When Treatment Works… But Doesn’t Hold

If you’ve been treated for:
• bacterial vaginosis (BV)
• ongoing discharge
• vaginal irritation or imbalance

…and it continues to return, this is not uncommon.

But it is also not something you need to accept as ongoing.

In many cases, the issue is not just what is present —
it is why the environment is not holding balance.

What Is Vaginal Dysbiosis?

Vaginal dysbiosis refers to:
• an imbalance in the vaginal microbiome
• reduced protective bacteria (lactobacillus)
• increased opportunistic organisms
• a shift in vaginal pH

This is not always a single infection.
It is often a change in the environment itself.

Why It Keeps Coming Back

1. The environment has not been restored

Most treatments focus on:
• removing bacteria

But do not address:
• the condition of the vaginal tissue
• the stability of pH
• the ability of protective bacteria to return

If the environment is unchanged, recurrence is likely.

2. Lactobacillus has not been rebuilt

Lactobacillus is responsible for:
• maintaining acidity
• protecting the vaginal wall
• preventing bacterial adhesion

If levels remain low:
• the environment stays vulnerable

3. pH remains elevated

An optimal vaginal environment is acidic.

If pH remains elevated:
• opportunistic bacteria continue to grow
• protective bacteria struggle to survive

4. Biofilm behaviour

Some bacteria form protective layers (biofilms).

This allows them to:
• persist despite treatment
• re-emerge after treatment stops

5. Hormonal and tissue factors

The vaginal wall requires:
• adequate epithelial integrity
• local oestrogen influence
• glycogen production

Without this:
• the microbiome cannot stabilise

6. Gut and bladder influence

The vaginal environment is not isolated.
• gut microbial imbalance can influence vaginal flora
• bladder conditions may sit alongside vaginal dysbiosis
• shared epithelial tissue contributes to this connection

7. Sexual and environmental factors

The vaginal environment is influenced by:
• semen (alkaline, alters pH)
• oral bacteria
• hygiene practices
• partner microbiome

This does not mean these are the cause —
but they can contribute when the environment is already unstable.

Why Standard Treatment Often Falls Short

Standard approaches may:
• reduce symptoms temporarily
• shift bacterial load

But often do not address:
• tissue health
• microbial rebuilding
• long-term stability

A More Complete Approach

A more effective approach involves:
1. Reducing overgrowth (when required)
2. Correcting vaginal pH
3. Rebuilding lactobacillus
4. Supporting epithelial tissue
5. Identifying contributing systems (gut, bladder, hormonal)

This is what allows results to hold.

What This Looks Like In Practice

In clinic, this may involve:
• appropriate testing where required
• understanding your individual pattern
• targeted herbal and nutritional support
• internal support where appropriate
• staged treatment — not one step

When To Look Deeper

If you are experiencing:
• recurrent BV
• persistent discharge or odour
• irritation or sensitivity
• symptoms that return after treatment
• bladder symptoms alongside vaginal symptoms

It is time to look beyond surface-level treatment.

How I Work With This

Support is individualised and may include:
• Everyday Ailment Consults For acute or active presentations
• Under the Skin Consults For ongoing or complex patterns involving multiple systems
• Herbal Remedy Bar A practitioner-guided approach to herbal medicine — not self-prescribing

The Aim Is Not Short-Term Relief

The aim is to:
• restore balance
• rebuild the environment
• reduce recurrence

Support Starts With a Conversation

Charmaine D
Naturopathic Herbalist
Where Tradition Meets Evidence

Why This Area Matters More Than Most People Realise

If you’ve experienced ongoing vaginal imbalance, recurrent BV, irritation, or even
bladder sensitivity — it may not be what you think.

This is not always about infection.

It is often about epithelial tissue function, microbial balance, and the environment not holding stability.

What Is Epithelial Tissue — And Why It Matters

The vaginal wall is made of epithelial tissue.

This is the same tissue that lines:
• your gut
• your bladder
• your respiratory tract
• and forms your skin barrier

Which means:

these systems are connected — not separate

How a Healthy Vaginal Environment Actually Works

A stable vaginal environment depends on three key mechanisms:

1. The epithelial wall
• intact
• nourished
• hormonally supported

2. Glycogen production

Glycogen is produced within the epithelial cells and acts as:
fuel for beneficial bacteria

3. Lactobacillus (protective bacteria)
These bacteria:
• convert glycogen into lactic acid
• maintain vaginal pH
• prevent harmful bacteria from attaching

Why pH Is So Important

The vaginal environment should remain acidic.

This acidity:
• protects the tissue
• prevents overgrowth
• supports beneficial bacteria

When pH rises:
• lactobacillus declines
• pathogens increase
• imbalance develops

What Disrupts Vaginal pH
• hormonal changes
• antimicrobial or antibiotic use
• gut imbalance
• bladder inflammation
• semen (alkaline)
• oral bacteria
• ongoing stress or inflammation

The Gut, Bladder & Vaginal Connection
These systems share:
• epithelial tissue
• immune signalling
• microbial interaction

Bowel patterns matter
• constipation → increased bacterial exposure
• diarrhoea → irritation and disruption
• inflammatory bowel patterns → ongoing immune activation

Bladder connection
Bladder conditions (such as IC) often sit alongside vaginal imbalance due to shared tissue behaviour.

Hormones & Vaginal Tissue

Oestrogen is essential for:
• tissue integrity
• glycogen production
• microbial balance

Without this:
• the environment becomes unstable
• protective bacteria cannot thrive

Sexual Health & The Vaginal Environment

Factors that influence the environment include:
• semen (changes pH)
• oral bacteria
• mechanical irritation
• hygiene practices

This is not about avoiding intimacy — it is about understanding the environment.

Why This Is Not Just Infection

Many presentations are:
• microbial imbalance
• epithelial dysfunction
• loss of environmental control

What Happens If This Is Not Addressed

• recurrent BV
• ongoing discharge or odour
• vaginal sensitivity
• bladder symptoms
• difficulty maintaining balance

A Different Way to Approach This

In practice, this is not treated as:

“what infection is present”

But rather:

• what is the condition of the tissue
• why is the environment not stable
• what is driving recurrence

How I Work With This

Support may include:
• Everyday Ailment Consults For acute or active symptoms
• Under the Skin Consults For deeper, ongoing or complex patterns

When To Seek Support

If you are experiencing:
• recurrent vaginal imbalance
• ongoing discharge or odour
• irritation or sensitivity
• bladder symptoms alongside vaginal symptoms Support

Starts With a Conversation

Charmaine D
Naturopathic Herbalist
Where Tradition Meets Evidence

Why your body isn’t responding — even when everything looks “normal”
By Charmaine D – Naturopathic Herbalist

There is a pattern I see often — and it is usually missed.

A woman will come in and say:

“I feel flat.”
“I’ve put on weight I can’t shift.”
“My face looks puffy… I don’t look like myself.”
“I’m doing what I used to do — and nothing is working.”

Her results may sit within normal ranges.
She is functioning. She is managing.
But something has clearly changed.

When the issue isn’t production — it’s utilisation

In many of these cases, the thyroid gland is not the primary problem.

The issue is how thyroid hormone is being used at a cellular level.

T4 is your storage hormone.
T3 is your active hormone.

But under certain conditions, the body diverts T4 into reverse T3 (rT3).

Reverse T3 does not activate the cell.
It blocks activity.

This is not dysfunction —
it is a protective response.

Why the body applies the brake

The body will favour reverse T3 when it perceives load.

That load might be:
• sustained stress
• inadequate recovery
• digestive inefficiency
• inflammation
• inconsistent nourishment
• or cumulative life demand (which is often underestimated)

From a clinical perspective, the body is asking:

“Do I have the resources to run at full capacity?”
If the answer is no —
it slows everything down.

Where this overlaps with the Cell Danger Response

This pattern aligns with what has been described in research as the
Cell Danger Response (Naviaux, 2014).

This model explains how cells temporarily reduce activity in response to perceived threat or stress.

In that state, cells:
• limit energy output
• reduce communication
• and prioritise protection over performance

While this is designed to be short-term,
in clinical practice we often see it persisting.

This is where patients begin to experience:
• low energy despite adequate sleep
• resistance to weight loss
• fluid retention and puffiness
• reduced mental clarity
• and a lack of response to effort

Why “doing more” stops working

At this point, many women try to correct it by:
• exercising harder
• eating less
• increasing discipline

But if the body is already applying a brake,
this reinforces the signal to stay in that state.

You cannot outwork a system that is trying to conserve.

The signs I look for clinically

This pattern has a very recognisable presentation.

You may notice:
• a lack of drive in the morning
• reliance on caffeine to function
• a short window of better energy
• followed by a drop
• a heavier or puffier face
• fluid retention through the body
• slower digestion or bloating
• and a sense that your body is “not responding”

This is not one isolated issue —
it is a pattern.

What I do differently

I do not start by pushing metabolism.

I start by removing the reasons it slowed down in the first place.

That means working on:
• digestion (so you are actually nourished)
• bowel clearance (so you are not holding stagnation)
• protein and fuel timing (so the body feels supported)
• adrenal load (so the system is not constantly compensating)
• and fluid movement (so tissues are not congested)

Only once that begins to shift
does the body start to respond again.

Starting quickly — without overcomplicating it

If you recognise yourself in this,
you do not need to wait until everything is fully investigated to begin.

This is where my Everyday Ailments Consult (40 minutes) is useful.

In that session, I can:
• assess your current pattern
• identify whether this presentation fits
• and begin a tailored herbal formulation immediately

This may include support for:
• insulin regulation
• fluid retention
• lymphatic movement
• adrenal function
• and metabolic signalling

From there, we continue to build your case properly if needed.

Herbal prescribing — why it matters here

Through my Herbal Remedy Bar, I prescribe practitioner-only formulations.

These are not generic products.

They are selected and dosed based on:
• your current presentation
• your tolerance
• and what your body will respond to

In cases like this, the aim is not to overstimulate —
it is to gently shift the system out of conservation.

Working externally — for those based in Adelaide

This pattern is not just internal —
it shows in the tissues.

Often through:
• puffiness in the face
• reduced definition
• heaviness through the body

For my Adelaide clients, I also work externally with this.

Using techniques including:
• Chinese-style cupping
• targeted stimulation
• and circulatory support treatments

This is not simply lymphatic drainage.

It is about:
• improving oxygen flow
• stimulating cellular activity
• and reducing stagnation

Over time, this helps:
• restore facial shape
• reduce fluid retention
• and improve how the body feels overall

My formulations and skincare approach

I have developed specific formulations for this pattern.

This includes:
• a herbal blend applied through jojoba oil
to support circulation and oxygenation in the skin

And where appropriate:
• internal amino acid support such as citrulline
to assist blood flow and delivery at a cellular level

Alongside:
• serums and creams designed to support lymphatic movement
You can read more about this here:
Clickhere to read the blog

This is not a weight loss problem — it is a response
problem

Once this pattern begins to shift, we typically see:
• improved energy
• clearer thinking
• reduced puffiness
• better digestion
• and a body that begins responding again

Weight may change —
but it is no longer forced.

If this is you

You can begin with:
• an Everyday Ailments Consult (40 minutes)
• or explore support through the Herbal Remedy Bar

From there, we build your case properly —
with structure, not guesswork.

Further support

You may also find this helpful:
Everyone’s Insulin Resistant (eBook)

Final note

When the body slows down, it is rarely without reason.

The key is not pushing harder —
it is understanding what changed,
and working with it properly.

Support starts with a conversation

A clinical case reflection from my naturopathic practice
By Charmaine D – Naturopathic Herbalist

There is a type of woman I see often in clinic.

She is not significantly overweight by medical standards.
She is functioning. Working. Showing up. Managing a household.

From the outside, she is “fine”.

But she will sit in front of me and say:

“I don’t feel like myself anymore.”
“Nothing is working.”
“I’m doing what I used to do… and my body just won’t respond.”

And what makes it harder —
is that her blood tests often come back as “within range”.

This is not uncommon — and it is not imagined

Recently, I worked with a woman in her early 40s.

Her main concerns were:
• weight gain that began after her second pregnancy
• persistent fatigue
• brain fog
• bloating and a sense that food “just sits there”
• and a body that no longer responded to effort

She was not overeating.
She was not inactive by intention.
She was doing her best within a life that had become significantly busier.

But her system had shifted.

When your body moves into conservation mode

From a naturopathic perspective, what I often see in these cases is not a lack of effort — but a change in how the body is using energy.

After periods of:
• increased demand (pregnancy, children, work)
• reduced recovery
• inconsistent nourishment

…the body adapts.

It becomes more efficient at:
• holding onto energy
• slowing processes down
• and prioritising storage over output

This is not a fault.
It is a response.

But when that pattern stays in place, it begins to feel like everything is harder than it should be.

“My thyroid is normal” — but is it functioning efficiently?

Standard thyroid testing may sit within reference ranges.
From a medical perspective, that is appropriate.

But clinically, we sometimes see patterns where:
• energy is low
• metabolism feels reduced
• weight is resistant
• and mental clarity is affected

One of the patterns I explore is how well thyroid hormone is being converted and utilised, not just produced.

Under certain conditions — such as ongoing demand, digestive inefficiency, or inadequate nourishment — the body may favour more conservative pathways.

What that looks like day-to-day is:
• low drive in the morning
• needing stimulation to get going
• a brief window of better energy
• followed by another drop

Why going harder can make things worse
This is where many women unintentionally push themselves further into the problem.

They:
• reduce food
• increase exercise intensity
• try to be more disciplined

But if the body is already conserving,
this reinforces the signal to slow down further.

If the system doesn’t feel supported, it won’t spend energy.

So instead of forcing change,
we change the conditions the body is responding to.

Digestion — often the missing link

In this case, digestion was central.

She described:
• food sitting high in the stomach
• frequent burping
• pressure after eating
• bowel motions that were daily, but incomplete

This tells me food is not being broken down efficiently.

If that step is compromised:
• nutrients are not properly absorbed
• the body remains undernourished
• and energy production is affected

So even when you are eating well,
you may not be receiving the benefit of that food.

Fluid retention and facial puffiness

One of the first things many women notice — and often feel self-conscious about — is the face.

That subtle change:
• puffiness
• loss of definition
• a heavier, more stagnant look

This is something I see clearly in clinic.

It often reflects what is happening deeper in the body:
• fluid not moving efficiently
• circulation not as active
• and cellular activity slowed

Where I start in these cases

I do not begin by pushing weight loss.

I begin by restoring function.

That means:
• improving digestion
• supporting proper elimination
• increasing nourishment earlier in the day
• introducing the right type of movement
• and reducing what is keeping the body in that holding pattern

Sometimes the most effective place to start is not stimulation —
it is nourishment and support.

The part most people don’t expect — but deeply need

There is another piece to this that is often overlooked.

Women in this stage of life are:
• giving constantly
• managing everything
• and very rarely receiving care themselves

And yet, the body responds incredibly well
when it is both supported and cared for.

In this particular case, alongside her naturopathic plan,
she also began coming in for regular treatments.

These are not just “skin treatments”.

They are designed to:
• reduce stagnation
• stimulate circulation
• and bring activity back to the tissues

I use techniques including Chinese-style cupping across the face and body.

Not purely for lymphatic drainage —

but to:
• encourage oxygenation
• stimulate cellular activity
• and gently move areas that have become sluggish

On the face, this helps:
• reduce puffiness
• restore shape and definition
• and bring a healthier tone back to the skin

Through the body, it supports:
• movement of stagnation
• improved circulation
• and a sense of lightness returning

Treatment becomes part of the process — not separate from it

What I find is that when women come in regularly:
• they begin to feel change sooner
• they reconnect with how their body feels
• and they stay engaged with the process

It also allows space to:
• check in
• adjust what we are doing
• and guide the next steps

Often we will:
• complete the treatment
• then sit for 10–15 minutes
• and review how things are progressing

This becomes a natural extension of their care — not an extra task.

For those local to Adelaide

If you are based in Adelaide,
this becomes an added layer of support available to you.

Alongside your consultation and protocol,

you have access to:
• in-clinic treatments
• ongoing guidance
• and hands-on support as your body begins to shift

For those not local, we continue to work virtually —
but for those who are, this is where we can deepen the process.

What happens when the body starts to respond

When we correct the environment — rather than force outcomes —
we begin to see:
• improved digestion
• more complete bowel movements
• reduced puffiness (especially in the face)
• clearer energy
• better mental clarity
• and a body that begins to respond again

Weight often follows —
but it is no longer the only measure of progress.

This is why I wrote Everyone’s Insulin Resistant

Not because everyone has a diagnosis —
but because many women are experiencing a pattern where the body is not using energy
efficiently.

Where:
• fuel is not being utilised well
• storage is prioritised
• and the system feels stuck

In the eBook, I explain:
• how this develops
• what it looks like
• and how we begin to shift it

Where to from here

If you recognise yourself in this:

You can access the eBook
Everyone’s Insulin Resistant

Or receive it as part of your initial consultation with me.

From there, we work through your case properly — in a way that fits your current life, not an ideal one.

Final thought

There is a point where pushing harder stops working.

And there is a point where supporting the body properly
changes everything.

Support starts with a conversation

There is a very specific presentation I see in clinic — and it’s often overlooked or treated in isolation.

It’s the person who says, “My gut feels off… and my skin isn’t right either.”

They’ve often tried different products, changed their diet, maybe even taken probiotics — but nothing has fully settled. There is still bloating, irregular digestion, or a sense that something internally isn’t quite right. And at the same time, the skin is reactive, inflamed, or not behaving as it once did.

This is where we stop looking at symptoms separately.

Because the body doesn’t work in isolation.

When the internal environment of the gut is disrupted, it doesn’t stay contained. It can influence digestion, immune signalling, inflammatory pathways, and how the skin behaves. The body begins to communicate that something needs attention — not through one symptom, but through a pattern.

This is where herbal medicine, when prescribed correctly, may be considered as part of a broader clinical approach.

Botanical & Traditional Context

Black Walnut (Juglans nigra) has a long history of traditional use in Western herbal practice, particularly where the internal environment requires support. The hull of the walnut has been valued for its strong, active constituents and its role in addressing patterns associated with microbial imbalance and digestive disruption.

Traditionally, it has been used where there is a need to “clear” or rebalance the internal terrain — particularly in cases where stagnation, dysbiosis, or parasitic patterns are suspected. However, this language, while useful historically, needs to be translated carefully into modern clinical practice.

Today, we look less at labels — and more at patterns.

Phytochemistry & Research

Black Walnut contains a number of bioactive compounds, including juglone, tannins, flavonoids, and polyphenols. These compounds contribute to its traditional and investigated antimicrobial, antifungal, and astringent properties.

Preclinical research has explored its activity against a range of microbial species, as well as its antioxidant capacity. While human clinical data is limited, its continued use in practitioner settings reflects its role within pattern-based prescribing — particularly where the internal environment appears disrupted.

Clinical Application

In clinic, I may consider Black Walnut where I see a pattern that includes:

• digestive discomfort, bloating, or irregular bowel habits
• a feeling of internal “heaviness” or imbalance
• skin flare-ups that do not respond to topical care
• a history of recurrent gut disturbances or antimicrobial use

It is not used as a general “gut herb,” and it is not appropriate in every digestive presentation.

It is selected when the pattern suggests that the internal environment requires specific support — and always within the context of the individual.

Preparation & Form Considerations

Black Walnut is most commonly prescribed as a liquid extract within a practitioner formulation, allowing for precision dosing and combination with other herbs.

Capsules or tablets may be used in some cases, particularly where compliance or taste is a concern, but the selection of form depends on the clinical picture, the acuity of symptoms, and the individual’s tolerance.

Due to its active nature, it is not a herb I recommend self-prescribing.

Clinical Considerations

As with all practitioner-prescribed herbal medicine, Black Walnut is pharmacologically active.

It may not be suitable in all cases, particularly where the digestive system is already sensitive or depleted. Consideration must also be given to existing medications, individual tolerance, and the broader clinical picture.

This is why assessment is essential.

Who Might Seek Assessment

You may consider seeking support if you recognise this pattern:

• your gut feels unsettled, even when you are trying to eat well
• your skin is reacting or flaring without clear reason
• you feel like something internally is “not right,” but can’t quite explain it
• you’ve tried multiple approaches without resolution

Herbal Remedy Bar + Booking

This is exactly where my Herbal Remedy Bar and Everyday Ailment Consults come in.

Short, targeted consultations designed to assess what your body is showing now — and determine what support may be appropriate, including practitioner-prescribed herbal medicine where indicated.

If this resonates with you, you don’t need to guess your way through it.

You need clarity.

Professional Note

This article is for educational purposes only and is not intended to diagnose, treat, or replace personalised medical advice. Herbal medicines should be prescribed following professional assessment.

There is a particular kind of discomfort that is often dismissed or normalised — especially when it comes to the body.

It’s the feeling of tension. Tightness. Cramping.

A sense that the body is “holding on” rather than moving freely.

For some, this shows up as abdominal discomfort or cramping. For others, it is a more general sense of tension — physically or internally — that doesn’t fully resolve.

And often, the advice is to ignore it, push through it, or simply accept it as part of life.

But the body does not create tension without reason.

Botanical & Traditional

Black Haw (Viburnum prunifolium) has a long history of use in Western herbal medicine, particularly in relation to smooth muscle tension and cramping patterns.

Traditionally, it has been used where there is a need to support relaxation of the body — especially in presentations involving uterine or abdominal discomfort. However, its role extends beyond one system.

It is a herb that speaks to how the body holds and responds.

Phytochemistry & Research

Black Haw contains compounds such as coumarins, flavonoids, and salicin-like constituents, which are thought to contribute to its traditional use in supporting muscle relaxation and reducing spasmodic activity.

While clinical research is limited, its continued use in herbal practice reflects its value in addressing patterns of tension and cramping — particularly where there is a nervous system component involved.

Clinical Application

In clinic, I may consider Black Haw where I observe:

• cramping or spasmodic discomfort
• a sense of physical tension or tightness
• discomfort associated with cyclical changes
• a body that appears to be “holding” rather than relaxing

It is not used simply because cramping is present.

It is used when the pattern suggests that the body requires support in how it regulates and releases tension.

Preparation & Form Considerations

Black Haw is most often prescribed as part of a liquid herbal formulation, allowing for flexibility in dosing and combination with other supportive herbs.

In some cases, tablet or capsule forms may be considered, depending on individual preference and compliance.

The form and dosage are always selected based on the clinical picture.

Clinical Considerations

Not all tension is the same.

Some presentations require stimulation. Others require nourishment. Others require calming.

Using the wrong approach will not resolve the pattern.

This is why proper assessment is essential before introducing any herbal medicine.

Who Might Seek Assessment

You may recognise this pattern if:

• your body feels tight, tense, or uncomfortable
• you experience cramping that doesn’t fully resolve
• you feel like your body is “holding” rather than relaxing
• symptoms fluctuate but never fully settle

This is where my Herbal Remedy Bar and Everyday Ailment Consults are designed to help.

These consultations allow me to assess your current presentation and determine what support may be appropriate — including practitioner-prescribed herbal medicine where indicated.

You don’t need to push through discomfort.

You can understand it.

Professional Note

This article is for educational purposes only and does not replace personalised medical advice. Herbal medicines should be prescribed following professional consultation.