Alternative Treatments for yeast infections

By Sara Twogood, MD

Desperate times call for desperate measures so we’re here to talk about non-traditional treatments for yeast infections. Yes, you could just go to the drugstore and buy OTC miconazole and use that … so things can’t be that desperate. And I’ve reviewed the traditional yeast infection treatments in this post for some profesh tips.

But I know people want to know about alternative treatments. What about the garlic clove in the vagina? The tea tree oil spritz? The apple cider vinegar douche? I’ve heard a lot in my clinical career.

Here’s the run down and what’s probably legit, what’s probably not, and what to run the other way from!

PROBIOTICS

Probiotics – taking them orally, won’t recolonize the vagina. BUT, some evidence that recurrent yeast infections come from colonization of GI tract with yeast, so helping promote healthier GI tract may prevent vulvar vaginal yeast infections too. 

I probably don’t need to tell you what probiotics are. But just in case: 

They are living microorganism that help the health of the host (pro – meaning in favor of, and biotics – refers to the organism, and host – is you!). A more useful way to think about them: a supplement that helps with gastrointestinal (and therefore other health) issues by adding “good” bacteria. 

I’m a fan and take them myself. Our knowledge about the microbiome and the way we can support it is becoming increasingly important to our overall health. Even though studies are not definitive in terms of the benefits of probiotics for vulvar and vaginal health, there is ongoing research that is promising. And there doesn’t seem to be a downside, besides cost. 

What do we know about probiotics and yeast infections in particular? 

One expert opinion is that yeast is spread from the GI tract to the vagina. Remember, all the holes in female anatomy are very close to one another. Probiotics may be able to block this transition of yeast to the vagina. 

Probiotics may be able to inhibit overgrowth of yeast and decrease inflammatory markers associated with yeast. 

In another study, the total amount vaginal discharge was less in females who took probiotics compared to placebo

Remember that these probiotics are all taken by mouth. What about using them vaginally? 

There’s not a lot of info, it’s difficult to get from compounding pharmacies since they need to be validated and aren’t routinely used, so for now, best to stick with the oral ones only. 

Bottom line: limited evidence but enough for me to recommend!

BORIC ACID

Boric acid seems to be everywhere these days, which also is a big clue that it’s not regulated or FDA approved for anything. 

It is a weak acid suppository, placed inside the vagina (NEVER TAKE IT BY MOUTH. You could literally die). It has antibacterial, antifungal, and antiviral activity – that all sounds great, right? The problem is that it doesn’t target any one particular bacteria or fungus or virus. It targets them all. So it can help get rid of some bad bacteria / fungus / virus but it may get rid of some of the good too. This is why it should be used prudently. 

In terms of yeast infections in particular, there is hope! Used properly, it can decrease growth of Candida and help with the itching and inflammation of the vulva and vagina.

What is this “proper” way? 600mg vaginal suppository once a day for 14 days. 

Pro tip: Consider getting it from a compounding pharmacy. While boric acid can be bought basically wherever feminine hygiene products are sold, a compounding pharmacy typically follows more tight guidelines and quality checks. It may be more expensive, but your vagina is worth it. 

BAKING SODA / VINEGAR “BATHS”

Let’s be clear – I do NOT recommend douches of any kind. Douches are products that are put inside the vagina with promises of feeling fresh or clean. Never do this. The inside of the vagina can maintain its own pH balance and microbiome and trying to “clean” it with soaps or products tends to cause more harm than good (and your vagina does not need cleaning!) . 

I DO recommend sitz baths – soaking the external (vulvar / perineal / anal) skin with lukewarm water to help decrease all types of inflammation.

When it comes to treating symptoms of a yeast infection, both baking soda and vinegar “baths” have been studied. Baking soda (sodium bicarbonate, or simply “bicarb”) baths can help pretty quickly with vulvar irritation – adding a small of bicarb to the sitz baths is the way to go. 

A tablespoon of baking soda in half a liter of water was the formulation that showed relief. 

Diluted vinegar gently sprayed over the external skin may help too. But I don’t recommend this. The data is more controversial, and like essential oils (below), it can be irritating to the skin. Chemical burns to the skin have been reported. Yikes! 

ESSENTIAL OILS (specifically tea tree oil)

Essential oils are pure oils extracted from plants. They contain “the essence” of the plant – its scent and flavor. 

Essential oils are traditionally used for their scent.

Try lavender for its calming properties, grapefruit for its energizing properties, clove for its grounding properties.

Our olfactory sense – our sense of smell – is a powerful tool that can help with mood, memories, and wellbeing.

I highly recommend experimenting with smells and scents to see how they can help with your overall wellbeing. 

But when people talk about essential oils for vulvovaginal health, they are using the oil for its topical properties – what it does when applied to the skin itself.

Even though many oils have antifungal and antibacterial qualities, the oil itself is too concentrated to apply directly to the skin. I’m talking to you, tea tree oil. It can cause irritation and inflammation. There is not a good sense of how dilute a product should be to NOT cause irritation and it’s likely dependent on skin sensitivity. And skin is already sensitive and inflamed with an active yeast infection! If you must experiment, it’s usually suggested to dilatue 1 drop of oil in 1 milliliter of water. That still seems very concentrated to me and I urge you to use the alternatives instead. I recommend avoiding using essential oils for topical treatments until we know more.  

GARLIC

From one extreme scent to another. 

Garlic in the vagina is more popular on TV shows than in real life. But does it actually work? 

Garlic does have many therapeutic properties, likely because of its high alicin content, which has the antiviral, antifungal, antibacterial effects we look for. Allicin gives garlic its distinct odor and in nature helps the plant protect itself against bugs, viruses, and bacteria. Garlic also has high levels of the antioxidant selenium. 

But in terms of use for vulvovaginal health – don’t use it. Even though there is theoretical promise, the right formulation, dose, and mode of delivery isn’t known. And the body odor, topical reactions, and other side effects are just too likely to make it worth a try.

Let me know what you’ve tried or heard – I truly love hearing these stories.