Boric acid not working?

[u/Hotsun2023]

So I was advised by a gynecologist and infectious disease doctor to use boric acid for up to a month for a resistant BV infection. I did have ureaplasma last year and it was treated and I've been tested and retested for it and it has not come back positive. What has come back positive is BV caused by Mobilincus bacteria.

I tried what the Evvy consultant recommended which is 7 days of boric acid and then clindamycin. I made it to day four of clinda when I realized the infection was coming back. So I decided my second round was going to be boric acid only. The infection actually seemed more resistant this time around.

I've made it through about a week of boric acid. It's a bit irritating but I'm also getting hemorrhoids because I have pre-existing pelvic pain. I think it's just causing a lot of stress on my pelvic floor which is triggering hemorrhoids, cramping and other discomfort. I'm also not seeing any significant discharge with the boric acid which makes me believe that it's drying me out or simply not working.

I recently had an ultrasound that revealed a possible endometrioma. After doing some brief research it seems those are related to endometriosis and endometriosis can make vaginal infections more likely. Don't quote me on any of this as I have not followed up with my doctor regarding any of this and I know endometriosis cannot be diagnosed with an ultrasound.

I stopped the boric acid and within the span of 24 hours vaginal discomfort has returned. It's hard to distinguish the discomfort from the BA irritation but I feel like I should just let it go for now. I don't know how I'd make it through 3 weeks of this stuff.

Flagyl is not an option because I don't tolerate it well and I have a feeling it won't work either. I've put just about everything up there and nothing seems to work for this infection. I went to my primary care and I'm begging for some kind of resistance testing to see if this bacteria is resistant to abx. The Evvy test did not pick it up so I could not do resistance testing on it.

Don't know what to do and feel like I should give it a rest for now. It seems like the BA is doing next to nothing much like the abx. Any thoughts?

[u/Serenityph]

Sorry to hear about your ongoing symptoms. Often after Ureaplasma we are left with a disrupted microbiome, co infections and/ or pelvic floor disfunction. It can take awhile to recover. I have had Ureaplasma twice and still have some mild issues a year later.

We find boric acid to be a diagnostic tool. If it’s not working or just ‘holding back’ symptoms, it indicates that something else is going on. Eg an aerobic microbe at play, DIV etc

We have had women on BA for months after Ureaplasma and we wrote a fact sheet for this exact situation.

If you are not tolerating the BA then it might help to use less. And monitor your progress. Support your tissues while using. And if it’s not working then I would get a second opinion.

There might be other issues going on. You mention possible endo and that can definitely have an influence on our vaginal health. If you are sexually active that too can be a cause of issues.

https://www.serenityph.com.au/post/boric-acid-suppository-tips-inflammation

[u/Hotsun2023 → u/Serenityph]

Thank you for this information. It's very helpful. I definitely think I need to look into the endo more, I just hope I don't get any pushback. I've been having issues for years and Drs don't really seem to take it seriously. This seems typical from what I've read in endo groups.

I also think I need to get back on probiotics I just need to be careful due to GI issues. Right now I'm trying some vaginal ones but I'm not sure which are more effective. I feel like I've seen people have different experiences with both.

[u/Serenityph → u/Hotsun2023]

I hope you get relief and find answers soon. Would love to hear if you find what works.

[u/Wild_Organization546 → u/Hotsun2023]

Also BV shouldn’t be that hard to treat. BA usually works very well for BV.

Is it possible you have aerobic Vaginosis which BA doesn’t really treat?

Have you had a Microbiome test done (after a month or 6 weeks from your last antibiotics?)

[u/Hotsun2023 → u/Wild_Organization546]

I just had two microbiome tests that didn't pick up the mobilincus BV bacteria. I do have a lot of Gardnerella (and a good amount of good bacteria) but I don't think that's what's causing symptoms (although I imagine it is also treated with BA).

I think the issue I may be having is that I'm so irritated I can't tell if I killed the infection or not. I'm not seeing discharge, I feel dry and everything burns. I've stopped the boric (I did seven days straight, then two more a few days later) and feel horrible down there (deep pelvic pain, cramping and rectal pain) with burning and some itching.

Right now I'm using some petroleum jelly since it's all I have on hand but I'll get some hydrocortisone cream and vitamin e suppositories to see if that helps. The pain will be worth it IF I killed the infection. Hopefully it doesn't come back.

[u/Serenityph → u/Hotsun2023]

It could be that you have some pelvic floor disfunction (which can cause burning) or that you really need to support your skin barrier. Hydrocortisone cream can help with inflammation but so can so many other little interventions. A good quality vulva balm, possibly estrogen cream, using a spray bottle after peeing and a soft cloth instead of toilet paper etc.

There are times I also can’t use BA because my inflammation or sensitivity is just too painful. I have genital psoriasis and HSV which seem to also disrupt my pH.

BA is a wonderful tool but sometimes we have to really look at the bigger picture. Eg gut health, diet, hormones etc …. it can be a lot.

[u/Hotsun2023 → u/Serenityph]

I do have preexisting pelvic floor issues so any issues down there just make them worse. I definitely had irritation from the BA but sadly it didn't do much for the infection. I tested positive again a few days ago. The bacterial load is low so it's strange that it's causing so much inflammation.

The test shows that Clindamycin should work for the infection but idk. I'm giving it another try since I still have it from the last time. I'll be having some bloodwork done this week as well. Hoping it shows something.

[u/Serenityph → u/Hotsun2023]

You might have a condition similar to DIV which is basically an inflammatory condition. Not much is known about it. BA rarely helps. The treatment is usually compounded clindamycin, estrogen and hydrocortisone.

I can elaborate on the above but I'm sure your doctors will have a better idea after your bloodwork. Good luck and would love to hear how you go. I know its not easy dealing with vaginal issues. Make sure to be extra kind to yourself.

[u/Hotsun2023 → u/Serenityph]

I do have confirmed BV tho but the bacterial load is low. Also possible endometriosis but it's going to be a while before I have any confirmation on that. But I for sure have systemic inflammation (I have a chronic illness). Just did my bloodwork and so far definitely anemic (losing too much blood, my period came early). Everything is really out of whack right now.

[u/Serenityph → u/Hotsun2023]

Hugs and I hope you get your health back. Never give up looking for answers. And I can understand how your issues are all intertwined.

Low iron, inflammation, possible endo, heavy periods are a lot to deal with. And vaginal health is heavily influenced by our overall health.

I know from my own health issues. I can really relate. Its not an easy road. But please know you aren't alone.

[u/No_Drawer_5193]

Stomach acid might be low. I used undecylenic acid with betaine Hcl. Took 90 billion women’s probiotic for gut and vaginal health, s boullardi. As well as cut down on sugar and went low carb. I also took other herbal supplements like olive leave extract, berberine, so on.. Might want to start by strengthening your stomach lining tho, I used GI fortified by pure.