Facts About Vaginal Boric Acid Treatments

Bacterial Vaginosis and vulvovaginal candidiasis recurrences are becoming more common due to medication resistant strains, use and overuse of antibiotics, immunocompromising conditions, or poor vaginal health practices. These infections are becoming harder to eliminate with bacterial biofilms and exposure to uncommon yeast strains being the most recent theory.

Boric acid has been used as a treatment for these 2 vaginal infections (and many other health conditions) with great success for centuries. While the why/how boric acid works is still not fully explained or understood, scientists do know that it does break down the bacteria’s biofilm and yeast cell walls making those pathogens more susceptible to our body’s natural defenses and prescription medications as well as creating a pH level that is very close to where the vagina prefers to be making it difficult for pathogens to get out of control.

But before you run to your local store and end up bringing home pesticide quality boric acid I want to provide some basic information about this chemical compound so you know what it is and is not, and what it can and cannot do for your vaginal health.

The Nitty Gritty of this Gritty Treatment!

Boric acid is a weak, topical, bateriostatic and fungistatic agent (static which means to inhibit) that inhibits the growth of yeast and bacteria. This is partly how boric acid is able to help resolve yeast infections and some bacterial vaginosis infections-by creating an environment where neither pathogen is able to replicate or adhere very well.

Boric acid has a 5.0pH level however and the vagina normally prefers to be between 3.5-4.5 pH. So if your pH is below 5.0 and you insert boric acid, the boric acid will raise your pH to 5.0 temporarily. Inserting boric acid to acidify your vagina will only do so if your vaginal pH is currently above 5.0…hopefully that makes sense, I had to use a lot of repeat numbers there!

It can also “cure” and control recurrent bacterial vaginosis by disrupting what is callaed a biofilm. A biofilm is a thin, slimy protective film layer covering bacteria that adheres to a surface and can create a protective matrix between bacteria cells. Boric acid also disrupts and destroys the protective fungal cell membranes of yeasts/candida. Studies are showing these protective layers to be the main contributor to infection recurrence and resistance. The exact mechanism of how boric acid works to inhibit the growth of yeast and bacteria, disrupt the biofilms and cure infections is unclear however it is suggested that it works by penetrating and disrupting the fungal cell membrane wall and bacterial biofilm membranes making the little buggers more susceptible to our body’s natural defenses and prescription medications.

Boric acid vaginal suppositories are a compounded medication that is deliverable to the vagina in a safe concentration. “This medication/treatment should only be used under the advice and recommendation of your doctor. A lot of women are saying ‘oh this is awesome, you don’t have to go to the doctor, you could just put the acid in the capsules yourself and it’s inexpensive!’ but that’s not the case, you need a proper diagnosis and to make sure the boric acid is medical grade or pharmaceutical grade as opposed to the kind that’s just in roach killer!” – Dr. Moore.

You are able to purchase safe boric acid for use in capsules and vaginal suppositories in many stores and online, however I urge you to talk with your doctor or pharmacist and do some research into which product you purchase so you know you are getting a high quality product that will actually benefit you.

Typical Dosing and Side Effects

  • Typical dosing for an active infection is one 600 mg boric acid capsule or vaginal suppository inserted twice a day for 14 days.
  • Typical dosing for prophylactic or preventative use is one 300-600 mg boric acid capsule or vaginal suppository inserted 1-2 times a week, or after sexual intercourse that includes insemination (as ejaculate has a pH of 7-8ish and will raise the vaginal pH way up there temporarily making you susceptible to pathogenic organism takeover).

Side effects of using a boric acid vaginal suppository include: watery vaginal discharge, redness, mild burning sensation, and a gritty sensation in the vagina. Some have reported mild spotting while using boric acid as well so between the mild spotting and discharges while using this product, it’s probably best to keep some liners or pads on hand. Do not insert tampons while using boric acid.

Stop using this medication and call your Dr. at once if you have: new or worsening sympotoms (itch, vaginal discharge, etc.), vaginal burning sensation, high fever, or symptoms that go away and come back.

Get emergency medical help if you have signs of an allergic reaction such as hives, difficult breathing, swelling of your face, lips, tongue and throat.

Side Note: Some studies have shown that a very small percentage of women with recurrent vulvovaginal candidiasis (RVVC) develop vestibulitis/vestibulodynia and in those patients the pain from using boric acid would exceed the symptoms observed in patients without this problem and it may in fact exacerbate the vestibulits/vestibulodynia.

You should not use boric acid if you are allergic to it or if you have: pain or tenderness in your pelvis or lower stomach, fever, chills, nausea, vaginal bleeding, Pelvic Inflammatory Disease, an active sexually transmitted infection, high blood pressure, heart disease, a weak immune system, blood vessel disorder, or if you are pregnant or breastfeeding. NO drug interactions have been reported involving boric acid.

Please note that boric acid WILL NOT kill bacteria, it is not an antibiotic.

Only a small percentage of women with BV infections can resolve their infection with boric acid and this is most likely due to:

  • Boric acid lowering the vagina’s ph level creating a hostile environment for the bacteria
  • Breaking down the bacteria’s biofilm defense system leaving the pathogenic organisms vulnerable and
  • Their body having an immune system that was able to clear the infection on its own.

However, using boric acid alone to try and cure a BV infection is not a successful treatment for most women you will also need a prescription antibiotic to take along with the boric acid to reap the full benefits of both treatments.

The current studies show that the most successful treatment we have right now for a bacterial vaginosis infection is taking a presciption as needed (meaning you have a positive test result for the BV bacteria causing an active infection) from your doctor for metronidazole 500mg pill twice per day for 7 days ALONG WITH simultaneously taking the 600mg boric acid twice per day for 14 days. These treatments need to be started together in order to obtain the high cure rate but doing so is showing a promising long term cure rate of >88% at 12 weeks, combine that with a vaginal formulated probiotic that includes Lactobacillus Crispatus, L. Reuteri, and L. Rhamnosus and we might get ahead of these infections plaguing us!

Just Some tid bits….

More recently, biofilms have been implicated in vaginal infections, most notabley BV and VVC particulary in the setting of treatment failure and recurrence. Biofilms are of major medical significance becasue they decrease susceptibility to prescriptions used to treat BV and VVC and enhance the spread of antimicrobial resistance. Additionally, they provide a safe haven for other opportunistic pathogens to thrive and be a source of infection. The biofilms are not fully destroyed by antibiotics so biofilm-related (resistant) infections tend to persist and so BV tends to have a high rate of relapse and recurrence(Bradshw et al., 2006)

Compared with conventional azole antifungal medications (yeast infection medication), one of the more effective therapies for RVVC is intravaginal boric acid. When an antifungal medication fails to resolve an infection or a person is having 4 or more infections in a 12 month period (usually due to not complete elimination of original infection) boric acid is breaking down and inhibing the fungal cell wall and biofilm and normalizing the vaginal ph to 4.5-5pH which creates a hostile environment for both bacterial vaginosis and yeast infection.

Yeast infections and bacterial vaginosis are such frustrating conditions to have for anyone who has a vagina especially when recurrences are happening over and over and no end seems in sight. If you (or someone you care about) are suffering this way please talk to your doctor about how boric acid may benefit you, print off the studies I use for any of my blogs to help you if you are unsure about how to discuss any topic.

Check out my post about probiotics as well as it is another great addition to combating repeated infections along with a proper prescription and boric acid-a triple threat if you will, but also in helping to create a healthy vaginal environment that can prevent infections from starting.

And as always, feel free to reach out to me with any questions here on the website or on Twitter and Instagram @healthyhooha !

Sources:

https://www.ncbi.nlm.nih.gov/m/pubmed/25935553/

https://www.ncbi.nlm.nih.gov/m/pubmed/26834706/

https://www.ncbi.nlm.nih.gov/m/pubmed/19704395/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1784796/

https://www.drugs.com/mtm/boric-acid-vaginal.html

https://www.ncbi.nlm.nih.gov/m/pubmed/26210791/

https://www.google.com/amp/amp.timeinc.net/health/sexual-health/boric-acid-treatment-bacterial-vaginosis

https://www.ncbi.nlm.nih.gov/m/pubmed/21774671/

32 comments

  • Pingback: The Role of Probiotics in Combating Chronic BV and Yeast Infections | Healthy Hooha

  • I have recurrences. 4 a year.it seems to me that sperm any kind of toy or est.it will infect me.im sorry tired of goin to the doctor .metronitazole pills and cream I’ve used for years.and I’ve tried other meds but still get it back.could you please help me with this problem..

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    • It sounds like your vaginal epithelium and microbiome is not very healthy. If you are using hormonal birth control, pills or IUD, that can destroy vaginal health. Have you tried adding in a vaginal formulated probiotic containing L. Crispatus? And you mention that you’ve done metronidazole and boric acid regimins but have you used them together as shown in the study data? And then rellenished your vaginal microbiome with the strains typically found in the vagina after the treatment was finished? Establishing what treatments have been tried is helpful in getting you the info you need

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    • It sounds like your vaginal epithelium and microbiome is not very healthy. If you are using hormonal birth control, pills or IUD, that can destroy vaginal health. Have you tried adding in a vaginal formulated probiotic containing L. Crispatus? And you mention that you’ve done metronidazole and boric acid regimins but have you used them together as shown in the study data? And then rellenished your vaginal microbiome with the strains typically found in the vagina after the treatment was finished? Establishing what treatments have been tried is helpful in getting you the info you need. Oh and to make sure– are you getting positive test results for BV?

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  • Hi! Thanks for this article and explaining the science behind boric acid. Does boric acid work the same way with other bacterial strains like chlamydia and Gonorrhea?

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    • So far the data only has been on Trich and boric acid looks to have a similar success rate in Trich as it does BV or yeast which isn’t perfect but works for many. Boric acid, if studied on Chlamydia or Gonorrhea, would probably show that the protective biofilms get broken down via boric acid the same way. There has been data for quite a while that shows that a vaginal pH of 3.5-4.5 is able to inhibit the infection of those pathogens as well as HIV and Evofem Biosciences is starting clinical trials on their lactic acid gel, similar to the Phexxi they just released. But I imagine, theoretically, boric acid could break down the biofilms of Gonorrhea and Chlamydia if they were in small enough numbers and then the acidity of the vagina would then be able to kill of the organisms, again-theoretically as long as they were in low numbers. Male sense?

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  • Thank you so much for all your research. I have been suffering with BV off & on for the past couple years after I tried having a IUD. I have tried almost everything you can think of. I have tried metronidazole & also Clindamycin (vaginal suppository cream . I have been clinically diagnosed 6 times in 18months. I have tried to solve it at home many times especially recently. I have tried Boric Acid but on the 3rd day I felt like it was making things more raw feeling. I have tried vaginal probiotics & or gels to try to restore a good PH, coconut oil, natural lube & condoms for sex, organic pads & tampons (rarely use anymore), I never use anything but water & my hand to wash my vaginal area and I have tried a ton of different brands of oral Probiotics (I just ordered the one you recommended). I am thinking about giving into my antibiotics that I was prescribed a few weeks ago but Aunt Flo is on her way & I have the Clindamycin vaginal cream antibiotic this time bc the Metronidazole makes me feel crappy. Do you think it would be a good idea if after Aunt Flo leaves that I try boric acid suppositories at night for a couple days then use the Clindamycin antibiotic cream suppositories & use the new kind of oral probiotics twice a day? Thanks again for all your research bc yes I am soooo frustrated with BV!

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    • I’ve been dealing with a yeast infection……had one in september and now another one. First one I was put on terazol cream and it set me on fire. I thought I had a UTI it hurt so bad and was making me urinate frequently. Cultures for UTI came back negative. This month I got another yeast infection so I started the boric acid suppositories. Fire again. I don’t understand what’s causing the burning. I used a little organic coconut oil and got immediate relief. I hope it continues to help so I can get back to normal. This website has been very helpful!

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    • I hope you get this response, I’ve been hearing from people they aren’t seeing my responses.

      I strongly suggest the regimen laid out in this article and my probiotics article but some vagina owners simply can’t tolerate the boric acid. Boric acid can give some women a little dermatitis which won’t help the situation. If you feel this is maybe what was happening with you you could probably lower the usage to 2-3 times a week instead of everyday and you’ll still get good benefit.

      However if you choose to use the clindamycin gel or even the metronidazole gel you should definitely try to use the boric acid as the gels just don’t have the success rate as the flagyl pills do.

      Tums is your best friend with flagyl or even sulfa-trimethoprim which is used for UTI’s. But these antibiotics do make us feel shitty and seriously a bottle of tums and smalls meals/snacks every couple of hours helps greatly!

      There wont be much benefit to using the boric acid and then stopping while you use the clind gel as the boric acid is complimentary to the gel in that they need to be used together, so i don’t know that that plan will do you much good.

      How many days are you supposed to use the clind gel?

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    • Oh and feel free to move this conversation to the healthy hooha email if you want healthyhoohainfo@gmail.com

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    • I primarily have a vulvar yeast infection is there any way boric acid can be used externally?

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      • Not really. You could probably figure out a way to make it a paste and slather it on your vulva and lay there spread eagle for a couple of days but thats unrealistic. Youd be better off applying a vulvar aplroved antifungal cream if you can tolerate them, its not just applying monistat to the outside, they are sometimes a little easier on the skin but you can apply something like monistat directly to the vulva it just might burn from the dermatitis. If you know youre not really able to tolerate those the dr can usually prescribe one thats a little easier to tolerate but some still have trouble because theres so much dermatitis happening.

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  • I thought my BV was coming back again. Now not sure after I used a boric acid suppository and noticed no unwanted odor on my finger. I do have on hand an RX for Flagyl. But will not take it unless necessary as I have had a reoccurrence of this nightmare probably 4 times in the last 12 months so I am hypersensitive to any strange odor. I try to not use tampons. Sometimes it has been necessary. Anyway, I mainly have one partner but I have had one where immediately after he ejaculated in me I noticed that all to familiar smell. Then it seemed to go away. But I had such anxiety I only just checked today and this has been a week since being with said man. I know it’s frowned upon but I have had two parteners kind of back to back if you will. One of which I am very steady with and usually no reaccuring issues. I just don’t want to feel like a dumpster. To my knowledge both of those men have only been with me. Sorry for the long rant. I guess my question is should I continue with the suppository- only did one. I do take a feminine pro-biotic which might have taken care of things for over the coarse of the past week. Keep taking or if no Oder or other typical symptoms is it ok to just stop and keep it on hand? Will continue with the probiotics. I don’t want to create a problem.

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    • If you aren’t totally sure you have an active infection I suggest going with the prophylactic regimen laid out by the research data. The studies and drs recommend inserting one 300-600mg suppository 1-2 times a week.

      Then keep taking your probiotics, (hopefully it contains L. Crispatus) and if you wanted the research data also says that inserting a 10 billion cfu suppository showed there were still beneficial bacteria clinging to the vaginal walls 10-12 days later so you you could try mixing one of your L. Crispatus probiotics with a little bit of coconut oil just to make a ball, chill it for ease of insertion, insert and lay with your butt elevated for a few hrs with towels. If you only use a tiny bit of oil it shouldn’t be a huge mess but it is oil and thus a pain to wash out! But you could try that to give it some direct application while the oral route gets ramped up.

      Don’t worry about your sexual habits. Yes it is shown that different/new partners are a huge contributer to starting a BV infection but thats simply due to the different flora, micro tears, and the rising pH from the ejaculate. Condom use has been shown to actuall improve the vaginal microbiome! Most likely due to not introducing the strange flora.

      A product that might help you is Phexxi. I wrote an article about that as well. The makers of it are working of getting approval to have thr product used as a BV/STI preventative due to its acidity/lactic acid.

      No need to wipe out your microbiome from the antibiotics just yet unless youre absolutely sure you have an infection. Try the study/dr recommended regimen of prophylactic boric acid first.

      Please be aware that I am not a dr but can only tell you what has been shown to be regimens that have worked during studies and what drs recommend as preventative courses. 🙂

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  • I got a YI, I’ve had 2 in my life before (I’m 30) and so I knew to go get monistat. I hadn’t tried the 1 day dose so I got that, nothing. Then went to the gyno who persriped me the pill, took it, still unbearable itchiness and tenderness. It was also pretty inflamed. They perscribed me a 2nd dosage and it seemed to get a little better and then my period arrived. It seemed to be getting better but once my period was over, the symptoms were back, all but the yeast. I went back to the gyno who perscribed me terconazole, 3 suppository creams. After those three in three nights I’m feeling about 75% better. There’s still mild itching. It’s been 5 days since that medication was done and it’s been consistently mild itching and gets worse if I’m walking around. Would boric acid help? It also feels a bit dry sometimes. But that could be the ACV washes I do once a day in the bath. It’s really been getting to me and bringing me down mentally. I’m definitely calling my gyno again but any thoughts? Thank you!

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    • Im sorry it took so long to reply, I had an annual event at work I had to prep for all week. What you’re experiencing is common aftermath for yeast infections. Most of the time a topical steroid to bring down the lingering inflammation is needed. I dont think you need boric acid or more antifungals, this really sounds like a classic case of lingering inflammation. I do recommend tho that you stop the ACV baths right away. Baking soda may help a little bit really its getting the inflammation down and a light barrier like coconut oil or vasaline to prevent urine from irritating the flesh. If you are medically cleared to do so take ibuprofen as well. You can try cortisone10 in vasaline only applied to your vulva as the steroid but only about half of people can tolerate cortisone and the rest need a mid-strength steroid prescription like triamcinolone. How are you feeling now?

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  • Hi! Thank you for all the info! I had to take an antibiotic in May and I’ve had trouble with YIs ever since. I have a really good oral probiotic, but just realized that it doesn’t contain L. crispatus. I have vaginal probiotics that do contain this strain. I s/w my Gyn today and she said to try boric acid, but really didn’t give me any other info. I’m going to coat my labia with a&d ointment before inserting to help with irritation. How long after finishing the BA should I wait to start the probiotic suppositories? Thank you again for the valuable information.

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    • I’m glad I was able to help you with dosage and usage recommendations! You may still have irritation while using the boric acid because your vulva is irritated, try keeping some vasaline or coconut oil oil on it. If its still too irritating try going down to the prophylactic dosing. As for your specific question you can technically insert the vaginal probiotic opposite the boric acid whenever you want but that can get quite goopy. So really i would just take the probiotics orally until you finish the boric acid. I have been having trouble with people seeing my responses so hopefully you see this!

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  • I was diagnosed with BV and a yeast infection (but the yeast infection was only on my outer vulva area and not internal- i had no discharge) and I tried boric acid only to wake up with lots of white clumpy discharge. Would it be possible for boric acid to have triggered a yeast infection? or could it have cleansed out my vagina of previously existing yeast that was stuck up there? I’m so confused haha. thank you!

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    • Since it was so soon after inserting it was probably coincidental and the boric acid hadnt been used long enuf before the yeast over took the area. Remember too that while boric acid is great it isnt perfect, its not a cure-it only breaks down the protective coatings and then the medication or your immune system does the actual work in killing the pathogenicorganisms. AND boric acid can also cause some women irritation and sometimes a little irritation is all thats needed to even just spark off a YI lol so since you were confirmed to have both infections i would recommend also getting a diflucan to just be hitting it on all angles

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  • Thanks so much for this article! I’ve been officially diagnosed w BV 2x. Jan 2019 and again in jan 2020. Both times my GYN has said the bacteria Count isn’t super high but it still is enough to be diagnosed with it. I know I’ve wiped out all my healthy bacteria with taking the Metro pills and gel about 5x within that timeframe. If I had sex and something felt off I would use the gel for a few nights and some boric acid. I went 8 months without having sex thinking that would reset me down there lol I just bought some oral vaginal probiotics, Good Clean love PH balancing and moisturizing gel and PH strips and it’s in the abnormal range like 5. I have boric acid that I started back using off and on awhile ago but I’m using more now. Since I started back having sex I’ve noticed I’m not as lubricated as I once was but I haven’t felt like myself down there since mid 2018 Since my UTI & antibiotics . I think it all went downhill From there. I don’t have a fishy odor or anything but when I have sex I notice a slight odor that’s really annoying/embarrassing. I called to get an appointment w my GYn to swab name for BV but it’s not until Jan. What can I do to improve my symptoms now? I have some metro gel left , & boric acid. Should I use that for a few days and hope it gets better? Also how do you feel ab honeypot wash products? I’ve been using that again lately but don’t know if it’s doing more harm than good. Sorry this is so long!

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    • If youre on a hormonal birth control it could be contributing to the BV cycles but not as much as new partners do. Birth control also can significantly affect your lubrication abilities.

      Any washes are unnecessary are honestly can do more trouble than good. If someone’s vulva is bothered a single ingredient, even if its not typically an allergy, it will cause your vagina’s immune system to go into overdrive and that’s not a good thing either as then inflammation can happen and that leads to lowered beneficial bacteria etc. So i wouldnt use a wash at all but if you must I’d stick with something like vanicream gentle face wash and most importantly you have to force yourself to not wash the vulva aggressively or too often as these behaviors can cause hyperactive immune response as well. The ingredients in honeypot specifically seem to be very good but you may be mildly allergic to any ine of those plant based ingredients and be just fine in the rest of your body but due to direct access to your vulva as well as something called counter current flow to the vagina-any one of them could cause you an issue. I get into more detail about this in my allergy article. Remember, the vestibule/inner labia and vagina are just like your mouth-very permeable and sensitive to chemicals, allergens, plants, everything.

      I strongly recommend not using any of your antibiotics or boric acid until you get a test done-do you have access to an urgent care type clinic? They are very familiar with swabbing women for infections and that would get you in and tested as soon as they open where ever you live.

      Also to be perfectly honest a BV infection a year apart isn’t totally uncommon for a woman who is sexually active

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      • Thank you so much for your quick reply!! I’m not on BC currently although I was on it for about 10 years straight. I’ve been off ab a year. That’s a good idea about the urgent care I’m going to try there! I went months without honeypot and I could tell the regular one was causing a reaction so I started using the sensitive one but I honestly don’t need it. I have sensitive skin anyway so I will stop using it again just to be safe! Thanks Sooo much again.

        Liked by 1 person

      • You’re welcome 🙂

        You knowing your have sensitive skin is good it will help you be more aware of things that can trigger your vulvovaginal response. Body products, menstrual pads, dairy, spring and fall allergens, hell even “too much” sex. The vulva/labia really only likes 5-15 mins of friction before it really starts cranking up the inflammatory reaction despite how it might feel while performing the sexual act. Also anything that gets put on your skin can accumulated to varying levels in the vaginal epithelium ramping up the immune response so while the more info i provide people can make them feel a little overwhelmed about having a vagina in the end it makes us all better stewards of its care! ❤

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  • Thanks for this. Do you think resistance would be built up by using boric acid preventatively 1-2x week (e.g. after sexual intercourse) as opposed to a full course of 14 days (as would be done with anitbiotics)?

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  • Hi! I personally emailed you at the email addess provided. Its ALOT to read but i desperately need your help! Thank you!!

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  • My BV nightmare and bladder infections started with anal play. After years of boric acid temp smell fixes, vaginal and oral  antibiotics, expensive vaginal specific probiotic supplements, kefirs,, kombuchas, naturally soured  sauerkrauts and ton of other probiotic foods I finally fixed it with a grocery store danone activia yogurt. It contains 1 billions of active  Bifidobacterium animalis (also marketed under regularis or lactis) per portion. I bought it because it was on sale and had one a day for 14 days. BV gone even after period.It does make you very regular more than I’d like. Also don’t wash your privates with intimate antibacterial soaps. I used popular intimate Lactacyd  odor block soap for years. It contains povidone iodine to deal with the BV smell.Another tip for reducing vulva pain after sex; pour cold 500 ml water bottle on it once or twice right afterwards when sitting on toilet. Hope this helps someone!

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  • Hi, I’m wondering if you could explain what is the reason for the watery discharge, and what the different amounts mean. It seems inconsistent. Thank you!

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    • Can you elaborate a little more on what seems inconsistent so I can best answer? Does your discharge seem inconsistent or do you feel info in the article seems inconsistent? Thanks Rachel!

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