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Treatment
Oral antifungal medications such as fluconazole or topical antifungal preparations such as miconazole and clotrimazole, inserted into the vagina as a cream or suppository, typically are prescribed to treat yeast infections. Boric acid, a chemical with mild antiseptic, antifungal, and antiviral properties, is another option. In one study of 92 women with chronic yeast vaginitis that had failed to respond to treatment with over-the-counter or prescription antifungal medicines, 98% of the women successfully treated their infections with 600 mg boric acid capsules inserted into the vagina twice per day for two-to-four weeks.1 Other studies have shown cure rates of 92% to 100%.2 One woman who tested HIV positive found no relief from symptoms of candida vaginitis after nine months of using fluconazole, at 100 mg daily. Subsequent use of 600 mg of boric acid as vaginal suppositories and 5% lanolin ointment alleviated symptoms within 24 hours. Use was continued for 10 days and followed up with a two-to-three-day course of boric acid treatment during three relapses in the following five months. Long-term use of topical boric acid is considered less toxic, less expensive, and more readily available and just as effective as oral prescription antifungal agents. A study that followed 22 women who used either oral itraconazole or topical boric acid for one year found no statistically significant differences between the two groups in terms of positive culture results (15.1% vs. 12.1%, respectively), signs and symptoms (33.3% vs. 24.2%, respectively), or number of relapses.3 Boric acid is available from pharmacies in powder form and can be packed into empty gelatin capsules for use as suppositories.
Cautions
Boric acid suppositories should not be used during pregnancy and is very toxic if taken orally. It should be kept out of children’s reach. No serious side effects have been reported from the use of boric acid as a treatment for vaginitis.
1Jovanovic R, Congema E, Nguyen, HT. Antifungal agents vs. boric acid for treating chronic mycotic vulvovaginitis. J Reprod Med 1991;36(8):593-7.
2Shinohara YT, Tasker SA, Successful use of boric acid to control azole-refractory candida vaginitis in a woman with AIDS. J AcquirImmune Defic Syndr Hum Retrovirol 1997;16(3):219-20.
3Guasohino S, De Seta F, et al. Efficacy of maintenance therapy with topical boric acid in comparison with oral itraconazole in the treatment of recurrent vulvovaginal candidiasis. Am J Obstet Gynecol 2001;184(4): 598.
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