Dear Dr Mitchell,
Is it OK to soak in apple cider vinegar occasionally to prevent conditions like yeast and bacterial vaginosis? I find that when I do this once a month I am less likely to be affected. I just sit in a bath with about two tablespoons of ACV. Also, I have heard that I can do garlic vaginal inserts to treat yeast infections. Is this a good idea?
Douching is usually not advised since it tends to destroy the normal bacteria in the vagina called lactobacillus, and allows for overgrowth of abnormal bacteria. Attention to general personal hygiene and washing of the vulval and vaginal areas with an unscented white soap is always a simple and safe option to reduce bacterial infection.
A fungal infection (candidiasis) or bacterial infection (bacterial vaginosis) needs specific treatment. The treatment for each is also different, and so it is important for you to be examined by a doctor to determine the exact underlying cause of the vaginal discharge or other symptoms that you experience before using any medications.
In addition, there may be other significant infections such as chlamydia which could be missed if you self-treat, and this can have serious consequences with subsequent infertility and chronic pelvic pain if there is a delay in diagnosis and treatment. To reduce recurrent yeast infections you should dry your underwear in the sun, since dark areas in the bathroom tend to facilitate the overgrowth of yeast infections. Recurrent bacterial vaginosis can be reduced by avoiding douching, the use of scented soaps, scented panty shields and sanitary pads, and tampon usage.
The use of condoms can sometimes trigger bacterial vaginosis, especially if flavoured. However, the added benefit of preventing major sexually transmitted infections far surpasses any slight risk of bacterial vaginosis. Having multiple sexual partners also increases the risk of bacterial vaginosis.
There have been anecdotal reports of success with the use of garlic inserted in the vagina for treating yeast infections, but it is always safer to consult your doctor to ensure that the correct diagnosis is made. You may get symptomatic relief of the itching from garlic insertions, but antifungal medication should be prescribed to ensure that the infection is fully cured.
Your partner should also be treated in order to reduce recurrent infection. A blood test to check your blood glucose level and screening for HIV should be done, especially if the condition is recurrent. Diabetes mellitus and an immunocompromised state as seen in HIV-positive patients can be associated with recurrent vaginal infections.
Consult your doctor who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to firstname.lastname@example.org; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.