There are three main causes of vaginal infections: the fungus (yeast)
Candida albicans, the parasite
Trichomonas vaginalis, and the bacterial organism
Factors that can contribute to vaginal infections include antibiotics (which kill friendly bacteria, allowing yeast to grow), corticosteroids and HIV (which suppress the immune system),
and pregnancy (which alter the vaginal environment by changing hormone levels), and
(increased sugar levels provide a friendly environment for yeast).
Conventional medical treatment for vaginal infections caused by
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.
infections are treated with oral metronidazole, and
infections with oral or vaginal metronidazole or vaginal clindamycin. So-called nonspecific vaginitis is usually caused by
gardnerella, but there are other causes.
There are some promising natural treatments for vaginal infections caused by
and other organisms, but the scientific evidence for them is not yet strong.
Probiotics (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. Probiotic supplements can help restore a normal balance of vaginal organisms, which could, in theory, reduce the chance of developing a vaginal yeast infection.24 For this reason, women who frequently experience yeast infections, or who are taking antibiotics, are often advised to consume probiotics. However, evidence that probiotics really help prevent vaginal yeast infections remains incomplete and inconsistent.25-26
A fairly large study (278 participants) failed to find
Lactobacillus helpful for preventing yeast infections caused by antibiotics.26
Another kind of vaginal infection, called bacterial vaginosis, is most often caused
by Gardnerella vaginalis. In a study120 women with a history of bacterial vaginosis, researchers found that vaginally inserting a daily capsule containing the probiotics Lactobacillus rhamnosus, acidophilus, and
Streptococcus thermophilus did reduce recurrence.33 While this study found benefit, other studies have produced mixed results regarding the benefits of probiotics in the treatment and prevention of bacterial vaginosis.29-32
Tea tree oil, an essential oil from the plant
, possesses antibacterial and antifungal properties
and appears to spare friendly bacteria in the
Tea tree oil has been tried for various forms of vaginal infection, but again there is little scientific evidence as yet that it works. In an
trial, 96 women with
trichomonal vaginitis were treated with tampons saturated in tea tree oil, which were left in the vagina for 24 hours, and then followed by daily vaginal douches with a tea tree oil solution.9
The researcher reported good results with this regimen in 3 to 4 weeks. However, because this was not a double-blind trial, the results mean little. (For information on why double-blind studies are so important, see
Why Does This Database Rely on Double-blind Studies?)
A double-blind study of 100 women found vitamin C vaginal tablets (250 mg) at most marginally helpful for nonspecific vaginitis.28
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 somewhat outdated antifungal drug nystatin.11 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 be applied to the skin of infants.13
trial, involving 100 women with
vaginitis, compared nystatin suppositories against suppositories made from the plant
Solanum nigrescens and found equivalent benefits.14
However, this plant can be toxic and should not be used except under physician supervision.
Test tube studies have found antifungal properties in numerous herbs, including the tropical tree
Tabebuia avellanedae,16garlic extracts,17-19
the plant alkaloid berberine sulfate (found in
of various plants, including
cinnamon, eucalyptus, lemongrass, oregano, palmarosa, and
However, it is a long way from
studies to proof of safety and effectiveness in people.
ElmerGW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections.
McGroarty JA. Probiotic use of lactobacilli in the human female urogenital tract.
FEMS Immunol Med Microbiol.
Hilton E, Isenberg HD, Alperstein P, et al. Ingestion of yogurt containing
as prophylaxis for candidal vaginitis.
Ann Intern Med.
Friedlander A, Druker MM, Schachter A.
and vitamin B complex in the treatment of vaginal infection.
Hilton E, Rindos P, Isenberg HD.
GG vaginal supositories and vaginitis [letter].
J Clin Microbiol.
Reid G, Bruce AW, McGroarty JA, et al. Is there a role for lactobacilli in prevention of urogenital and intestinal infections.
Clin Microbiol Rev.
Williams LR, Home VN, Zhang X, et al. The composition and bactericidal activity of oil of
(tea tree oil).
Int J Aromather.
Hammer KA, Carson CF, Riley TV. In vitro susceptibilities of lactobacilli and organisms associated with bacterial vaginosis to
(tea tree) oil [letter].
Antimicrob Agents Chemother.
oil. Its use for trichomonal vaginitis and other vaginal infections.
Lippert U, Walter A, Hausen B, et al. Increasing incidence of contact dermatitis to tea tree oil [abstract].
J Allergy Clin Immunol.
2000;105(1 pt 2):A127.
van Slyke KK, Michel VP, Rein MF. Treatment of vulvovaginal candidiasis with boric acid powder.
Am J Obstet Gynecol.
Jovanovic R, Congema E, Nguyen HT. Antifungal agents vs. boric acid for treating chronic mycotic vulvovaginitis.
J Reprod Med.
Penna RP, Corrigan LL, Welsh J, et al.
Handbook of Nonprescription Drugs.
6th ed. Washington, DC: American Pharmaceutical Association; 1979:424.
Giron LM, Aguilar GA, Caceres A, et al. Anticandidal activity of plants used for the treatment of vaginitis in Guatemala and clinical trial of a
Zawadzki J, Suchy H, Scheller S. Use of propolis for treatment of vaginitis and cervicitis [in Polish; English abstract].
Guiraud P, Steiman R, Campos-Takaki GM, et al. Comparison of antibacterial and antifungal activities of lapachol and beta-lapachone.
Sandhu, D.K. Warraich, MK Singh S. Sensitivity of yeast isolated from cases of vaginitis to aqueous extracts of garlic.
Ghannoum MA. Studies on the anticandidal mode of action of
J Gen Microbiol.
Hughes BG, Lawson LD. Antimicrobial effects of
L. (elephant garlic), and
L. (onion), garlic compounds and commercial garlic supplement products.
Kaneda Y, Torii M, Tanaka T, et al. In vitro effects of berberine sulphate on the growth and structure of
Ann Trop Med Parasitol.
Pattnaik S, Subramanyam VR, Bapaji M, et al. Antibacterial and antifungal activity of aromatic constituents of essential oils.
Quale JM, Landman D, Zaman MM, et al. In vitro activity of
against azole resistant and sensitive Candida speces and a pilot study of cinnamon for oral candidiasis.
Am J Chin Med.
Singh HB, Srivastava M, Singh AB, et al. Cinnamon bark oil, a potent fungitoxicant against fungi causing respiratory tract mycoses.
Reid G, Charbonneau D, Erb J, et al. Oral use of
GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women.
FEMS Immunol Med Microbiol.
Jeavons HS. Prevention and treatment of vulvovaginal candidiasis using exogenous
J Obstet Gynecol Neonatal Nurs.
Pirotta M, Gunn J, Chondros P, et al. Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomised controlled trial.
Petersen EE, Magnani P. Efficacy and safety of vitamin C vaginal tablets in the treatment of non-specific vaginitis; a randomised, double blind, placebo-controlled study.
Eur J Obstet Gynecol Reprod Biol.
Falagas ME, Betsi GI, Athanasiou S. Probiotics for the treatment of women with
Clin Microbiol Infect.
Larsson PG, Stray-Pedersen B, Ryttig KR, et al. Human lactobacilli as supplementation of clindamycin to patients with bacterial vaginosis reduce the recurrence rate; a 6-month, double-blind, randomized, placebo-controlled study.
BMC Womens Health.
2008 Jan 15.
Barrons R, Tassone D. Use of
probiotics for bacterial genitourinary infections in women: A review.
Petricevic L, Witt A. The role of L
actobacillus casei rhamnosus
Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis.
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.
Last reviewed September 2014 by
EBSCO CAM Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.