Vaginitis: Natural Prevention and Treatment
Just about every woman is susceptible to vaginitis, or vaginal infection, at some point in her life. But not every vaginal symptom is related to an infection. Sometimes it is simply a sign of normal changes in a woman’s cycle or pregnancy. Other times it is related to temporary inflammation, local irritation or other causes. There is much to learn about your vagina and keeping it healthy and feeling well.
Discharge changes in response to the changing hormonal environment throughout the menstrual cycle. For example, women notice an increased amount of clear to cloudy, odorless, slimy egg-white discharge around the time of ovulation to help the sperm reach and fertilize the egg. The hormones of pregnancy also cause an increase in normal vaginal discharge, as well as an alteration in the acid/base balance of the vagina. This can lead to an imbalance of normally occurring microorganisms, and thus increase one’s susceptibility to vaginal infections (especially yeast).
The normal reduction of hormones during breastfeeding, and more dramatically after menopause, cause the vaginal walls to become thinner and dryer. This makes the area more prone to becoming sore (especially during sexual intercourse), irritated, and prone to yeast infections. Allow time for the normal increase in vaginal secretions during sexual arousal before penetration, and use all-natural water soluble lubricants or Astro-glide. Menopausal women may want to consider the option of bio-identical all-natural hormonal vaginal cream.
Possible Culprits for Vaginitis
The vaginal area is sensitive and can easily become irritated (look red, burn, and/or itch) for a variety of reasons. Most commonly, this is from substances within a new product that you or your sexual partner are using, such as:
Detergent, fabric softener or bleach
Chemically scented body soap or bath oil, powder or lotion
Douches, deodorant vaginal sprays and perfumes
Tight clothing
Synthetic underwear or pantyhose
Colored or perfumed toilet paper
Conventional pads and tampons
Vigorous and frequent sexual intercourse (more than 3 times in 24 hours)
Foreign objects in the vagina such as contraceptive devices, spermicidal cream, foam, jelly and medication applied locally, dildos and vibrators
Bubble baths, hot tubs, and prolonged or frequent immersion in a swimming pool
Hanging out in a wet bathing suit
Horseback riding or cycling
Eliminate these irritants one by one to see if your symptoms improve. Buy a mild natural detergent without bleach (such as those made for infant clothes), or use an extra rinse in your laundry cycle. Use corn starch rather than talc-based powder to keep dry. Buy white unscented toilet paper, and avoid perfumed toiletries and feminine hygiene products. Try using a menstrual cup or go organic and green with your pads and tampons.
Bacterial overgrowth is another common cause of vaginal infections that is often associated with frequent sexual intercourse and other factors that upset the normal balance of the vaginal flora (such as routine douching and medications like antibiotics, steroids, hormones) and results in an overgrowth of organisms like gardnerella. It occurs in all women, even those in a mutually monogamous relationship, as it is not believed to be sexually transmitted.
Bacterial vaginosis should be treated with prescription medication in pregnancy as it has been implicated in premature rupture of membranes, preterm labor and uterine infection postpartum. It carries risks for all women, namely increased susceptibility to other more serious sexually transmitted and genital tract infections, as well as reproductive disorders from ectopic pregnancy and fertility issues, to pelvic inflammatory disease. Men generally do not have symptoms, same sex partners can absolutely have symptoms, but all partners should be treated simultaneously so they do not reinfect their spouse. A vaginal antibiotic is a short term band-aid that may or may not work and recurrence is common, so it is important to follow the prevention and natural treatment suggestions below for a more effective long term solution.
A vaginal infection caused by trichomonas protozoa is most often sexually transmitted when there is more than one sexual partner. However, less commonly it can be caused by anal-vaginal contact, sitting on a dirty wet toilet seat or being splashed with dirty toilet water, use of communal baths or hot tubs, and sharing moist contaminated clothing, washcloths or towels.
This type of infection also needs treatment in pregnancy as it has been associated with complications similar to bacterial vaginitis. Your sexual partner should be treated simultaneously to avoid recurrences in you, even though he may be without symptoms. If you have a trichomonas infection, you should be screened for other more serious sexually transmitted infections, and protect yourself by having a mutually monogamous sexual relationship, abstinence from intercourse or at least by using latex condoms (with spermicide containing nonoxynol-9 if you want to prevent pregnancy as well).
Vaginitis Prevention
Unless you have an actual vaginal infection or are prone to one, you should avoid routine douching (especially in pregnancy), as it washes out the natural secretions and organisms that normally reside in the vagina. Further, it alters the delicate acid-base balance there that actually protects you from infection. The only exception is if you are NOT pregnant and treating an actual confirmed infection, or are prone to recurrent vaginal infections and nothing else is working.
If you are pregnant, you can certainly acidify your system by drinking unsweetened cranberry juice diluted in other fruit juices to reduce the sour taste, or add a scoop of cranberry juice powder to your smoothies, oatmeal or yogurt. You can also take powdered cranberry juice concentrate in capsule form, like Cranactin (1 capsule twice daily). Combine 1 Tbsp of apple cider vinegar, juice of ½ fresh lemon and honey to taste in a cup of hot water and drink several cups daily.
Calendula cream or diluted tincture, or aloe vera gel, applied morning and night helps strengthen vaginal tissues, heal minor abrasions, relieve pain and discourage infection. You can spread some of the gel onto a menstrual pad and wear it throughout the day.
Change tampons and pads at each bathroom visit, and do not leave in for more than 8 hours at a time. Avoid tampons during scant menstrual flow and a vaginal infection. Or switch to menstrual cups.
Wear cotton crotch stockings, loose clothing, and organic cotton underwear changed daily. Even better, skip the underwear altogether and go panty- free, especially during sleep, to allow for air circulation and to keep the area dry and hostile to infectious organisms. As soon as practical, change out of wet bathing suits and sweaty clothing.
You and your partner each need to wash the genital area daily with a mild soap, rinse and dry well. Always wipe yourself from the front (vagina) towards the back (anus) to avoid contamination from the bowel. Avoid painful or abrasive sex, and sexual practices that involve the anal/rectal area.
Don’t share unwashed bathtubs, towels, washcloths, contraceptives or douching equipment. Avoid reinfection by not reusing washcloths, towels and underwear that have not been laundered. And don’t sit on public toilets - either squat or put paper on the seat before sitting.
Maintain health and general resistance to infection by eating a nourishing and wholesome diet that includes:
Lots of fresh organic fruits and vegetables
Whole grains
Beans and tofu
Nuts, nut butters and seeds
Organic whole eggs
Turkey or chicken
Beef, lamb, wild game
Fresh raw organic whole dairy—ideally goat or sheep (avoid dairy if you get recurrent yeast infections)
Fish tested free of pollutants or from non-polluted waters like wild Alaskan salmon
At least 64 ounces daily between meals of filtered, spring or well water (at least 20-30 minutes before or 2 hours after eating)
Organic cold expeller pressed extra virgin olive and coconut oil or goat butter for cooking
Minimize highly processed foods laden with refined white flour, sugars, refined vegetable oils and partially hydrogenated fats, as well as products with food dyes, chemicals and preservatives. If you are prone to recurrent vaginal infections, you many find the best results by completely avoiding sugar, simple refined carbohydrates, fruit juices, dairy and alcohol.
Eat more fresh garlic (a few cloves daily sautéed, baked or crushed into salads or added to cooked vegetables) and Asian mushrooms (like shiitake and maitake) to boost your immune system. Take a good all-natural food-based multivitamin, mineral and probiotic supplement to ensure you are getting full nourishment beyond what is supplied by diet alone. Limit exposure to harmful chemicals and toxins (this also includes those found in drugs, cigarettes, food, water, cosmetics, toiletries, and household products).
Be sure to get enough sleep, and exercise 30 minutes 5 days per week. Good options are brisk walking, dancing, cycling, swimming or low impact aerobics.
The mind, body and heart are intricately connected and when out of balance, dis-ease can result - physical or emotional. You can create more joy by doing more of what you love, and create more inner calm and peace of mind with several daily “healing intervals” or breaks during the day to calm and center yourself, which will enhance your health tremendously. Use such techniques as meditation, breathwork and/or prayer. Do regular yoga (especially Yin, prenatal, gentle and restorative), practice progressive muscle relaxation techniques (yoga nidra), QiGong, Tai Chi, or take a walk outside in nature. Read these recent blog posts on natural remedies for stress and ways to manage your emotions. Make a conscious effort to improve your emotional state and reaction to stress, surrounding yourself as much as possible with people, things, sounds and places that inspire, relax and restore you, while limiting exposure to things and people that agitate your mind and create negativity. For more information about this and other great ways to improve your physical and emotional well-being, read Natural Health, Natural Medicine by Dr. Andrew Weil, Practicing the Power Of Now by Eckhart Tolle, Loving What Is by Byron Katie, and Prescriptions for Living by Dr. Bernie Siegel.
Natural Treatment for Vaginitis
If you develop an unusual change in the amount, color, consistency or odor in your vaginal discharge with itching, burning and/or soreness, you may have a vaginal infection. The following natural remedies are quite effective against vaginal infections and are often safer (especially in pregnancy). They can certainly be used in the early stages of your symptoms without having to know the responsible organism. Many of the treatments mentioned below can be adapted to your sexual partner.
It is best to avoid intercourse and oral sex until the vaginal infection has cleared up, as the area is uncomfortable, irritated and needs time to heal. And it is possible to pass the infection to your partner unless you are using condoms.
Wash the genitals after urinating and after sex as the associated fluids can aggravate the situation (squirt yourself from to back with a peri-bottle filled with warm water and any of the herbs or herbal combination mentioned below). Wash undergarments in hot water, disinfect tubs, and soak your diaphragm, douche equipment and sex toys in vinegar.
If you are not pregnant, while reclining in the empty bathtub, use a vinegar douche once daily until the symptoms improve for 7-10 days. You can make your own by mixing ¼ part apple cider vinegar with 3/4 part warm water in a reusable douche bag. A douche of cranberry juice concentrate (one tablespoon to one quart of water) is also very effective to acidify the vaginal environment and discourage growth of infectious organisms, as is a solution of pure all-natural grapefruit seed extract as directed. If the acidic applications are too irritating, try douching with 2 Tbsp baking soda to 1 cup water instead. A douche of 1 ½ Tbsp Tea Tree oil to 1 cup warm water 2–3 times per day is a very effective anti-fungal, as are the Tea Tree oil vaginal suppositories.
If you are prone to recurrent yeast infections, especially after sex, antibiotics or a known trigger, you can use a lower dose vinegar douche once to ensure the vagina is mildly acidic and hostile to unwanted bacteria. To make the douche, combine 2 Tbsp of apple cider vinegar, white vinegar, or pure lemon juice with a pint of warm water. Again, routine douching for general hygiene is not recommended, as it is actually harmful and increases risk of genital tract infection.
If you are pregnant or simply prefer not to douche, you can acidify the vagina with vaginally inserted ActiGel, Vitanica vaginal suppository, or you can put a few cups pure apple cider vinegar in your bath water or ½ cup vinegar in a warm sitz bath. Either way soak for 15-20 minutes several times a day. Another effective option for is to apply 600 mg of encapsulated pharmacy grade Boric Acid suppositories inserted high in the vagina for 1 to 2 weeks (although ideally not during pregnancy).
Add Aveeno powder (oatmeal), or a few drops of the essential oils of Calendula, Chamomile or Lavender to the bath water and sitz bath to help soothe symptoms of itching and irritation, and to the peri-bottle of water for use after the bathroom. You can also add tea tree, sandalwood and/or thyme oil to help fight the infection.
Restore your gut and vaginal flora. Take a multi organism high colony count probiotic for women orally as directed, that includes the strains Lactobacillus reuteri and Lactobacillus rhamnosus. A reputable brand is Green’s First Probiotic for Women. You can also place 1-2 capsules high in the vagina in the morning and before going to sleep for 2 weeks. If you are not pregnant, a few live culture tablets can be dissolved in one quart of water to be used as a douche once daily for a week, then every other day for a week, then twice weekly for a few more weeks (you can alternate this with your vinegar douche).
Apply plain live-culture yogurt to the affected areas and vagina as needed to help relieve itching, inflammation and restore the normal bacterial environment in the vagina. Put a few Tbsp of yogurt on your finger and smear it inside the walls of your vagina and around your cervix, or use a vaginal applicator to insert the yogurt. Repeat twice daily during an infection and a few times weekly if you are prone to recurrences. You can also dilute 16 ounces of yogurt in the water for a sitz bath. (Yuck! But it works!).
Garlic suppositories are also effective. To use, insert a peeled clove lubricated with olive oil high up into your vagina before bed for a few weeks before bed, and in the morning. You can wrap it in a thin layer of gauze with a tail for retrieval, but it is not necessary as it will eventually come out itself in your discharge. Don’t worry - it can’t get lost or travel further up then your vagina, which is a dead end.
Wet compresses of Burrows solution can be soothing to irritated skin - apply externally only. Comfrey Root powder, Slippery Elm powder and Marshmallow Root powder, will also soothe dry itchy vaginal tissue, relieve irritated and inflamed tissue and promote healthy skin growth. Goldenseal Root powder is effective for treating the actual infection and enhancing your immune response. You can apply each powder or an equal part mixture directly to the vulva and vagina daily for 1-2 weeks. You can make your own healing compress by mixing 1 Tbsp of any of the herbal powders with 1 cup warm water. Dip gauze pads in to make the compresses and apply. You can also soak a menstrual pad and wear it throughout the day.
Apply healing and soothing salves that contain Chickweed, Calendula and/or Plantain, to relieve itching, reduce inflammation and discourage infection. Also, use topical vitamin E oil to aid healing on itching and sore inflamed skin.
Some find it helpful to apply fresh bee honey for its anti-fungal properties, and to moisturize and heal tender tissue (sticky!).
You can drink Burdock root, Chickweed and Dandelion root teas, but an herbal combination infusion or tincture is more effective to reduce inflammation and infection. You can make your own by steeping a handful of each Dandelion root, Chickweed and Burdock root into a quart of boiling water, brew covered for a few hours, strain in a glass mason jar and drink 1-2 cups daily. You can add fresh lemon or lime juice, mint leaves or a dash of honey to taste. If you prefer the tincture, take 1-2 dropperfuls each of Burdock root, Chickweed, and Dandelion root tinctures 1-3 times per day.
For any infection, you can always use Gaia’s Echinacea Supreme tincture to kill unwanted germs as well as stimulate your own immune system. Take 1-2 dropperfuls every few hours at the earliest sign of infection. Make sure your diet and multivitamin is sufficient in Vitamins C, E, B complex, A with mixed carotenoids, selenium and omega threes.
If you are not pregnant, you can take additional immune boosting supplements:
Vitamin C, 1000 mg 3-4 times per day
Zinc, 25-50 mg every day
Vitamin E, 400-800 IU each day
Vitamin B complex 50 mg three times daily until the infection has cleared.
If you are prone to frequent infection, you may want to consider daily supplements in addition to a multivitamin to enhance immunity. Good options are New Chapter’s Garlicforce, Oil of Oregano, Olive Leaf, Goldenseal, and Host Defense combination of Asian mushrooms 1-2 capsules each daily, as well as oral all natural Grapefruit Seed extract as directed. If you are pregnant, these remedies and doses are a safer option to combat infection and boost immunity.
For those who have recurrent vaginal infections not helped by these suggestions, at first onset of symptoms and around the time you usually get the symptoms (for example after sex, antibiotics, your period, swimming, certain stresses), apply vaginally as directed RePhresh vaginal gel (up to every three days), or a vaginal Prebiotic.
Natural Treatment Specific For Yeast and Bacterial Vaginosis Infection
Yeast and bacterial vaginosis infections both occur more frequently under the following circumstances:
During pregnancy
After menopause
With increased stress
Use of certain medications (such as antibiotics, steroids, and hormones)
A diet high in simple sugar, refined carbohydrates and/or alcohol
Frequent or regular douching
Wearing synthetic tight underwear, thongs, pantyhose, and using conventional menstrual and products laden with toxic chemicals and synthetic fragrances.
Anemia, obesity, diabetes, and other medical conditions that increase blood sugar and/or alter the normal environment in the gut and vagina, or suppress the immune system.
Limit excess intake of sugars (including fruits and fruit juices), refined carbohydrates (white breads, cakes, and other such products, especially those that contain yeast and gluten), and fermented foods (like synthetic yeast and pickles) until the problem has cleared up. One of my Integrative OB/GYN role models, Dr. Christiane Northrup advises actually increasing certain fermented foods rich in healthy bacteria like miso, tempeh, sauerkraut, kefir, kombucha, kimchi, and plain yogurt for both bacterial vaginosis and yeast vaginitis. You may need to limit or avoid these foods plus others on a regular basis if you are otherwise healthy but prone to frequent yeast infections and follow the yeast free or anti-candida diet, which is very strict and not clear that it makes a difference or worth the trouble. And do a healthy full body detox, like with Bentonite Clay. See a naturopath or holistic nutritionist for additional guidance.
Eat more fresh vegetables (especially the dark green ones, raw garlic and onion, turnips, and cabbage), quality protein, complex carbohydrates (like brown rice, quinoa, kasha and millet), and live culture plain yogurt.
For vaginal candida, you can take homeopathic Yeast Guard internally, insert homeopathic vaginal suppositories or Yeast Arrest by Vitanica vaginally as directed and apply it externally as well - all safe in pregnancy. Consult a classical homeopath who can prescribe a homeopathic oral remedy specific to your individual symptoms if without relief or you get recurrent infections.
Drink Pau D’Arco tea (3 cups per day), use the superfood powder in cooking, and/or insert tampons soaked in the extract vaginally and change every 12 hours. It has antifungal and antibacterial properties. If you are not pregnant, take Pau D’Arco 500 mg capsules, 2-4 once or twice daily. You can also use it in your douche (1 part strong tea to 3 parts warm water) or douche with ½ teaspoon of Goldenseal powder to 1 cup warm water 1-2 times per day.
Dr. Aviva Romm advises creating your own herbal suppositories. Although they do take some effort, they are very effective. She also recommends supplements to support your adrenals and stress response, especially if you are getting recurrent infections related to increased stress and overwork so common in modern times.
If all else fails, for yeast, you can use diluted Gentian Violet painted locally for more stubborn cases (yes, it temporarily stains everything bluish purple), or contact your provider for prescriptive medications (ideally after the first trimester of pregnancy). Frequent use of antifungal creams such as Monistat and Gyne-Lotrimin sold over the counter in grocery or drug stores is discouraged for they are not strong enough and can promote the growth of less common yeast strains, leading to recurrent or persistent infections. Your sexual partner will need treatment only if symptomatic or you are otherwise healthy but suffer from chronic or repeated episodes.
Please consult your practitioner if the above mentioned suggestions do not help, your symptoms become worse, do not clear up after 1-2 weeks, or recur frequently. And certainly if you develop:
Lower abdominal pain
Fever
Vaginal bleeding or spotting
Heavier or more painful periods
Unusual lumps or sores
Sexual contact with someone suspected of having syphilis, gonorrhea, chlamydia, warts, herpes or HIV infection
Bleeding, regular contractions or cramping, low pelvic or back pressure, or leaking fluid with pregnancy
Aside from being uncomfortable, untreated yeast infections are not dangerous, but if they occur close to delivery can increase the chance of newborn thrush and subsequent yeast infection of the breast feeding nipples.
For those with any sort of chronic frequent infections in which serious causes have been ruled out and none of the natural and allopathic remedies help, consult your provider. If you need more personal guidance, as always, schedule a chat with me so I can advise you about the best supplements, remedies and dosages specific to your situation.
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