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 !