Infections that keep coming back? Biofilms could be the culprit. Learn how these clever microbial communities help infections hide and survive, and what the latest science says about tackling them.
A rich text element can be used with static or dynamic content. For static content, just drop it into any page and begin editing. For dynamic content, add a rich text field to any collection and then connect a rich text element to that field in the settings panel. Voila!
Headings, paragraphs, blockquotes, figures, images, and figure captions can all be styled after a class is added to the rich text element using the "When inside of" nested selector system.
Infections that keep coming back? Biofilms could be the culprit. Learn how these clever microbial communities help infections hide and survive, and what the latest science says about tackling them.
Sometimes, vaginal infections like thrush or BV just keep coming back no matter what you try. We want you to know that you’re not alone – and it’s not your fault. Repeat vaginal infections are incredibly common, with many people finding themselves stuck in a frustrating cycle of treatment, short-term relief, and repeat symptoms.
So what’s really fuelling this cycle? Growing research points to biofilms – structured communities of microbes working together to hide and survive, even after treatment.
Let’s break down what biofilms are, how they relate to recurrent vaginal infections, and what the latest science is telling us.
A biofilm is a group of bacteria that stick together and attach to a surface, like the walls of the vagina. To protect themselves, they create a slimy layer that acts like a shield.
Inside this layer, the bacteria aren’t just floating around. They’re working together, helping each other survive and stay hidden from antibiotics, antifungals, and even your own immune system.
In the context of vaginal health, biofilms make infections much harder to treat. Even if symptoms go away after treatment, the bacteria inside a biofilm can remain, ready to regrow and trigger symptoms all over again.
The first major discovery of vaginal biofilms came in 2005, when scientists found dense clusters of Gardnerella bacteria in women with BV. These weren’t just stray bacteria; they were organised, layered, and stuck firmly to the vaginal lining.
In a healthy vaginal microbiome, protective bacteria called Lactobacilli help keep things in balance. They protect against infection by lowering the pH and crowding out harmful microbes. But in women with bacterial vaginosis (BV), those protective bacteria are significantly reduced, leaving space for other bacteria (like Gardnerella, Prevotella, and others) to overgrow.
These harmful bacteria don’t just multiply. They team up and form biofilms, building layered communities that stick to the vaginal walls. Once a biofilm forms, the infection becomes embedded, providing a physical and chemical barrier that makes infection much harder to treat.
Recurrent thrush or yeast infections (caused by Candida albicans) can form fungal biofilms, too. Yeast cells can form dense networks that shield them from treatment, making it harder to clear the infection fully.
The key problem? Once a biofilm is established, the microbes inside can become up to 1,000 times more tolerant to antibiotics or antifungals. So while medication may help temporarily, it often doesn’t target the underlying cause, which is why symptoms keep coming back.
Another reason infections linger? Your body may not even realise there’s a problem.
Some BV-related bacteria (like Gardnerella) release enzymes that break down the protective mucus in your vagina and weaken your immune defences. This makes it harder for your body to spot and fight the infection.
Without a strong immune response, BV often causes little to no inflammation, which is why it can fly under the radar. This ability to avoid detection is part of what makes BV so persistent – and why standard treatments don’t always work long-term.
Plus, Gardnerella doesn’t act alone. When it teams up with other bacteria like Fannyhessea and Peptostreptococcus, they form stronger, mixed-species biofilms that are even harder to treat. One study found that BV was twice as likely to come back when all three species were present, compared to Gardnerella alone.
Treatments like metronidazole and clindamycin are commonly prescribed for BV. However, these antibiotics were developed to target free-floating bacteria, not ones hiding inside biofilms.
Research shows that:
That’s why more than 60% of women with BV experience a repeat infection within a year of treatment.
Research is still in early stages, but scientists are exploring new ways to disrupt biofilms, allowing them to target the microbes hiding inside and break the cycle of infection.
Some promising approaches include:
These treatments aren’t yet widely available, but they signal a shift: from simply “killing bacteria” to changing the environment that allows infections to survive. It’s a promising new direction in vaginal health.
At UVISA, we’re exploring the potential of light therapy as a new way to treat vaginal infections, including those protected by biofilms. Targeted light could penetrate the biofilm barrier and help disrupt the microbes hiding inside. It’s a simple, non-invasive approach – and while we’re still investigating exactly how light interacts with biofilms, the science is promising. This could represent a whole new way of tackling repeat infections at the source.
If you’re stuck in a cycle of repeat vaginal infections, biofilms could be part of the reason. These infections aren’t just stubborn, they’re protected. And while antibiotic resistance can play a role, the bigger challenge for many people is biofilm resilience; the natural defence system that helps infections survive, hide and return.
Understanding this is a powerful first step. If your symptoms keep coming back, consider bringing up biofilms with your doctor. These treatments aren’t yet part of standard care, but awareness is growing, and asking the right questions can help you get closer to the right support.
