Lactobacillus acidophilusis a strain of friendly bacteria that is an integral part of normal vaginal flora. Lactobacilli help maintain the vaginal microflora by preventing overgrowth of unfriendly bacteria and Candida. Lactobacilli produce lactic acid, which acts like a natural antibiotic. These friendly bacteria also compete with other organisms for the utilization of glucose. The production of lactic acid and hydrogen peroxide by lactobacilli also helps to maintain the acidic pH needed for healthy vaginal flora to thrive. Most of the research has used yogurt containing live cultures of Lactobacillus acidophilus or the topical application of such yogurt or Lactobacillus acidophilus into the vagina. The effective amount of acidophilus depends on the strain used, as well as on the concentration of viable organisms.

Vaginal application of a proprietary Lactobacillus acidophilus preparation may help bacterial vaginitis. In one trial, 80% of women with bacterial vaginitis who used the preparation were either cured or experienced marked improvement in symptoms.¹ In another trial, application of a vaginal capsule containing Lactobacillus rhamnosus, Lactobacillus acidophilus, and Streptococcus thermophilus reduced the recurrence rate of bacterial vaginosis. The treatment was given for 7 consecutive days, and then after 7 days off was given for another 7 days.² In another trial, women who were predisposed to vaginal Candida infection because they were HIV-positive received either Lactobacillus acidophilus vaginal suppositories, the antifungal drug, clotrimazole (for example, Gyne-Lotrimin), or placebo weekly for 21 months.³ Compared to those receiving placebo, women receiving Lactobacillus acidophilus suppositories had only half the risk of experiencing an episode of Candida vaginitis—a result almost as good as that achieved with clotrimazole. In a preliminary trial, women with vaginal Trichomonas infection received vaginal Lactobacillus acidophilus suppositories for one year.⁴ Over 90% of them were reported to be cured of their clinical symptoms in that time.

Two specific strains of lactobacillus (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) have been found to be effective against bacterial vaginosis when taken orally. In a double-blind study, supplementation with a capsule containing 10 billion of each of these organisms twice a day for 30 days increased the cure rate from antibiotic therapy to 88%, compared with a 40% cure rate in the group receiving antibiotics alone.⁵

Lactobacillus acidophilus is a strain of friendly bacteria that is an integral part of normal vaginal flora. Lactobacilli help maintain the vaginal microflora by preventing overgrowth of unfriendly bacteria and Candida. Lactobacilli produce lactic acid, which acts like a natural antibiotic. These friendly bacteria also compete with other organisms for the utilization of glucose. The production of lactic acid and hydrogen peroxide by lactobacilli also helps to maintain the acidic pH needed for healthy vaginal flora to thrive. Most of the research has used yogurt containing live cultures of Lactobacillus acidophilus or the topical application of such yogurt or Lactobacillus acidophilus into the vagina. The effective amount of acidophilus depends on the strain used, as well as on the concentration of viable organisms.

Vaginal application of a proprietary Lactobacillus acidophilus preparation may help bacterial vaginitis. In one trial, 80% of women with bacterial vaginitis who used the preparation were either cured or experienced marked improvement in symptoms.⁶ In another trial, women who were predisposed to vaginal Candida infection because they were HIV-positive received either Lactobacillus acidophilus vaginal suppositories, the antifungal drug, clotrimazole (for example, Gyne-Lotrimin), or placebo weekly for 21 months.⁷ Compared to those receiving placebo, women receiving Lactobacillus acidophilus suppositories had only half the risk of experiencing an episode of Candida vaginitis—a result almost as good as that achieved with clotrimazole. In a preliminary trial, women with vaginal Trichomonas infection received vaginal Lactobacillus acidophilus suppositories for one year.⁸ Over 90% of them were reported to be cured of their clinical symptoms in that time.

Two specific strains of lactobacillus (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) have been found to be effective against bacterial vaginosis when taken orally. In a double-blind study, supplementation with a capsule containing 1 billion of each of these organisms twice a day for 30 days increased the cure rate from antibiotic therapy to 88%, compared with a 40% cure rate in the group receiving antibiotics alone.⁹ In another double-blind trial, women with bacterial vaginosis received one capsule of L. rhamnosus GR-1 and L. reuteri RC-14 (1 billion of each strain per capsule) twice a day or placebo for 6 weeks. After 6 weeks, the percentage women who no longer had bacterial vaginosis was significantly higher in the probiotics group than in the placebo group (62% vs. 21%).¹⁰ Women with bacterial vaginosis should consult their doctor to determine whether these probiotic strains might be an effective alternative to antibiotics.

In a double-blind, placebo-controlled trial, a cream containing neem seed extract, saponins of Sapindus mukerossi (reetha), and quinine hydrochloride (5 ml applied vaginally once at bedtime) eliminated all symptoms in 10 of 14 women with chlamydia compared with none of four women given placebo cream.¹¹ Neither cream was effective in women with trichomoniasis or candidal vaginitis.

Teas of goldenseal, barberry, and echinacea are also sometimes used to treat infectious vaginitis. Although all three plants are known to be antibacterial in the test tube, the effectiveness of these herbs against vaginal infections has not been tested in humans. The usual approach is to douche with one of these teas twice each day, using 1–2 tablespoons (15–30 grams) of herb per pint of water. One to two pints (500–1,000 ml) are usually enough for each douching session. Echinacea is also known to improve immune function in humans.¹³ In order to increase resistance against infection, many doctors recommend oral use of the tincture or alcohol-preserved fresh juice of echinacea (1 teaspoon (5 ml) three or more times per day)—during all types of infection—to improve resistance.

Teas of goldenseal, barberry, and echinacea are also sometimes used to treat infectious vaginitis. Although all three plants are known to be antibacterial in the test tube, the effectiveness of these herbs against vaginal infections has not been tested in humans. The usual approach is to douche with one of these teas twice each day, using 1–2 tablespoons (15–30 grams) of herb per pint of water. One to two pints (500–1,000 ml) are usually enough for each douching session. Echinacea is also known to improve immune function in humans.¹⁴ In order to increase resistance against infection, many doctors recommend oral use of the tincture or alcohol-preserved fresh juice of echinacea (1 teaspoon (5 ml) three or more times per day)—during all types of infection—to improve resistance.

Teas of goldenseal, barberry, and echinacea are also sometimes used to treat infectious vaginitis. Although all three plants are known to be antibacterial in the test tube, the effectiveness of these herbs against vaginal infections has not been tested in humans. The usual approach is to douche with one of these teas twice each day, using 1–2 tablespoons (15–30 grams) of herb per pint of water. One to two pints (500–1,000 ml) are usually enough for each douching session. Echinacea is also known to improve immune function in humans.¹⁵ In order to increase resistance against infection, many doctors recommend oral use of the tincture or alcohol-preserved fresh juice of echinacea (1 teaspoon (5 ml) three or more times per day)—during all types of infection—to improve resistance.

Topically applied tea tree oil has been studied and used successfully as a topical treatment for Trichomonas, Candida albicans, and other vaginal infections.¹⁶ Tea tree oil must be diluted when used as a vaginal douche, and should only be used for this purpose under the supervision of a healthcare practitioner. Some physicians suggest using tea tree oil by mixing the full-strength oil with vitamin E oil in the proportion of 1/3 tea tree oil to 2/3 vitamin E oil. A tampon is saturated with this mixture or the mixture is put in a capsule to be inserted in the vagina each day for a maximum of six weeks.

Some doctors recommend vitamin E (taken orally, topically, or vaginally) for certain types of vaginitis. Vitamin E as a suppository in the vagina or vitamin E oil can be used once or twice per day for 3 to 14 days to soothe the mucous membranes of the vagina and vulva. Some doctors recommend vaginal administration of vitamin A to improve the integrity of the vaginal tissue and to enhance the function of local immune cells. Vitamin A can be administered vaginally by inserting a vitamin A capsule or using a prepared vitamin A suppository. Vitamin A used this way can be irritating to local tissue, so it should not be used more than once per day for up to seven consecutive days.

Some doctors recommend vitamin E (taken orally, topically, or vaginally) for certain types of vaginitis. Vitamin E as a suppository in the vagina or vitamin E oil can be used once or twice per day for 3 to 14 days to soothe the mucous membranes of the vagina and vulva. Some doctors recommend vaginal administration of vitamin A to improve the integrity of the vaginal tissue and to enhance the function of local immune cells. Vitamin A can be administered vaginally by inserting a vitamin A capsule or using a prepared vitamin A suppository. Vitamin A used this way can be irritating to local tissue, so it should not be used more than once per day for up to seven consecutive days.