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Health Condition

Vaginitis

  • Lactobacillus acidophilus Vaginal Application

    A topical preparation or suppository containing live Lactobacillus acidophilus may help relieve symptoms and prevent recurrent infections.

    Dose:

    Apply a daily topical preparation or a suppository containing live culture
    Lactobacillus acidophilus Vaginal Application
    ×
     

    Lactobacillus acidophilusis a strain of friendly bacteria that is an integral part of normal vaginal flora. Lactobacilli help maintain the vaginal microflora by preventing overgrowth of unfriendly bacteria and Candida. Lactobacilli produce lactic acid, which acts like a natural antibiotic. These friendly bacteria also compete with other organisms for the utilization of glucose. The production of lactic acid and hydrogen peroxide by lactobacilli also helps to maintain the acidic pH needed for healthy vaginal flora to thrive. Most of the research has used yogurt containing live cultures of Lactobacillus acidophilus or the topical application of such yogurt or Lactobacillus acidophilus into the vagina. The effective amount of acidophilus depends on the strain used, as well as on the concentration of viable organisms.

    Vaginal application of a proprietary Lactobacillus acidophilus preparation may help bacterial vaginitis. In one trial, 80% of women with bacterial vaginitis who used the preparation were either cured or experienced marked improvement in symptoms.1 In another trial, application of a vaginal capsule containing Lactobacillus rhamnosus, Lactobacillus acidophilus, and Streptococcus thermophilus reduced the recurrence rate of bacterial vaginosis. The treatment was given for 7 consecutive days, and then after 7 days off was given for another 7 days.2 In another trial, women who were predisposed to vaginal Candida infection because they were HIV-positive received either Lactobacillus acidophilus vaginal suppositories, the antifungal drug, clotrimazole (for example, Gyne-Lotrimin), or placebo weekly for 21 months.3 Compared to those receiving placebo, women receiving Lactobacillus acidophilus suppositories had only half the risk of experiencing an episode of Candida vaginitis—a result almost as good as that achieved with clotrimazole. In a preliminary trial, women with vaginal Trichomonas infection received vaginal Lactobacillus acidophilus suppositories for one year.4 Over 90% of them were reported to be cured of their clinical symptoms in that time.

    Two specific strains of lactobacillus (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) have been found to be effective against bacterial vaginosis when taken orally. In a double-blind study, supplementation with a capsule containing 10 billion of each of these organisms twice a day for 30 days increased the cure rate from antibiotic therapy to 88%, compared with a 40% cure rate in the group receiving antibiotics alone.5

  • Lactobacillus rhamnosus G R-1 and Lactobacillus reuteri RC-14 Oral

    Supplementing with probiotics may help prevent recurrences of bacterial or candidal vaginitis.

    Dose:

    Take a supplement providing 10 billion of each twice per day
    Lactobacillus rhamnosus G R-1 and Lactobacillus reuteri RC-14 Oral
    ×

    Lactobacillus acidophilus is a strain of friendly bacteria that is an integral part of normal vaginal flora. Lactobacilli help maintain the vaginal microflora by preventing overgrowth of unfriendly bacteria and Candida. Lactobacilli produce lactic acid, which acts like a natural antibiotic. These friendly bacteria also compete with other organisms for the utilization of glucose. The production of lactic acid and hydrogen peroxide by lactobacilli also helps to maintain the acidic pH needed for healthy vaginal flora to thrive. Most of the research has used yogurt containing live cultures of Lactobacillus acidophilus or the topical application of such yogurt or Lactobacillus acidophilus into the vagina. The effective amount of acidophilus depends on the strain used, as well as on the concentration of viable organisms.

    Vaginal application of a proprietary Lactobacillus acidophilus preparation may help bacterial vaginitis. In one trial, 80% of women with bacterial vaginitis who used the preparation were either cured or experienced marked improvement in symptoms.6 In another trial, women who were predisposed to vaginal Candida infection because they were HIV-positive received either Lactobacillus acidophilus vaginal suppositories, the antifungal drug, clotrimazole (for example, Gyne-Lotrimin), or placebo weekly for 21 months.7 Compared to those receiving placebo, women receiving Lactobacillus acidophilus suppositories had only half the risk of experiencing an episode of Candida vaginitis—a result almost as good as that achieved with clotrimazole. In a preliminary trial, women with vaginal Trichomonas infection received vaginal Lactobacillus acidophilus suppositories for one year.8 Over 90% of them were reported to be cured of their clinical symptoms in that time.

    Two specific strains of lactobacillus (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) have been found to be effective against bacterial vaginosis when taken orally. In a double-blind study, supplementation with a capsule containing 1 billion of each of these organisms twice a day for 30 days increased the cure rate from antibiotic therapy to 88%, compared with a 40% cure rate in the group receiving antibiotics alone.9 In another double-blind trial, women with bacterial vaginosis received one capsule of L. rhamnosus GR-1 and L. reuteri RC-14 (1 billion of each strain per capsule) twice a day or placebo for 6 weeks. After 6 weeks, the percentage women who no longer had bacterial vaginosis was significantly higher in the probiotics group than in the placebo group (62% vs. 21%).10 Women with bacterial vaginosis should consult their doctor to determine whether these probiotic strains might be an effective alternative to antibiotics.

  • Neem

    In one trial, a cream containing neem seed extract, saponins of reetha, and quinine hydrochloride eliminated all symptoms in 10 of 14 women with chlamydia.

    Dose:

    Use a cream containing seed extract, saponins of Sapindus mukerossi (reetha), and quinine hydrochloride (5 ml applied vaginally once at bedtime)
    Neem
    ×
     

    In a double-blind, placebo-controlled trial, a cream containing neem seed extract, saponins of Sapindus mukerossi (reetha), and quinine hydrochloride (5 ml applied vaginally once at bedtime) eliminated all symptoms in 10 of 14 women with chlamydia compared with none of four women given placebo cream.11 Neither cream was effective in women with trichomoniasis or candidal vaginitis.

  • Vitamin D

    In one double-blind trial, women with vaginitis who were not experiencing any symptoms were given vitamin D daily and had a higher cure rate than the control group.

    Dose:

    Refer to label instructions
    Vitamin D
    ×
    In a double-blind trial, women with bacterial vaginosis who were not experiencing any symptoms were given 2,000 IU of vitamin D per day or no vitamin D (control group) for 15 weeks. The cure rate was significantly higher in the vitamin D group than in the control group (63.5% vs. 19.2%).12 Vitamin D is thought to work by improving the functioning of the immune system.
  • Barberry

    Barberry is antibacterial and may be effective against infectious vaginitis.

    Dose:

    Refer to label instructions
    Barberry
    ×
     

    Teas of goldenseal, barberry, and echinacea are also sometimes used to treat infectious vaginitis. Although all three plants are known to be antibacterial in the test tube, the effectiveness of these herbs against vaginal infections has not been tested in humans. The usual approach is to douche with one of these teas twice each day, using 1–2 tablespoons (15–30 grams) of herb per pint of water. One to two pints (500–1,000 ml) are usually enough for each douching session. Echinacea is also known to improve immune function in humans.13 In order to increase resistance against infection, many doctors recommend oral use of the tincture or alcohol-preserved fresh juice of echinacea (1 teaspoon (5 ml) three or more times per day)—during all types of infection—to improve resistance.

  • Echinacea

    Echinacea is antibacterial and known to improve resistance to infection.

    Dose:

    Refer to label instructions
    Echinacea
    ×
     

    Teas of goldenseal, barberry, and echinacea are also sometimes used to treat infectious vaginitis. Although all three plants are known to be antibacterial in the test tube, the effectiveness of these herbs against vaginal infections has not been tested in humans. The usual approach is to douche with one of these teas twice each day, using 1–2 tablespoons (15–30 grams) of herb per pint of water. One to two pints (500–1,000 ml) are usually enough for each douching session. Echinacea is also known to improve immune function in humans.14 In order to increase resistance against infection, many doctors recommend oral use of the tincture or alcohol-preserved fresh juice of echinacea (1 teaspoon (5 ml) three or more times per day)—during all types of infection—to improve resistance.

  • Goldenseal

    Goldenseal is antibacterial and may be effective against infectious vaginitis.

    Dose:

    Refer to label instructions
    Goldenseal
    ×

    Teas of goldenseal, barberry, and echinacea are also sometimes used to treat infectious vaginitis. Although all three plants are known to be antibacterial in the test tube, the effectiveness of these herbs against vaginal infections has not been tested in humans. The usual approach is to douche with one of these teas twice each day, using 1–2 tablespoons (15–30 grams) of herb per pint of water. One to two pints (500–1,000 ml) are usually enough for each douching session. Echinacea is also known to improve immune function in humans.15 In order to increase resistance against infection, many doctors recommend oral use of the tincture or alcohol-preserved fresh juice of echinacea (1 teaspoon (5 ml) three or more times per day)—during all types of infection—to improve resistance.

     
  • Tea Tree

    Topically applied tea tree oil has been used successfully as a topical treatment for TrichomonasCandida albicans, and other vaginal infections.

    Dose:

    Refer to label instructions
    Tea Tree
    ×
     

    Topically applied tea tree oil has been studied and used successfully as a topical treatment for Trichomonas, Candida albicans, and other vaginal infections.16 Tea tree oil must be diluted when used as a vaginal douche, and should only be used for this purpose under the supervision of a healthcare practitioner. Some physicians suggest using tea tree oil by mixing the full-strength oil with vitamin E oil in the proportion of 1/3 tea tree oil to 2/3 vitamin E oil. A tampon is saturated with this mixture or the mixture is put in a capsule to be inserted in the vagina each day for a maximum of six weeks.

  • Vitamin A

    Some doctors recommend vaginal administration of vitamin A to improve the integrity of the vaginal tissue and to enhance the function of local immune cells.

    Dose:

    Refer to label instructions
    Vitamin A
    ×
     

    Some doctors recommend vitamin E (taken orally, topically, or vaginally) for certain types of vaginitis. Vitamin E as a suppository in the vagina or vitamin E oil can be used once or twice per day for 3 to 14 days to soothe the mucous membranes of the vagina and vulva. Some doctors recommend vaginal administration of vitamin A to improve the integrity of the vaginal tissue and to enhance the function of local immune cells. Vitamin A can be administered vaginally by inserting a vitamin A capsule or using a prepared vitamin A suppository. Vitamin A used this way can be irritating to local tissue, so it should not be used more than once per day for up to seven consecutive days.

  • Vitamin E

    Some doctors recommend vitamin E (taken orally, topically, or vaginally) for certain types of vaginitis.

    Dose:

    Refer to label instructions
    Vitamin E
    ×
     

    Some doctors recommend vitamin E (taken orally, topically, or vaginally) for certain types of vaginitis. Vitamin E as a suppository in the vagina or vitamin E oil can be used once or twice per day for 3 to 14 days to soothe the mucous membranes of the vagina and vulva. Some doctors recommend vaginal administration of vitamin A to improve the integrity of the vaginal tissue and to enhance the function of local immune cells. Vitamin A can be administered vaginally by inserting a vitamin A capsule or using a prepared vitamin A suppository. Vitamin A used this way can be irritating to local tissue, so it should not be used more than once per day for up to seven consecutive days.

What Are Star Ratings
×
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

References

1. Karkut G. Effect of lactobacillus immunotherapy on genital infections in women. Geburtshilfe Frauenheilkd 1984;44:311-4 [in German].

2. Ya W, Reifer C, Miller LE. Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study. Am J Obstet Gynecol 2010;203:120.e1-e6.

3. Williams A, Yu C, Tashima K, et al. Weekly treatment for prophylaxis of Candida vaginitis. Presentation. 7th Conference on Retroviruses and Opportunistic infections. Foundation for Retrovirology and Human Health in collaboration with the (US) National Institute of Allergy and Infectious Diseases and the Centers for Disease Control and Prevention. January 30-February 2, 2000.

4. Litschgi MS, Da Rugna D, Mladenovic D, Grcic R. Effectiveness of a lactobacillus vaccine on Trichomonas infections in women. Preliminary results. Fortschr Med 1980;98:1624-7 [in German.]

5. Anukam K, Osazuwa E, Ahonkhai I, et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes Infect 2006;8:1450-4.

6. Karkut G. Effect of lactobacillus immunotherapy on genital infections in women. Geburtshilfe Frauenheilkd 1984;44:311-4 [in German].

7. Williams A, Yu C, Tashima K, et al. Weekly treatment for prophylaxis of Candida vaginitis. Presentation. 7th Conference on Retroviruses and Opportunistic infections. Foundation for Retrovirology and Human Health in collaboration with the (US) National Institute of Allergy and Infectious Diseases and the Centers for Disease Control and Prevention. January 30-February 2, 2000.

8. Litschgi MS, Da Rugna D, Mladenovic D, Grcic R. Effectiveness of a lactobacillus vaccine on Trichomonas infections in women. Preliminary results. Fortschr Med 1980;98:1624-7 [in German.]

9. Anukam K, Osazuwa E, Ahonkhai I, et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes Infect 2006;8:1450-4.

10. Vujic G, Jajac Knez A, Despot Stefanovic V, Kuzmic Vrbanovic V. Efficacy of orally applied probiotic capsules for bacterial vaginosis and other vaginal infections: a double-blind, randomized, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol 2013 Feb 7 [Epub ahead of print].

11. Mittal A, Kapur s, Garg S, et al. Clinical trial with Praneem polyherbal cream in patients with abnormal vaginal discharge due to microbial infections. Aust NZ J Obstet Gynaecol1995;35:190-1.

12. Taheri M, Baheiraei A, Foroushani AR, et al. Treatment of vitamin D deficiency is an effective method in the elimination of asymptomatic bacterial vaginosis: A placebo-controlled randomized clinical trial. Indian J Med Res 2015;141:799–806.

13. Melchart D, Linde K, Worku F, et al. Immunomodulation with echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245-54 [review].

14. Melchart D, Linde K, Worku F, et al. Immunomodulation with echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245-54 [review].

15. Melchart D, Linde K, Worku F, et al. Immunomodulation with echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245-54 [review].

16. Pena E. Melaleuca alternifolia oil: Its use for trichomonal vaginitis and other vaginal infections. Obstet Gynecol 1962;19:793-5.

17. Wilcox G, Wahlqvist M, Burger H, et al. Oestrogenic effects of plant foods in postmenopausal women. BMJ 1990;301:905-6.

18. Shalev E, Battino S, Weiner E, et al. Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent Candidal vaginitis and bacterial vaginosis. Arch Fam Med 1996;5:593-6.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2020.

Drugs used to treat VAGINITIS. Select drug name to view medication information and pricing