\u201d she said. \u201cI had to help me out.\u201d <\/p>\n Even when antibiotic treatment is prescribed, relief is often temporary. Studies show<\/a> that BV returns in 50 to 80 per cent of cases within a year of antibiotic treatment. Antibiotic treatment can also trigger yeast infections by wiping out the good bacteria alongside the bad. <\/p>\n Nicole Pasquino, registered nurse and clinical director at Options for Sexual Health, estimates that roughly 30 to 40 per cent of people treated for BV end up with a secondary yeast infection as a result.<\/p>\n \u201cIt ends up being like an unfortunate cycle of trying to manage the BV versus the yeast, especially with people who have recurrence,\u201d Pasquino said.<\/p>\n Another Vancouver resident, Julia Goudkova, said she spent close to two decades dealing with recurring yeast infections, sometimes needing medication almost every month.<\/p>\n \u201cIt would change my lifestyle,\u201d she said. \u201cI would have to think twice \u2014 am I going to go on a bike ride or not?\u201d<\/p>\n It was only when she saw a gynecologist for an unrelated issue that boric acid treatment was mentioned, she said. <\/p>\n Boric acid works as a mild antiseptic by restoring vaginal pH and creating an environment less hospitable to the bacteria and fungi associated with both BV and yeast infections. Research supports<\/a> its use for recurrent cases.<\/p>\n \u201cI was so pissed,\u201d Goudkova said. \u201cIt costs pennies. It’s so much cheaper than over-the-counter medication and it\u2019s much more effective.\u201d<\/p>\n Tanisha, a Black Vancouver woman whose name has been changed to protect her privacy, has been dealing with vaginal infections since she was 15. She is now 32. <\/p>\n Black and Hispanic women in North America experience BV at significantly higher rates<\/a> than other groups. Tanisha believes racial bias affected how seriously some doctors treated her concerns.<\/p>\n Left to her own devices, Tanisha also pursued alternative treatments that research showed held promise. She has treated her infections with boric acid, lactic acid, ascorbic acid and hydrogen peroxide, and paid privately for vaginal microbiome testing because the standard testing available through her doctors was not giving her clear answers. <\/p>\n \u201cI got so sick of wasting days at a time trying to get a diagnosis and medication that I just bought a microscope,\u201d she said. <\/p>\n She said she eventually started making folders with all the documents to track her symptoms and doctor visits. <\/p>\n \u201cI’ve even made so many graphs and timelines to consolidate everything into one document so that I can print it out and take it to appointments,\u201d Tanisha told The Tyee via email.<\/p>\n Self-diagnosing helped with yeast infections, she said, because medication for them is available over the counter. But BV has been more difficult.<\/p>\n Getting a BV diagnosis in B.C. usually starts with a clinic visit. A doctor orders a swab and sends a sample to the lab. Patients wait for results and followup treatment. Tanisha said that for her, that last step has never happened.<\/p>\n \u201cI have literally never been called back or offered treatment when I’ve tested positive,\u201d she said.<\/p>\n And so the process would start over: another appointment, another swab, another wait to see whether anyone would actually call her back this time.<\/p>\n Tanisha has also noticed that positive BV results have not been flagged as abnormal on patient portals such as LifeLabs\u2019 MyCareCompass. She has sometimes wondered whether her doctors were being notified at all. <\/p>\n Tanisha, who is based in B.C., eventually began booking telehealth appointments with Ontario-based doctors because she wasn\u2019t getting local followup.<\/p>\n At one point, she tested positive for ureaplasma, a bacteria linked to recurring vaginal infections. She asked her doctor for antibiotics and was refused. Tanisha said her doctor told her ureaplasma is not normally tested for or treated. She pushed back with a study she had found in a medical journal, but her doctor dismissed it.<\/p>\n \u201cMy doctor said what I read online isn’t the real medical literature that she has access to,\u201d Tanisha said.<\/p>\n She later received antibiotics. By then, she had also started suspecting sex was triggering recurrent infections and that her partner might be reintroducing bacteria. She asked her doctor whether he should be treated too and was told no. She then persuaded her partner to see his own doctor, and they both took antibiotics at the same time. After that, the infections stopped recurring.<\/p>\n Tanisha said she feels women\u2019s concerns about vaginal health tend to be taken more seriously only when pregnancy is involved. <\/p>\n \u201cThey only start to care if a fetus is involved,\u201d she said. \u201cI’m not satisfied with leaving BV untreated. If it\u2019s harmful to a fetus, then how is it harmless for me to have it over and over and over?\u201d<\/p>\n
\u2018Medicine is doing a bad job\u2019<\/p>\n Scientists still cannot say for sure why BV recurs so frequently or how to reliably cure it. <\/p>\n Dr. Caroline Mitchell, director of the vulvovaginal disorders program at Massachusetts General Hospital, has spent two decades studying BV. She\u2019s blunt about where things stand.<\/p>\n \u201cMedicine is doing a bad job,\u201d Mitchell said. \u201cAnd I’m really sorry, because we should be able to do better than this.\u201d<\/p>\n Mitchell said that unlike most infections, BV has no animal model, meaning every study must be conducted on people, which is slow and expensive. <\/p>\n When antibiotics do work, she said, the relief is often short-lived. About a quarter of patients see no change at all. For the rest, antibiotics may clear the infection temporarily, but without restoring the right kind of protective bacteria, BV tends to come back.<\/p>\n Dr. Caroline Mitchell, director of the vulvovaginal disorders program at Massachusetts General Hospital, says \u2018medicine is doing a bad job\u2019 when it comes to studying and treating bacterial vaginosis. Research, like a lot of things, follows the money, and for conditions that affect women specifically, there has never been much of it to follow. Only seven per cent of Canadian Institutes of Health Research project grant abstracts from 2009 to 2023 focused on female-specific research, a share that remained unchanged across 15 years, according to a 2025 study<\/a>.<\/p>\n Dr. Jerilynn Prior, professor emerita at the University of British Columbia and scientific director of the Centre for Menstrual Cycle and Ovulation Research, has witnessed those barriers in action throughout her career.<\/p>\n \u201cWhen a woman is writing a proposal about something that relates only to women, there are two strikes against it,\u201d Prior said. \u201cOne is that women’s issues are not considered very serious or scientific, and two, that the principal investigator is a woman.\u201d<\/p>\n Mitchell said that dismissal extends to the condition of BV.<\/p>\n \u201cThe most common symptoms are smelly discharge,\u201d she said. \u201cIt’s a quality-of-life-destroying infection; it really destroys people’s sense of self, and I don’t think many people value that.\u201d <\/p>\n Pasquino, who has worked in sexual health for nearly two decades, said the stigma around vaginal infections also prevents some people from seeking care.<\/p>\n \u201cWomen have been told over the years that the vagina is a dirty place,\u201d she said. \u201cAny time there’s some kind of imbalance, there’s that cultural and societal stigma of not being clean.\u201d<\/p>\n Access to care remains another challenge. About 23 per cent<\/a> of people in B.C. do not have a primary care provider, meaning many patients rely on walk-in clinics with little continuity between appointments. <\/p>\n <\/a> <\/p>\n A Week in the Life: An OB\/GYN Who Provides Abortions<\/p>\n
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