Vaginal Infection

There are three main causes of vaginal infections: the fungus (yeast) Candida albicans, the parasite Trichomonas vaginalis, and the bacterial organism Gardnerella vaginalis.

Factors that can contribute to vaginal infections include the use of antibiotics (which kill friendly bacteria, allowing yeast to grow), corticosteroids and HIV (which suppress the immune system), oral contraceptives and pregnancy (which alter the vaginal environment by changing hormone levels), and diabetes (increased sugar levels provide a friendly environment for yeast).

Conventional medical treatment for vaginal infections caused by Candida include vaginal suppositories containing antifungal medications, or in some cases, oral antifungal medications. Women with diabetes often find that yeast infections are less common when their blood sugar levels are well controlled.

Trichomonas infections are treated with oral metronidazole and Gardnerella infections with oral or vaginal metronidazole or vaginal clindamycin.

Proposed Treatments for Vaginal Infection:

There are some promising natural treatments for vaginal infections caused by Candida and other organisms, but the scientific evidence for them is not yet strong.

Acidophilus

Friendly bacteria such as acidophilus are normally found in the vagina. When colonies of these organisms are present, it is difficult for unfriendly organisms such as Candida to become established. For this reason, women have been advised to use yogurt or other products containing acidophilus, both orally and in vaginal suppositories, to prevent or treat yeast infections. Although this practice seems to make good sense, there is surprisingly little evidence to support it.

An unblinded crossover trial of 33 women with recurrent vaginitis found that those who ate yogurt containing Lactobacillus acidophilus for 6 months had a decreased incidence of vaginal infections during the year of the study. However, many of the women refused to participate in the non-yogurt portion of the study after obtaining good results, and only 13 completed the study to the end. This, along with the lack of blinding, makes the results of the study unreliable.

In an uncontrolled trial of 38 women who had not responded to conventional treatments, a vaginal douche of L. acidophilus twice daily along with a vitamin B supplement produced normal vaginal flora in 76% of the women 1 week after treatment. In another uncontrolled study of 28 women with recurrent vaginitis, participants were given vaginal suppositories containing Lactobacillus to be inserted twice daily for 7 days. All of the women reported subjective improvement, which was confirmed with pelvic exam. However, because these studies were not controlled, the results are less than reliable.

Nonetheless, there are good reasons to believe that increasing the population of friendly bacteria in the vagina will tend to prevent infections. Both oral and topical use of acidophilus should have this effect.

Although many available products purport to contain acidophilus, a study of a variety of health food products found that many contained few or no active organisms. For this reason, it may be preferable to use live-culture yogurt.

Tea Tree Oil

Tea tree oil, an essential oil from the plant Melaleuca alternifolia, possesses antibacterial and antifungal properties, and appears to spare friendly bacteria in the Lactobacillus family.

Tea tree oil has been tried for various forms of vaginal infection, but there is little scientific evidence as yet that it works. In an uncontrolled trial, 96 women with trichomonal vaginitis were treated with tampons saturated in tea tree oil and left in the vagina for 24 hours, followed by daily vaginal douches with a tea tree oil solution. The researcher reported good results with this regimen in 3 to 4 weeks. However, the study was poorly designed and has not been replicated.

If you wish to try tea tree oil, keep in mind that it can cause irritation to the skin and mucous membranes.

Boric Acid

Boric acid is a chemical substance with antiseptic properties. A double-blind comparison study of 108 women with yeast infections found that 92% of those who used boric acid suppositories nightly for 2 weeks experienced full recovery, as compared to 64% of those given suppositories of the standard antifungal drug nystatin.

Another small uncontrolled study of boric acid suppositories in women with chronic vaginal yeast infections also found benefit.

However, there are safety concerns with boric acid. If taken internally, it is quite toxic. For this reason, it should not be applied to open wounds. In addition, it should not be used by pregnant women, nor applied to the skin of infants.

Other Herbs and Supplements

Various tropical plants appear to possess antifungal properties, and have been tested as possible treatments for candidal yeast infections. The plant Solanum nigrescens has been tested in a single-blind comparison trial against the standard drug nystatin. In this study, 100 women with Candida vaginitis treated twice daily for 2 weeks with Solanum suppositories showed results equivalent to those given nystatin suppositories. However, this plant can be toxic, and should not be used except under physician supervision.

One preliminary study suggests bee propolis may be helpful for treating vaginal infections.

Test tube studies have found antifungal properties from numerous other herbs, including the tropical tree Tabeuia avellanedae, garlic extracts, the plant alkaloid berberine sulfate, and essential oils of various plants, including cinnamon, eucalyptus, lemongrass, palmarosa, and peppermint. However, it is a long way from such studies to proof of safety and effectiveness in people.