How to Do Recurrent BV and Candida Test: A Simple Guide

Bacterial Vaginosis (BV) is one of the most common vaginal infections that many women encounter. It happens when the delicate balance of bacteria in your vagina gets disrupted. Under normal circumstances, you have a healthy mix of beneficial bacteria, like lactobacilli, alongside some less helpful ones. However, when harmful bacteria begin to dominate, that’s when BV occurs.

Recurrent BV refers to when symptoms return after treatment, often within just a few months. This can be frustrating and confusing, as it may result from various factors such as resistance to treatment, incomplete eradication of the infection, or reinfection from new sexual partners.

Symptoms of Bacterial Vaginosis

A lot of people with BV might not even notice symptoms, but when they do show up, they can include:

• Thin, grayish-white discharge. This can have a strong fishy smell, especially after sex.
• Vaginal odor. The fishy scent tends to be more noticeable after intercourse.
• Burning during urination. Some might feel discomfort while peeing.

Itching or irritation. While less common, some may experience itching or irritation down there.

Now, let’s talk about candida infections. Different from BV, candida infection occurs when the fungus Candida albicans, which normally lives in small amounts in your body, overgrows. Usually, good bacteria keep this yeast in check, but certain factors can disrupt that balance and lead to a yeast infection.

Types of Candidiasis

Candida can show up in different forms, depending on where it affects you:

• Vaginal Candidiasis (Yeast Infection): This comes with symptoms like itching, soreness, pain during sex, and a discharge that looks a bit like cottage cheese.
• Oral Candidiasis (Thrush): This appears as white patches in your mouth and can make swallowing uncomfortable.
• Cutaneous Candidiasis: This can show up on your skin in warm, moist areas like your armpits or groin.
• Invasive Candidiasis: This is more serious, as the fungus can enter the bloodstream and impact vital organs.

Getting the right diagnosis is super important for treating BV effectively. Here’s how it’s typically done:

1. Vaginal Swab Test

In a vaginal swab test, a healthcare provider collects a sample of your vaginal discharge using a swab. This sample is then examined under a microscope to look for “clue cells,” which are vaginal epithelial cells that become coated with bacteria in cases of Bacterial Vaginosis (BV). 

2. pH Testing

A healthcare provider may also check your vaginal pH using a pH strip. If the reading is above 4.5, it could suggest the presence of BV, since a healthy vaginal pH is typically below this level. Additionally, you can perform at home BV test using a pH strip. For more detailed information about the pH test for BV, you can watch the video featuring Dr. Kamat in the interview below.

3. Microscopic Examination

In this testing method, a sample of vaginal discharge is placed under a microscope to identify specific bacteria linked to Bacterial Vaginosis (BV). Technicians look for “clue cells,” which are vaginal epithelial cells coated with bacteria, and assess the overall bacterial composition. A decrease in beneficial lactobacilli and an increase in harmful bacteria can confirm a BV diagnosis.

4. Molecular Testing

More advanced tests can identify specific DNA markers of the bacteria responsible for Bacterial Vaginosis (BV), offering a more precise and reliable diagnosis than traditional methods. These molecular tests analyze the genetic material in the vaginal discharge sample.

Here’s how healthcare providers typically do with Candida overgrowth test:

1. Visual Inspection

During a visual inspection, a healthcare provider will examine your vaginal area for signs of a candida infection. They will look for symptoms such as abnormal discharge, which may appear thick and white, similar to cottage cheese, as well as signs of irritation or redness in the vaginal region. 

2. pH Testing

Same as BV, pH testing is a crucial step in distinguishing between a candida infection and Bacterial Vaginosis (BV). The healthcare provider uses a pH strip to measure the acidity of your vaginal environment. A normal vaginal pH is typically below 4.5, and if the reading falls within this range, it suggests the presence of a yeast infection rather than BV. 

3. Potassium Hydroxide (KOH) Preparation

In the KOH preparation test, a sample of your vaginal discharge is mixed with potassium hydroxide before being examined under a microscope. The KOH solution helps to clear out the cellular debris, making it easier to identify the presence of yeast cells or hyphae. 

4. Molecular Testing

Molecular testing represents a more advanced diagnostic approach, utilizing DNA analysis to identify specific strains of candida. This method can detect the genetic material of the yeast, providing precise information about the type of candida involved in the infection.

5. Self-Testing Kits

For added convenience, there are self-testing kits available that allow individuals to check their vaginal pH and symptoms from the comfort of home. These kits typically include pH strips and guidelines for interpreting results.

After your period, your estrogen levels are usually low. This is the best time for BV to flare. 

But then estrogen builds up quickly and peaks just before ovulation. There is a secondary elevation in estrogen just before your menses, and this secondary elevation is linked to what we know as estrogen dominance in PMS.

In peak estrogen states, it is easy for Candida to flare. But it doesn’t mean BV doesn’t flare then. It can also flare together with Candida!

In the video that follows, Dr. Kamat shares the importance of keeping a diary of when estrogen peaks, and checking pH levels during the peaks. If pH is not what it should be during the estrogen peaks, this gives us a clearer indication of what is going on.

Here are the top 3 takeaways from the video:

1. In BV, the pH is more than 4.5 (alkaline); while in Candida, pH is less than 4.5 (acidic).
2. If a person is suffering from Candida and the pH is more than 4.5 during an estrogen peak, it is likely that the person is also suffering from a bacterial infection.
3. In this case, a vaginal swab should be done to confirm a diagnosis.

Are you leading a healthy lifestyle and consume probiotics, yet still experience symptoms of candidiasis, with test results coming back negative?

Perhaps your experience is similar to that of one of Dr. Radhika’s clients. Dr. Radhika shared a story about a patient who exhibited symptoms commonly associated with candida, such as itching, burning, and abnormal discharge, but the Candida test results were negative. If you want to know the reasons behind this, watch the video below!

Accurate testing is crucial not just for effective treatment but also to avoid complications from misdiagnosis. BV and candida symptoms can overlap with those of UTIs and other conditions, so it’s really important to consult with a healthcare professional who can provide the right tests.

So, there you have it! BV and candida test involves various methods like vaginal swabs, pH testing, and microscopic exams. Understanding these options helps you take charge of your health and seek timely medical advice for any pesky symptoms you might be experiencing.