Vaginal Yeast Infections (Candidiasis)
Boric acid is a solid therapy for recurring vaginal yeast infections when combined with a prescription antifungal, says Dr. Lessman. “The suppositories are effective treatment for infections with atypical yeast species, such as Candida glabrata or Candida tropicalis,” she explains.
Women who used boric acid as maintenance therapy for recurrent infections reported high satisfaction and few adverse events, according to a 2019 analysis.
One of the reasons why boric acid isn’t typically first line is because most yeast infections are caused by Candida albicans. “Since you don’t know what type is causing your problem, visiting your doctor for ongoing or reoccurring infections is best,” recommends Lessman.
To treat a recurrent yeast infection, place one boric acid capsule in your vagina nightly before bed for two weeks, or as recommended by your healthcare provider. While the capsules are not harmful to the vagina as a yeast infection treatment, they should never be taken orally.
There isn’t as much data to support boric acid in treating bacterial vaginosis, says Lessman. One randomized trial of two formulations of a boric-acid based therapy demonstrated a 50 to 59 percent improvement in women who’d had bacterial vaginosis for less than two weeks. But most studies look at using boric acid along with another therapy, such as an antibiotic.
For some women with recurrent bacterial vaginosis, boric acid may be recommended, particularly when taken along with an antibiotic, says Lessman.
According to research published in the journal Sexually Transmitted Diseases boric acid — used along with 500 milligrams of nitroimidazole, an antibiotic used to treat infections — improved symptoms in 92 out of 93 patients included in the study.
Dos and Don’ts of Boric Acid Suppositories
Never take boric acid suppositories by mouth — the medicine is intended only for the vagina.
People who are pregnant or trying to get pregnant should not use boric acid suppositories — even a tiny amount absorbed vaginally could harm a developing embryo, warns Lessman.
You should also talk with your doctor before you use boric acid if you have any of the following:
- Diabetes
- Frequent infections
- HIV or AIDS
- Immune system problems
- An unusual or allergic reaction to boric acid, other medicines, foods, dyes, or preservatives
If you’re breastfeeding, check in with your provider before using boric acid suppositories.
Boric acid can have other side effects, says Lessman. “In some women, boric acid can cause dramatic irritation, and sexual partners may report skin irritation,” she says.
Are Boric Acid Washes and Suppositories Effective for Vaginal Odor and Itching?
Boric acid should not be the first thing you reach for when you’re experiencing itchiness or vaginal odor, says Lessman. Unlike prescription treatments for vaginal infections, boric acid isn’t well regulated or thoroughly studied, she explains.
“Clinical studies were performed with boric acid suppositories made by compounding pharmacies. The commercially available formulations should be the same, but they haven’t proven that they deliver on their claims. And this is worse for the rinses or washes, whose drug delivery and efficacy is a mystery,” Lessman adds
Boric Acid Rinses or Other Cleansing Products May Actually Increase the Risk for Infection
“The bacterial flora of the vagina is a delicate balance that naturally protects the vagina,” says Jen Villavicencio, MD, the lead for equity transformation at the American College of Obstetricians and Gynecologists (ACOG). “Cleansing the vagina by any means threatens that balance and potentially increases the risk of vaginal infections, vaginitis, and vaginal injury. If you are struggling with a vaginal issue, consult a healthcare provider with experience in vaginal healthcare.”
What’s more, most of the products that are promoted as a way to “balance out yeast,” and “eliminate odor” are not regulated by the U.S. Food and Drug Administration. Dr. Villavicencio adds that the broad availability of other products that claim to balance vaginal pH and provide all-day freshness are also unnecessary, since the vagina is primarily self-cleansing.
What to Do About Vaginal Itching or Stronger-Than-Normal Vagina Odor
All vaginas will create discharge and have a slight odor that can change throughout the month. Everyone’s vagina has its own unique scent, which is normal and natural.
An unusual vaginal odor could be the sign of a bacterial infection, bladder infection, or STD, according to the Centers for Disease Control and Prevention. More rarely, it could be a sign of vaginal or cervical cancer.
“If someone is experiencing unusual vaginal symptoms, such as itching, increased discharge, or a new odor, seek the counsel of a healthcare professional that can appropriately diagnose the issue and recommend proper treatment. For routine vulvar [vaginal] hygiene, we recommend only the use of water or unscented soaps, and only for external use,” she says.
Diagnosis and treatment is key. Untreated, some vaginal infections with symptoms of odor or itching can lead to serious problems, including pelvic inflammatory disease (PID) or infertility.