I have been a Consultant of Genito-Urinary Medicine at St George’s Healthcare Trust for over 15 years. I have a specialist interest in Bacterial Vaginosis (BV), am a member of the British Association of Sexual Health and HIV (BASHH), and draft the National Guidelines for the Management of BV. These are the guidelines that are used in GUM Clinics across the UK used to diagnose, treat and manage BV.

We regularly see new cases of BV in clinic. Many of these women visiting the clinic for the first time with concerns about their symptoms are generally unaware of the condition. I also hold a weekly clinic for women with recurrent BV; these women can have recurrences every month.

Antibiotics are the most common treatment used for BV, but it’s not uncommon to see women again at a later date as their symptoms have returned. Unfortunately the antibiotics prescribed to treat BV have side-effects, which many of my patients find unpleasant. Aside from this they, quite rightly, aren’t keen on repeatedly taking antibiotics and would welcome an alternative treatment.

I have tried alternative treatment methods, such as acetic acid preparations such as Aci-Jel; these work by normalising pH. I have never been truly satisfied with their effectiveness though, particularly against recurrent BV, and often find myself prescribing antibiotics again.

Balance Activ™ Vaginal Gel appealed to me as the active ingredients offer more than the previous alternatives I have tried, and there is published clinical evidence that show that the product is as effective as antibiotics. I started using the product in my clinic in Spring 2007 and it has made a huge difference, as an alternative to antibiotics for women with recurrent BV.

I have used Balance Activ™ Vaginal Gel both to treat and prevent BV. To treat BV I recommend one pack of Balance Activ™ Vaginal Gel is used (apply at bedtime for 7 days). For recurrent BV I recommend they use 3 tubes around the time they expect recurrence to occur - this is usually with their period. It seems to work best if started the day before the period is due. If they are patients in my recurrent clinic I recommend that the patient continues to use Balance Activ™ Vaginal Gel to prevent further recurrences and maintain a healthy vaginal environment. To date, the use of Balance Activ™ Vaginal Gel in my recurrent clinic has had a really positive effect; the majority of my patients are really pleased with the results.

Another great thing about lactic acid gels is that, unlike antibiotics, it mimic’s the bodies natural defence mechanism so it’s safe for women to use as often as they like, as it doesn’t cause any side effects.

I would recommend women who suffer from BV try Balance Activ™ Vaginal Gel – It offers a much needed alternative to antibiotics for the treatment and prevention of the condition.

I have worked as a registered nurse in GU medicine for 10 years. BV is a common reason for women to visit the clinic; in fact I see it in around half of the female patients I see a week.

Many of my patients suffer with BV recurrently; commonly after their periods or after sex, but lots of my patients don’t notice any particular trigger for it to return.

I’ve tried lots of ways to treat the condition; antibiotics are the most common treatment and work well, but many of my patients have returned within a couple of months as BV has returned yet again. Plus an antibiotic won’t prevent recurrence.

Balance Activ™ offers everything I need to give a patient to manage her condition. It’s not an antibiotic but is just as effective in treating BV, and its’ safe for a woman to use as often as she likes. I’ve found in our chronic BV clinic that most women are using it just before their period or after sex to prevent recurrence. For the women who haven’t worked out their trigger, they can use it as soon as they notice their symptoms returning, some just for one day, and it keep’s it at bay.

It’s really easy to use, and it’s great that it’s available for women to buy rather than having to have a prescription. It means that they can take it away on holiday with them - we get requests for prescriptions prior to women taking a holiday ‘just in case’.

Most of my patients love it – in fact, one patient recently referred to it as her miracle cure!! It’s great for me too - now I don’t see the same faces in clinic month after month, I’ve finally been able to help them.

I have been a Consultant in Genitourinary Medicine at The General Infirmary at Leeds for over 15 years. I have a specialist interest in Bacterial Vaginosis (BV), and am an active member of the British Association of Sexual Health and HIV (BASHH).

I regularly see women who sufferer from recurrent BV. A course of antibiotics is the usual initial treatment for BV, but recurrence of BV after treatment is frequent. There are various published treatment options for trying to prevent recurrent BV. Some of these involve regular oral or intravaginal antibiotic use for several months. However, repeated use of antibiotics is not desirable due to the potential for adverse side effects and possible resistance, so these are not my preferred choice to prevent recurrence.

I have performed a review of the published evidence on BV and recurrences. The background reading for this lead me to believe that trying to maintain an acidic vaginal pH is important in the prevention of BV. Ideally this should be with a product containing lactic acid, but until recently this formulation wasn’t available to me. A product that I did use for many years for prevention of recurrent BV was an acetic acid preparation called Aci-Jel. Unfortunately the manufacturers of Aci-Jel ceased production in 2005 and at that stage all I could offer my recurrent BV patients was repeated antibiotics.

I started to use Balance Activ™ as soon as it was available. It meant I was able to give my patients an acidifying vaginal gel again and as it contains lactic acid and glycogen it mimics the body’s natural protective mechanisms. I now give my recurrent BV patients the initial 7 day course of antibiotics then provide them with Balance Activ™ to use every other day for 3 months to try to prevent their recurrent BV. All of my patients are recalled every month to evaluate the vaginal flora and measure the pH.

Not only does Balance Activ™ appear to be effective in preventing BV in my patients, it also seems to be better tolerated than Aci-Jel. It is less messy as it appears to have better vaginal adherence, which means my patients don’t notice much leakage. Previously some of my patients could not tolerate Aci-Jel, but I’m not aware of any of my patients being unable to tolerate Balance Activ™.

Another benefit of Balance Activ™ is that it is safe to use during pregnancy, and I use it to prevent recurrent BV in pregnant women.