How to manage aerobic vaginitis or AV?

If you have treated vaginal infection with prescription drugs for yeast and/or BV but your infection persists, your condition might not be yeast or BV. If you run a lab test and the result shows Enterococcus faecalis, E. coli, and/or Staphylococcus, or other bacteria not related to BV (like Gardnerella), the diagnosis does not support yeast or BV. The condition may be Aerobic Vaginitis (AV), because these bacteria can grow under aerobic condition with air or oxygen. This is different from BV bacteria that are anaerobic.

Enterococcus faecalis and E. coli are fecal bacteria normally live in the gut; Staphylococcus is a skin bacterium. Due to menopause-related vaginal atrophy, the resistance against infection in the vaginal tract reduces. Fecal or skin bacteria may enter the vagina and cause this type of infection.

To understand how vaginal atrophy may increase vaginal infection by fecal or skin bacteria , you may find this article helpful:

The concept of AV is relatively new and is not yet in many textbooks for medical students. This may be the reason why some doctors are not familiar with this condition and how to manage it.

Because the cause of AV is related to vaginal atrophy, it may occur in women of post or peri-menopausal age. I could happen in younger women if they are on birth control, hormonal IUD,  breastfeeding or cancer therapy. The treatment strategy is to reverse vaginal atrophy by using NeuEve.

Selection of a suitable NeuEve product depends on your age, menopausal status and health condition.

If you are over 55 and postmenopausal, you can start with NeuEve Silk for 1-4 months:

Then, you can move up a phase to Silver. (If you are 50-55, you can start directly with NeuEve Silver.)

After you are on Silver for 1-4 months, you can move up a phase to NeuEve Gold.
(If you are <50, you can start directly with NeuEve Gold.)

For clearing this infection, you will need to use the product twice as frequently as it is used for maintenance as suggested on the box.

You may find this article helpful:

How to clear BV with NeuEve Gold, Silver, or Silk suppositories or cream?

You will notice more relief once you are on Silver. However, reversing atrophy takes time. It may take several months to notice complete relief.

Once you are on Gold, your symptoms will diminish. However, in case you have a stubborn case of AV and Gold is not sufficient to clear it, you can move up a phase to BV Clear after on the Gold for 3 months. The Gold will give you more relief from vaginal atrophy and you will be able to tolerate the strong BV Clear formula after using Gold for 3 months.

At the same time, you can change your lifestyle to avoid fecal contamination by:

  1. Changing synthetic fiber underwear to 100% cotton and change it at least once a day.
  2. Wiping from front to back, not from back to front to reduce the risk of fecal contamination.
  3. Washing butt at least once a day with a mild soap.

Please do not use any antibiotics for chronic infection because it may only provide a temporary relief but also eliminate vaginal friendly Lactobacillus bacteria. Once the drug is stopped and flushed out from your body, the infection will come back. A better way is to build up resistance, which can provide you with a long-term relief.

Please let us know if you encounter any difficulty and need more help.

Oct 3, 2022

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