LACTIN-V is a freeze-dried powder of L. crispatus originally isolated from a healthy woman, made by a Californian company called Osel. It’s delivered via a tampon-like device. In initial studies, women found it easy and comfortable to use, and the L. crispatus colonized 11 out of 18 women.

Craig Cohen sees the lack of a highly effective treatment for BV as keeping this major health problem off most people’s radar. There’s been no way to break the associations between BV and HIV and preterm birth because our current treatment leaves between one-third and two-thirds of women still suffering. We won’t see breakthroughs until we have a better treatment that keeps the vast majority of women BV-free for six months or more, says Cohen. “We need not just better antibiotics, but better approaches.”

The St. Louis woman has tried to gently educate her high-school students in the girls’ locker room when she gets a whiff of that unmistakable smell. She pulls them aside to make sure they understand that it’s a problem caused by bacteria and that their doctor can treat it. But when she’s out at a nightclub and women are cracking jokes about another woman in the restroom (“She nasty! She don’t take baths!”), she finds it harder to speak up.

“I’ve wanted to say something, but then that puts you out there. The moment I say something, it will be like, ‘Well, how do you know that?’” she says. “It’s still a very personal issue.” She’s also struggled in the bedroom to explain the condition to her partner. “You can’t do oral sex, you can’t really do much of anything until it’s gone away,” she says. “The doctor recommended not having sex, but I don’t think you can tell a fiancé or husband that.”

Like Cohen, both the Lewises and Cone believe real progress can’t be made on these problems until we have a better treatment for BV—one that cures most women. “Then women would not be buying boric acid and homeopathic suppositories and going back to their gynecologists all the time,” says Warren Lewis.

Cohen can see a future where metronidazole gel and products like LACTIN-V might be sold together over the counter—which would put BV in the pharmacy aisle, on the magazine ad page and, importantly, on people’s minds. Such a treatment would not only capture a huge slice of the estimated $140 million BV market in the US, but would also bring real relief to women shopping among those shelves of deodorizers, wipes and cleansers that do nothing to help cure the infection.

It could also bring BV out of the shadows. “We need to get on top of it,” says the St. Louis woman. “So women can treat it and talk about it. It should be just like a yeast infection … not such a shameful issue.”

This article appears courtesy of Mosaic Science.

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