From a lab test, how can I tell if my case is normal, BV, CV, AV or yeast?

Today, many microbiology labs offer vaginal microbiome testing with the cutting-edge NGS (next generation sequencing) technology.

The following labs offer a vaginal microbiome test.

The NGS technology uses a computerized robotic system to test your vaginal sample. It is dumb proof and provides complete information on the population of microorganisms inside your vagina.

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Then, how can I tell if my case is normal or abnormal? When the vaginal microbiome is imbalanced, it is called dysbiosis. Conditions that may cause dysbiosis include BV (bacterial vaginosis), AV (aerobic vaginitis), and CV (cytolytic vaginosis)?

  • Normal. If your lab test report shows predominantly protective Lactobacillus bacteria and you do not have any discomfort symptoms, you are normal.
  • BV. BV is an imbalance of the vaginal microbiome, not a true infection or inflammation. Thus, its name is bacterial vaginosis, not vaginitis. If your lab test shows predominantly anaerobic bacteria (>50%) and low (<50%) or no protective Lactobacillus and you have discomfort symptoms like fishy odor, discharge, itching, and/or irritation, you may have BV. Anaerobic bacteria commonly associated with BV include Gardnerella vaginalis, Prevotella species, Mobiluncus species, Atopobium vaginae, and other BV-associated bacteria. The recommended starting treatment is [BV Clear]( (age <45), [NeuEve Gold]( (age 46-51), [Silver]( (age 51-56), or [Silk]( (age 56 - 70). [Sensitive Silk]( (age >70). After one month of treatment, if your BV is not cleared, you may move up a phase. The strengths of these formulas from mild to strong are: Sensitive Silk ->Silk ->Silver ->Gold -> BV Clear->BV Finisher.
  • AV. AV is a true infection or inflammation. Thus, its name is aerobic vaginitis. The suffix "-itis" means inflammation. Thus, even if the lab test shows that the aerobic bacteria are less than 50%, or as little as 1%, and if you have painful inflammation symptoms, you may have AV. A key difference between BV and AV is that BV may have odor, itching, and irritation but rarely has pain because BV is not a true inflammation. AV is a true inflammation and is almost always associated with pain. Aerobic bacteria need oxygen to grow. The most common bacteria associated with AV include E. coli, Staphylococcus aureus, group B Streptococcus (GBS), and Enterococcus faecalis. The recommended treatment is AV NIL.
  • CV. If your lab test report shows nearly 100% (often over 98%) Lactobacillus bacteria and low or no other bacteria and you have CV-related discomfort symptoms like discharge, pain, and/or irritation, you may have CV. The pain is not caused by inflammation. It is caused by acid burns, like occasional stomach acid regurgitation into the mouth. The recommended treatment is CV Ease.
  • Yeast. The most common cause of vaginal yeast infection is Candida albicans. There are also other Candida species. If Candida is not detected, you do not have yeast infection. However, if Candida is detected and at a high level, it indicates that you have yeast infection. You can manage it easily with an over-the-counter antifungal drug like Monistat-3. You can find it in your local drugstore.
  • Exception. Lactobacillus iners is a bad apple in the Lactobacillus genus. Unlike other Lactobacillus species that are protective, Lactobacillus iners releases a cytolytic toxin called inerolysin. It may collaborate with Enterococcus (AV) or Gardnerella (BV) as an accomplice to exacerbate the damage. When it is dominant (over 50%) along with other Lactobacillus (total Lactobacillus over 98%), you may have CV-like symptoms like discharge, pain, and/or irritation, but using CV Ease may not provide relief, because its damage may be caused by acid and toxin. This bacterium is highly resistant to antibiotics and other treatments. The recommended treatment for Lactobacillus iners related infection is AV NIL.

What if my test shows both aerobic and anaerobic bacteria? What should I do?

Anaerobic bacteria are like fish, which can only grow in water, not on land. But aerobic bacteria need air to grow like land animals. They cannot grow inside water like fish. But some animals can swim, like ducks. They can live with fish in the same pound. Thus, anaerobic and aerobic bacteria can live in the same environment.

When your lab test shows both aerobic and anaerobic bacteria, you may potentially have both AV and BV. Your discomfort symptoms can tell which one is dominant.

If you have a bad fishy odor and discharge, but not much pain, BV may be dominant. You may treat BV first.

If you have little or no odor, but only pain, AV may be dominant . You may treat AV first.

If you have both fishy odor and pain, you may have both severe BV and AV. You may treat AV first because AV NIL and the subsequent maintenance product may clear both AV and BV, but BV treatment may not clear AV.

To understand vaginal dysbiosis, you may find this article helpful:

**Disclaimer: This article is for information purposes only. It is about natural products, nutrients, and/or methods for managing discomforts associated with vaginal dysbiosis (not a true infection or disease). It is not medical advice for the treatment of any disease.

Aug 23, 2023

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