Simply stated, bacterial vaginosis (BV) is a disruption of the microbiotic life in the vagina. This disruption of the bacterial life in the vagina consists of a loss of helpful probiotic bacteria and an overgrowth of harmful, pathogenic bacteria. The overgrowth of pathogenic bacteria in the vagina is an infection; and vaginal infections are referred to as vaginosis. So, since the infection is bacterial in nature, we refer to this condition as “bacterial vaginosis.” Concerning how widespread BV is, you may be a little surprised to learn that BV is in fact the most common vaginal infection. Because of the prevalence of this vaginal infection, it is a great idea to understand the basics of this condition--regardless of whether or not you are currently affected by BV.
In the past, BV has also been referred to as “non-specific vaginitis.” Vaginitis is a general term for vaginal infections or inflammation. The term vaginitis is a concise way of referring to vaginal infections, and is often used in medical literature. The scientific understanding of BV began to develop in the mid 1950’s. Since then, there has been a lot of attention given to this common female health concern. The bacteria that cause this condition are now well understood; they consist of harmful anaerobic bacteria; i.e., bacteria that do not use oxygen to survive. These bacteria break down small amounts of vaginal tissue via enzymes. This tissue breakdown results in the creation of chemicals that have unpleasant smells. Additionally, some of the pathogenic bacteria involved with BV transform a common chemical in the vagina into a volatile, odorous substance. The buildup of these odorous chemicals in the vagina causes this intimate area to have an unpleasant fishy smell. The odor caused by BV can also be more like strong cheese (specific attention, regarding a cheese smelling vaginal odor and discharge, is located on Candida Hub here: Cheese Smelling Vaginal Discharge); although a fishy odor is more common. In addition to odor, BV also frequently causes some vaginal discharge; and, this discharge often has a foul, fishy smell.
A great summarization of what exactly BV is, is provided in the book New Dimensions in Women’s Health (published in 2016). The book states that BV is an overgrowth of vaginal organisms and this condition may be transmitted by sexual activity. Women who have multiple sexual partners are also more at risk for acquiring this infection. BV can also increase a woman’s likelihood of contracting a sexually transmitted infection; and this includes the human immunodeficiency virus (HIV). There are a wide array of non-sexual causes of BV--such as taking antibiotics, having an intrauterine device, or having a current infection of the cervix. The book states that BV is the most common cause of abnormal vaginal discharge; and that BV causes abnormal vaginal odor. Concerning other symptoms, the book states BV can present with general vaginal pain, burning sensations during intercourse, pain during urination, redness of the skin, and itching.
Bacterial Vaginosis: The Most Common Vaginitis
One of the first critical looks at Gardnerella vaginalis happened in 1955 by two researchers: Herman Gardner and Charles Duke. The two published a study in The American Journal of Obstetrics and Gynecology [69.5 (1955): 962-976] discussing this bacteria as a prominent cause of nonspecific vaginitis. The bacteria’s original name, Haemophilus vaginalis, was briefly changed to Corynebacterium vaginale and finally reclassified to its current name Gardnerella vaginalis (in honor of Herman Gardner--most famous for drawing attention to this pathogen). Gardnerella vaginalis (G. vaginalis) is predominantly anaerobic (i.e., it thrives in an environment without oxygen) and prefers an elevated vaginal pH. G. vaginalis does seem to prefer an environment with about 5% blood; suggesting that a woman may be more susceptible to this bacteria shortly after menses. Hemolysis (the rupturing of blood cells) can be caused by this bacteria; but this is nothing to be worried about concerning a local vaginal infection.
So, how does the prevalence of bacterial vaginosis look in relation to other major vaginal infections like trichomoniasis and Candidiasis? The renowned Jack D. Sobel, M.D., in an academic paper on vaginitis published in the New England Journal of Medicine [337.26 (1997): 1896-1903], discusses the etiology (the causes and origins) of vaginitis. Among the common causes of vaginitis, bacterial vaginosis accounts for very close half of all infections. You may have not known, but bacterial vaginosis is certainly one of the classic main three vaginal health concerns. The other two, Candidiasis and trichomoniasis, Sobel proximates as causing nearly 25% and 20%, respectively, of all common vaginal infections. Although yeast infections are much more well known, they really are not as commonplace as bacterial vaginosis. So, don’t feel bad if you find yourself suffering from this infection, as it is an imbalance of vaginal microbiotic life that is highly common among women.
Research published in Infectious Diseases in Obstetrics and Gynecology [12.1 (2004): 17-21], also related that BV is the most common form of vaginal infection. According to the authors, BV frequently does not present with symptoms; as up to half of all incidences of BV are asymptomatic. Meaning, many women who actually have an overgrowth of anaerobic bacteria, which qualifies as BV, will not even have symptoms. As a result, it may be very hard to determine when a woman acquires BV; as noticeable symptoms may not arise until some indistinct point in the future. According to this study, approximately 25% of women with a vaginal infection will have more than one type of infection. The task of diagnosing a vaginal infection can also be complicated by menstruation or previous use of over the counter douches and creams. The following quote was taken from this study and the authors closely reiterate the remarks of Dr. Sobel regarding bacterial vaginosis:
Infectious vaginitis is responsible for between 5 and 10 million clinic visits annually with related healthcare costs of over $500 million each year. The three leading agents that cause 90% of infectious vaginitis are bacterial vaginosis (BV); fungal infections (yeast); and parasitic infections (Trichomonas vaginalis). BV is the most common vaginal infection (causing 15 – 50% of all vaginitis / vaginosis) and Gardnerella vaginalis is still considered to be one of the major bacteria causing this infection.
Another refreshing and elucidating paper on the topic of BV was published in the Journal of Applied Microbiology [110.5 (2011): 1105-1128]. The authors of the study also reiterate that “the most common vaginal infection among women of childbearing age is bacterial vaginosis (BV).” Contrary to what might be first speculated, the research affirms BV is not solely caused by the mere presence of G. vaginalis or other undesirable anaerobes (bacteria that do not utilize oxygen for metabolism). Rather, it is the unrestrained proliferation of G. vaginalis, and possibly other potential pathogens, that results in a woman developing BV. A vagina that is compromised with BV can frequently have 100 to 1000 times more pathogenic bacteria than a normal, healthy vagina. Yet, it is very common for a small amount of G. vaginalis to be present in a healthy vagina; as there are countless microbes normally living in the vaginal microbiome (a small area that has a specific microbiologic environment). The researchers state that G. vaginalis has historically been indicted as having the leading role in BV; making way for other strictly anaerobic bacteria to also multiply and contribute to the infection. The result of the overgrowth of unwanted anaerobes can be the clinical symptoms that are the classic indicators of this aggravating infection.
Jack Sobel, M.D., in another literary work specifically focusing on the subject of BV, also addresses the ubiquity of this condition. This academic paper of Sobel’s was published in the journal Annual Review of Medicine [51.1 (2000): 349-356]. The journal study relates that the prevalence of BV is somewhat dependent upon the population analyzed. Trustworthy estimates of those affected by BV include close to 10% of those in student health clinics, 19% of those in family planning clinics, 16% to 29% of pregnant women, and 24% to 40% in sexually transmitted infection clinics. Additionally, BV is more frequently reported in women attending infertility clinics than by pregnant women in general. The specific demographic BV tends to affect the most, according to Dr. Sobel, are young, sexually active females. However, it is important to note that BV can occur in women that do not have sexual intercourse.
One very eloquent and enriching literary work, that discusses the topic of BV, is the 1999 book Woman: An Intimate Geography, by Natalie Angier. Angier cites the women's health expert Sharon Hillier, a gynecologist at Magee Women’s Hospital in Pittsburg, and writes in detail about this important health topic. Angier actually sought out Hillier for the purpose of explaining the science behind why the vagina smells the way it does; a critical question when addressing the topic of BV. Angier relates that a healthy vagina is one that is swimming in good bacteria. And, according to Hillier, the quintessential factor for harmony in the vaginal ecosystem is symbiosis; i.e., beneficial bacterial species thriving together in the vagina. Hillier makes it clear, when the vaginal microbiome is dominated by probiotic Lactobacilli, these probiotics provide a positively salubrious benefit to a woman’s intimate health. Angier also states that a healthy vagina is clean and pure like a carton of wholesome organic yogurt you’d find at the grocery store. Regarding the smell of a healthy vagina, the book states: “A normal vagina should have a slightly sweet, slightly pungent odor. It should have the lactic acid smell of yogurt.” In contrast, concerning the smell that arises due to BV, Angier states the following:
But, gals, there’s no denying it: sometimes we stink, and we know it. Not like strawberry yogurt or a good cabernet but alas, like, albacore. Or even skunk. How does this happen? If you haven’t bathed for a week, I’ll let you figure it out yourself. But sometimes it’s not a matter of hygiene; it’s a medical issue, a condition called bacterial vaginosis. For a number of reasons, the balance of flora within the vagina is upset, and the lactobacilli start to founder. In their stead, other organisms start to proliferate, particularly anaerobic bacteria, which thrive in the absence of oxygen. These microbes secrete a host of compounds, each fouler than the last.
Outlining Bacterial Vaginosis Symptoms
Generally, there are merely two symptoms that present with BV; and, the condition is often quite non-threatening in nature. Frequently, the main concerns for women with BV, are the very undesirable cosmetic problems that accompany this condition. The most prominent symptom of BV is an abnormal “fishy” vaginal odor. Occasionally, BV causes the vagina to carry an offensive “cheese” smell. Secondly, BV can cause a thin, often times greyish in appearance, vaginal discharge. This discharge can also carry a very strong fishy or cheesy smell. It is more common for a woman to experience an undesirable fishy odor, and this is the most well known sign of BV. Although cosmetic in nature, these symptoms can drastically impact a woman’s quality of life; making this infection a very real concern.
These two symptoms of BV are very well documented; and there is a vast array of research papers discussing this condition which also affirm this. One of these papers, a study published in the Canadian Journal of Infectious Diseases and Medical Microbiology [16.2 (2005): 77-79], discusses the clinical symptoms (observable and diagnosable symptoms) of BV. The study states that a thin, grey vaginal discharge is a clinical symptom of BV; however, the lack of vaginal discharge does not negate the possibility that the vaginal microflora is imbalanced. According to the study, two symptoms of BV are:
- Vaginal discharge which thin, homogeneous, and yellow or grey in color
- A foul vaginal fishy odor
Concerning the foul odor created by BV, two key chemical compounds that are involved with the odor are the methylated amines trimethylamine (TMA) and trimethylamine oxide (TMAO). Healthy adult humans will excrete some of both of these chemicals in their urine--so do not worry, it is natural for the human body to have these chemicals in it. To further explain, amines are chemicals that are derivatives of ammonia; and both these chemicals are amines. It is common for bacteria to break down the urea in urine to form ammonia. Both of these chemicals are also methylated; meaning that a methyl group has been incorporated into the amine. Another key human physiological chemical that requires a methyl group is a form of the vitamin B-12 (methylcobalamin). So, do not worry; the names may sound intimidating; but, TMA and TMAO are normally present in all humans.
According to an older 1975 study, published in Metabolism [24.6 (1975): 721-735], TMA and TMAO are perhaps different than other methylated chemicals present in normal adult human urine. TMA and TMAO, according to the study, were thought to be produced by intestinal bacteria after the consumption of lecithin or choline--as opposed to being synthesized by the human body. Today, science has shown that the human body does not produce either of these amines; bacteria in the gut produce these chemicals. Consequently, you may be able to first reduce the amount of TMA and TMAO in your body simply by reducing the amount of lecithin and choline you consume in your diet. One food to greatly avoid, as it is one of the richest in choline and lecithin, is egg yolk. Beef liver and other cow organs can be rich in these nutrients, but actual regular hamburger and steak should not have elevated choline and probably lack any high amounts of lecithin (as it is a chemical associated with the liver). Thus, be wary of broad remarks that eggs altogether or beef altogether are high in these chemicals, as this could be a misleading statement.
The pathogenic anaerobic bacteria associated with BV sometimes convert TMAO into TMA. Human urine contains TMAO, along with other methylated amines; thus, TMAO is present in all women's vaginas. Fortunately, TMAO is non volatile and does not have a strong odor. Conversely, TMA is volatile, and carries with it a very strong fishy smell. Fish naturally have a good amount of TMAO in their bodies; and, when they are killed and allowed to sit out in a warm environment, the bacteria growing on the fish begin to break down TMAO into the odorous TMA. Consequently, as fish sit out at a fish market, more and more TMA will be sent out into the air--resulting in the area having a strong fish smell. Thus, in the same way, unwanted bacteria in the vagina can begin to decompose TMAO and cause their to be an undesirable odor.
One excellent study delved into the topic of these amines and how they correlated with vaginal odor. This research was published in the Scandinavian journal APMIS [113.7?8 (2005): 513-516]. The authors state that a healthy young adult passes 1 mg of TMA and 40 mg of TMAO out of the body on a daily basis. TMA and TMAO are both present in the urine and vaginal fluid, and TMA can even be excreted from the body via breathing. These normal levels of excretion can be significantly influenced by diet; especially when fish are consumed frequently. When a person regularly consumes fish, many hundred milligrams of TMAO can be excreted from the body, much more than just 40 mg. And, for a woman who currently has BV, this can mean a drastic increase in the amount of TMA the bacteria in her vagina can produce. Concerning some basics about these chemicals, and their elimination via the urine, the authors state the following:
Trimethylamine (TMA) is a pungent volatile amine that is responsible for the characteristic odor of rotten fish. Fresh marine fish contain low levels of the amine but higher levels of its N-oxide form, trimethylamine oxide (TMAO). It is well known that TMA is normally formed in the human body, mainly from dietary choline, where eggs, liver and soybeans are the main sources... TMA is absorbed from the gut and re-oxidized in the liver to TMAO, which, together with small amounts of non-oxidized TMA, is excreted through the urine.
The study found that women with BV had a significantly higher amount of TMA in their vaginal fluid and urine. Concerning the vaginal fluid of women with BV, there was proximately 42% more TMA present in their vaginal fluid than was detected in the vaginal fluid of women without BV. And concerning the urine of women with BV, there was close to 391% more TMA in these women’s urine than was present in the urine of women without BV. The study also stated that the vaginal levels of TMA detected, indicate that this amine was produced primarily locally within the vagina.
According to Dr. Sobel’s Annual Review of Medicine [51.1 (2000): 349-356] paper, the primary instigator of BV, G. vagnialis, causes unpleasent odor in the vagina by producing an enzyme that breaks down carboxylic acid, which comprises a wide variety of amino acids (and, amino acids are the building blocks of proteins). Simply put, Dr. Sobel explains that G. vaginalis, and other pathogenic anaerobes, break down vaginal tissue enzymatically. This enzymatic degradation results in the release of a host of amines, among which is TMA, that possess a fishy smell (Kwak, Jae, and George Preti; 2011). Thus, we see that TMA is produced by G. vaginalis and other anaerobes via the breakdown of vaginal tissue (protein).
Concerning the reduction of TMAO into TMA, G. vaginalis actually does not perform this hydrolysis (the breaking down of complex chemicals into a simpler ones). Rather, species of another bacterial genus, a common pathogen that also causes BV, creates a lot of TMA by hydrolysis. The bacterial genus is Mobiluncus. A study that demonstrated how Mobiluncus and Gardnerella acted on TMAO was conducted by researchers at the University of Iowa. These researchers explained their findings in a journal essay, published in Microbial Ecology in Health and Disease [1.2 (1988): 95-100]. The study found that Mobiluncus species produced a significant amount of TMA from TMAO. Interestingly, it was discovered that Mobiluncus bacteria grew better in the presence of TMAO. The study also examined G. vaginalis and determined that this bacteria did not reduce TMAO into TMA.
Yet, concerning the prevalence of Mobiluncus, it is not present in all cases of BV. Research examining a large group of women found that Mobiluncus bacteria were present in only 50% of women with BV and no other vaginal infection (Hallen, A., C. Påhlson, and U. Forsum; 1987). Thus, this may indicate that a woman, who also has Mobiluncus bacteria involved in her case of BV, will have more unpleasant vaginal odor. Subsequently, BV cases that lack Mobiluncus bacteria may not produce as much unpleasant vaginal odor. And, this fact may also allow us to extrapolate that BV odor will differ based on the composition of pathogenic bacteria causing a woman’s specific instance of vaginitis. Some women may be fortunate, while others may become infected with an assortment of bacteria that cause atypically severe vaginal odor. And, it is true, no two BV infections are completely alike.
Now, we have pretty thoroughly covered the odor associated with BV; but, what about the discharge? Vaginal discharge, as you know, is quite common for a variety of reasons. And, if it were not for the odor of BV induced discharge, this symptom of BV would not be as aggravating and frustrating. Again, the answer for why exactly BV causes discharge, comes from the amazing Dr. Jack Sobel--from his exposition of the topic, the aforementioned study published in the journal Annual Review of Medicine [51.1 (2000): 349-356]. According to Dr. Sobel, the vagina of a woman with BV becomes more permeable and the cells in the outer layer of vaginal skin begin to break off. And, when the vagina is compromised with an overgrowth of pathogenic bacteria capable of breaking down proteins, this does seem like an inevitable result. Although Dr. Sobel does not spend too much time on this clinical feature, he does make it clear that discharge resulting from BV has the following characteristics:
- The discharge is “fishy-smelling”
- The discharge is off-white
- The discharge is homogeneous (consistent in texture and appearance)
- The discharge is thin in consistency
Concerning other key factors, particularly useful in self diagnosing a BV infection, Dr. Sobel also states that BV will not cause redness or inflammation of the vaginal area, and the cervix will usually be normal. Concerning cervicitis (an infection of the cervix), Dr. Sobel states that if this infection is present, it is typically being caused by another type of condition--and not a result of BV. And, remember, many women with BV do not have any symptoms whatsoever; no smell, no discharge, etc..
Risk Factors for Acquiring Bacterial Vaginosis
Concerning the source and origin of BV, a study we’ve already mentioned, specifically looks into this topic. The study is entitled “The Aetiology of Bacterial Vaginosis,” (for clarification, aetiology is the british version of the word etiology--i.e., the study of the causes and origins of an ailment) and was published in the Journal of Applied Microbiology [110.5 (2011): 1105-1128]. The authors state that many researchers choose to define BV not as an infection, but rather as an imbalance of bacterial life in the vagina. What BV is, simply put, is a loss of vaginal Lactobacillus bacteria and the concomitant overgrowth of anaerobic pathogens. Concerning the risk factors of developing BV, the study provides the following as known risk factors for acquiring this form of vaginitis:
- Cigarette smoking
- Taking antibiotic drugs
- Having recently been involved with multiple sex partners
- Becoming involved with a new sex partner
This same 2011 study also states that the vast majority of research shows an inverse relationship between vaginal Lactobacilli species that produce hydrogen peroxide and the acquisition of BV. Therefore, when the probiotic hydrogen peroxide producing Lactobacillus bacteria in the vagina die off, there is a higher rate of BV occurence. This research also cites a 1996 longitudinal study, involving 182 nonpregnant women, that was conducted over a period of 2 years. Of the women who participated in this research, 50 of them developed BV during the 2 year duration of the study. Interestingly enough, the study found women lacking vaginal Lactobacilli had four times as much risk of developing BV compared to women with hydrogen peroxide producing Lactobacilli thriving in their vagina.
Now, if you have read research regarding BV, you may notice that douching was not listed as a risk factor. The 2011 Journal of Applied Microbiology study, that was just discussed, did list douching as a risk factor for BV. And, many other studies regarding this topic also assert that douching is in fact a risk factor for developing this condition. However, this is certainly a specious claim; especially when it is espoused by experts and those with advanced medical educations. Yet, here is the key: ask yourself “what kind of douche these studies and experts are talking about?” Clearly, they are likely all referring to classic, over-the-counter, commercially marketed douches--like the kind you would find at your local grocery or drug store. This is quintessential to why the mysterious, ambiguous “douches,” these experts refer to actually predispose a woman to ill vaginal health. The truth is, these douches usually contain ridiculous preservatives; i.e., chemicals that kill bacteria. And, there is totally, absolutely, and never will be a medical reason to put an antiseptic, synthetic chemical in a healthy woman’s vagina.
Douching is a common sense cleansing practice; and it is a great addition to any woman’s hygienic repertoire. Clearing out the vagina after menstruation, or after other activities, can be so practical it is odd to suggest this type of basic washing should not be done. But, of course, if you use something that kills off beneficial Lactobacilli bacteria in the vagina--like what is in nearly every over the counter douche--you are going to be at risk for yeast infections, BV, and who knows what else! So, the solution is to use clean water and natural, gentle acid like apple cider vinegar. Mixing in a little apple cider vinegar with water will make a great douche you can use at your convenience. If you have some pH testing strips, you can even make a liquid with a perfect 4.5 pH; or, slightly more acidic if you’d like.
The ideal pH of the vagina is 4.5; and soap, with a pH of around 10 (and, this of course varies between soaps; but, usually a typical soap is going to have a very alkaline pH close to 10), is not good at all to use as a douche. Pathogens like Candida (the genus of yeast that causes yeast infections) and G. vaginalis love an alkaline vagina. But, probiotic Lactobacilli bacteria prefer an acidic milieu; and, a healthy vagina’s acidic pH of 4.5 is ideal for Lactobacilli growth. So, it is important to never use an alkaline douche; keep your douches slightly acidic. Clean water shouldn’t be bad to use as a douche either--although something more acidic is preferable.
To give you an example of common douche ingredients, consider Summer's Eve Douche Fresh, 4.5 oz size (picture of product on the right). The ingredients for this douche are as follows:
- Water (Purified)
- Octoxynol 9 -- Commonly known as Triton-X-100, this chemical is used in several types of cleaning compounds. Triton-X-100 is used to break open living cells; and, according to the material safety data sheet (MSDS) for this compound, it is classified as a possible female reproductive system toxin. Triton-X-100 causes bacteria to die by lysis (cells ripping open) according to a 1978 Journal of Bacteriology [135.1 (1978): 153-160] study; which is available for free at the U.S. National Library of Medicine (a link to the full text of this study is located below in the sources). And, isn’t it just hilarious that no one refers to this chemical, for the most part, by the name Octoxynol 9?
- Citric Acid
- Sodium Benzoate -- A classic preservative, found in a vast amount of comestibles, that interferes with bacteria greatly.
- Disodium EDTA -- According to PubChem, this chemical is used as a detergent and is toxic.
As you can see, this popular douche is a veritable pandora’s box of insanity for a woman’s vagina. And, if you do some checking, you will see this Summer's Eve product, which was used as an example, is NOT the exception concerning hazardous ingredients; no, these types of ingredients are unfortunately the rule in popular douche products. There is really no need to buy a product like this when you can simply make a douche at home that is actually safe, effective, and much less expensive. It is just great wisdom to occasionally wash out the vagina; and nature makes this very clear. So, do what the specious experts say in regards to douching with these poisonous products that should have a toxic warning label on them: don’t douche with them. And, when it comes to safe douches, ignore “expert’s” ridiculous sophistry of “never douching;” and, go for an easy, safe douche of water and a gentle, natural acid--such as organic vinegar.
A Novel, All-Natural, 3 Day Permanent Cure for BV
If you have tried to get help with BV before, you certainly are not alone. As you may know, BV recurrence is actually a very severe problem. Around half of all BV infections will come back after treatment has ceased. Typically, the prescription antibiotic drug metronidazole is prescribed to treat BV. Yet, although drug companies push aggressively for women to use patentable, synthetic drugs; they really are not the soundest solutions for this very real, pervasive health problem. As you investigate the research, you will see that there is indeed a very high BV recurrence rate among women who use metronidazole. And, you may even be one of the many women that have seemingly tried everything to make this problem go away.
Women trying to get help with BV can be the victims of poor advice from those who refuse to suggest remedies that lack lucrative incentive for some pharmaceutical or medical corporation. As much as organizations try to put on a smile and say their mission statement is to “help” you and grow wild flowers by the lake to brighten the days of clientele; see what happens when you, or your government, cannot provide money to buy their benevolence!
One woman, Jennifer O’Brien, faced a recurrent case BV that greatly affected her life for a significant amount of time. The repeated prescriptions from Jennifer’s physician only worked temporarily. Like many women, Jennifer would use a prescribed drug and it would reliably eliminate her BV. Yet, it was never too long before Jennifer would develop another recurrence of BV. Jennifer even had her intrauterine device removed in an attempt to stop the recurrent BV; but this did not solve her problem either. Jennifer found herself facing regular itching and burning; and, it was difficult to have an intimate encounter with her boyfriend, who would later become her husband.
After being disappointed by the advice of professionals, Jennifer decided to personally do the work of understanding her condition and developing a permanent cure for BV. Jennifer was not able to find a solution overnight; but after a considerable amount of learning, she made very real progress. The generous help and advice of health professionals, and her own intense study, eventually yielded a solution. Jennifer was able to develop a 3 day treatment that naturally wiped out her BV. And, her solution also involved a comprehensive plan to address the underlying causes of BV and eliminate them within 30 to 60 days. Jennifer’s plan was quite successful, and has been proven to permanently end BV; allowing women to never have to worry about this condition affecting their lives again.
Jennifer went on to explain her natural approach to treating BV in her own book. Since Jennifer’s book was published over 7 years ago, over 130,000 women in 157 countries have used her plan successfully. Since then, Jennifer has updated her book with the feedback she has received from those women who personally followed her treatment protocols. Jennifer also states that 98.2% of those who try her treatment plan are satisfied with her program. Additionally, Jennifer O'Brien offers a 60 day refund period in which you can get your money back. Jennifer’s book is published by one of the largest digital publishers in the world; which is a subsidiary of Keynetics Incorporated--a firm based in U.S. state of Idaho. If you would like to find out more about about Jennifer’s personal life experience, or find out more about her book on BV, you can learn more at Jennifer O’Brien’s website.
- Google Books -- Alexander, Linda L., et al. “New Dimensions in Women's Health Seventh Edition” Jones & Bartlett Learning, 2016. ISBN: 9781284124187
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- http://dx.doi.org/10.1056/NEJM199712253372607 -- Sobel, Jack D. "Vaginitis." New England Journal of Medicine 337.26 (1997): 1896-1903. PubMed
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- Google Books -- Angier, Natalie. “Woman: An Intimate Geography.” Houghton Mifflin Harcourt, 1999. ISBN: 9780547344997
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- http://dx.doi.org/10.1111/j.1600-0463.2005.apm_175.x -- Wolrath, Helen, et al. "Trimethylamine and trimethylamine oxide levels in normal women and women with bacterial vaginosis reflect a local metabolism in vaginal secretion as compared to urine." Apmis 113.7?8 (2005): 513-516. PubMed
- https://doi.org/10.2174/138920111795909050 -- Kwak, Jae, and George Preti. "Volatile disease biomarkers in breath: a critique." Current pharmaceutical biotechnology 12.7 (2011): 1067-1074. PubMed
- http://dx.doi.org/10.3109/08910608809140187 -- Cruden, Diana L., and R. P. Galask. "Reduction of trimethylamine oxide to trimethylamine by Mobiluncus strains isolated from patients with bacterial vaginosis." Microbial Ecology in Health and Disease 1.2 (1988): 95-100. PDF Available Here
- http://dx.doi.org/10.1136/sti.63.6.386 -- Hallen, A., C. Påhlson, and U. Forsum. "Bacterial vaginosis in women attending STD clinic: diagnostic criteria and prevalence of Mobiluncus spp." Genitourinary medicine 63.6 (1987): 386-389. PubMed PDF
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC224794/ -- Cornett, JAMES B., and GERALD D. Shockman. "Cellular lysis of Streptococcus faecalis induced with triton X-100." Journal of bacteriology 135.1 (1978): 153-160. PubMed PDF
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