Important question about bv!! Please help

numbprincess16_

So I've been struggling with bv throughout my whole pregnancy and they keep treating with flagyl and it keeps coming back within a month or so. So my obgyn finally said i could use my boric acid suppositories (because that's always worked in the past) but I'm still terrified bc most people say don't. Can anyone give me any advice or has anyone ever used them while pregnant?

00kim00

A quick Google search confirms what you've found that most people say don't. It looks like it can be extremely toxic, cause birth defects, miscarriage, or low birth weight. However, that's from Google, I don't know the science behind it and didn't read any peer reviewed research. My best go-to for questions like these is Mother to Baby. They're a clearinghouse for evidence-based information about drugs and other exposures during pregnancy and breastfeeding . You can email, call, or chat with them about your particular question. I found them super helpful to get information on my medications so I could go into my doctor's appointment well armed with facts to guide our decisions. I ultimately decided to stop taking one med and continue with another, both of which were "recommended" not to take, but I had enough information to really weigh the risks and benefits. They'll tell you what research is not there, what exactly is known to happen as a result of the medication, and how big the risk is. If taking the meds means there's a 75% chance of birth defects, you may make a different decision than if it increased the risk from 5% to 6%, right? Give them a call (during the day when they're open, of course). https://mothertobaby.org/contact/

fertile-turtle

There’s genuinely not much in terms of specific studies that could help you decide about the safety of boric acid. There’s some on environmental exposure and oral boric acid, but nothing on vaginal suppositories.

That said, there may be treatment options that your OB hasn’t considered or wanted to suggest, or lifestyle changes that could work in conjunction with treatment to help prevent recurrence. Specifically, things like taking a probiotic along with the antibiotic to restore good bacteria, so that there’s a strong microbiome to protect you, and possibly treating your partner, too, since even though it’s not an STI, it is possible to kind of pass it back and forth since it’s just overgrown normal bacteria. It’s also worth discussing things like your specific hygiene habits, since fragrances in washes and baths can disrupt your microbiome and make you more susceptible to repeat infection.

Mostly, though, I’m always a fan of a second opinion when you’re unsure of a treatment option. If there’s another OB or midwife at the same practice, you can ask to see them, or you can seek out a completely outside opinion, though that may take some time. Make sure you have your full history, including specifically which tests were done and treatment and dosing, and discuss your concerns about both the BV and the boric acid.

numbprincess16_

See we've tried probiotics and sex isn't what's causing it. Bc I haven't even had sex. So that's why I guess she said to do the suppositories. She's a good obgyn I've trusted her with alot. But I'm just worried really bc there's not a lot of studies on it.

numbprincess16_

I did just research this to see if there is any new information. The studies that have been done are limited in human pregnancy. I found that less than 0.5% of boric acid or borax applied on your skin is absorbed into your system. Absorption through the vaginal mucosa (when using vaginal suppositories) was small, even in the presence of vaginal infections.Using boric acid vaginal suppositories for a 7 day course or less is not known to have any pregnancy risks. Due to the limited data, we would not advise using this product frequently or daily for long periods of time during pregnancy.

That's exactly what mothertobaby said. So after that what's your guys opinion?

meggyme

You need to ask these questions of your doctor. BV likely carries it’s own risk of complications and maybe a short exposure with a known risk is better than an extended risk of complication due to the infection. I agree a second opinion if you are unsure of her advice is a good idea. Internet strangers and googling is not an adequate substitute for medical advice for your particular case.

00kim00

I agree with @meggyme. Talk to your doctor, armed with your research. Talk to your partner/baby's father if there is one you're in a relationship with. Discuss all the options (is there anything else other than the boric acid and flagyl?), what are the risks and benefits of each option, including untreated or recurring BV. Make the decision you're most comfortable with, knowing the risks and benefits. What I would choose isn't relevant. It's comforting to know that there aren't any *known* risks in pregnancy in humans, but they're really cautious about doing studies on pregnant women, so there's a lot we don't know.

Personally, when I had COVID, I chose not to take Paxlovid because of the uncertainty even though there was no known risk and it was assumed to be safe. However, I am taking another medication that (in high doses well above what I'm taking, and in animals) has been shown to have risks. But my COVID was mild and my other condition is debilitating, and for my other condition the other options are either worse or don't work for me, and I was confident I exhausted exploring the other options. Eventually you make a choice that's the lesser of all evils, also considering your own personal suffering if treatments don't work or don't work well. Eventually something will pan out, and even though you may wish you didn't have to take anything, something will be the least bad of the options.

numbprincess16_

I have talked to my doctor, she's the one that told me it was perfectly fine to use them. 

numbprincess16_

Trust me a doctors opinion is waaay more important to me than anybody on the internet but she told me it was fine and honestly I just wanted to see other people's opinions on it as well.

harpseal135

What do others opinions matter? We are not MD, DO, PAs we didn't study medicine.  If you don't trust, then ask a pharmacist.  Internet people are the worst to trust.