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Vaginal health: Women have more options than ever

For many years, a patient had to see a doctor and get a prescription whenever she experienced a shift in her vaginal pH that caused symptoms. Today, numerous alternatives have emerged claiming to help maintain vaginal health.


So what really causes bacterial vaginosis, or yeast infections? Typically the vaginal pH is less than neutral, meaning it is acidic. This normal environment is maintained by the vaginal microbiome, a combination of many bacteria, dominated by lactobacillus acidophilus, and a small number of yeast. A shift in the pH that causes it to be more acidic, like when lactobacilli are killed by antibiotics, will result in an overgrowth of yeast, or a yeast infection. If the vaginal pH becomes more alkaline, that may result in bacterial vaginosis. The composition of bacteria in everyone’s vagina is slightly different, and this may cause bacterial vaginosis to be more symptomatic in some.


For years, alternatives to traditional antibiotics and antifungals to treat these conditions were sought. Compounding pharmacies made boric acid suppositories to adjust the pH closer to its normal, or sometimes even capsules of lactobacilli used as suppositories to restore their population in the vagina. These were not always widely available, as they were alternatives to traditional therapies.

Recently, numerous alternatives have cropped up. For instance, RepHresh is a gel product available over the counter that can be used to immediately adjust pH. Boric acid suppositories are also now widely available. Don’t let the acid in the name fool you. The vagina is slightly acidic, and these mildly acidic compounds are useful for adjusting the pH to alleviate irritation or discharge.

Most interesting is the emergence of oral supplements for vaginal health. Vaginal probiotics are taken by mouth and have been shown in some studies to result in repopulation of the lactobacilli in the vagina.

Many physicians and patients were skeptical at first. The mechanism for oral intake of bacteria to survive the gut was not well understood. Theoretically, the organisms migrate from the colon into the vagina, as do some other bacteria that can cause infections. This is an encouraging advancement, as many people do not find vaginal treatments comfortable or convenient.

Talk to your doctor now or when you have symptoms about the availability of these supplements and which ones may be most effective in your situation. Recurrent bacterial vaginosis, or persistent yeast infections, may respond to these supplements instead of requiring repeated rounds of antibiotics.

Written by Dr. Alisha Ware

Dr. Alisha Ware is an obstetrics and gynecology specialist with The Woman’s Clinic PA. Reach her at (228) 864-2752.

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