Bacterial infections of the vagina (also called bacterial vaginitis or bacterial vaginosis) are common in both pre-menopausal and post-menopausal women. For discussion of the causes and symptoms of bacterial vaginitis, see our Q&A called Bacterial Infections of the Vagina.
Some women experience occasional bacterial vaginitis, whether other women experience frequent (i.e., recurrent) bacterial vaginitis. An estimated 30% of women treated for bacterial vaginitis experience recurrence of the condition within 3 months.
Many factors, including improper hygiene, improper pH (i.e., improper balance of acidity and alkalinity) and lack of normal microbes in the vagina, can introduce bacteria into the vagina and make the vagina more susceptible to bacterial infections. Therefore, prevention of bacterial infections of the vagina involve:
Achieving and maintaining proper balance of pH and normal microbes in the vagina
Many ways to prevent, manage, and treat bacterial infections of the vagina are available, including the following self-care, naturopathic, homeopathic, and psychological approaches to achieve and maintain a balanced state of health of the vagina:[1-3]
Achieve and maintain and healthy body mass index (i.e., ratio of weight to height)
Eat a healthy diet that is abundant in freshly-caught, cold-water fish (which contain omega-3 and-6 fatty acids); whole grains; fresh, organic vegetables and fruits; and healthy fats (such as omega-3 and-6 fatty acids that have anti-inflammatory activity).
Enjoy foods containing soy, as soy contains phytoestrogens, plant substances that can mimic some of the effects of estrogen on the body,
Do not eat non-organically raised meat and poultry and non-organic dairy products.
If you eat meat, poultry, and dairy products, select organically-raised meat and poultry and organic dairy products, such as organic unsweetened yogurt.
To help prevent infections and inflammation of the vagina, limit your intake of sugar, dried fruits, fruit juice, candy, pastries, pies, cakes, cookies, and ice cream.
Avoid drinking beverages containing caffeine and/or alcohol.
Drink lots of water.
Do not smoke cigarettes.
Take oral supplements containing vitamins that have anti-oxidant activity, such as the vitamins, A, C, and E. Doses of 2000 to 3000 mg of vitamin C daily can help function of the immune system and aid in prevention and treatment of infections. Consult your integrative medical physician for guidance on doses of vitamins that are appropriate for you.
Take oral supplements containing soy isoflavones and/or black cohosh. These botanical supplements contain phytoestrogens, which can mimic some of the effects of estrogen on the body. Consult your integrative medical physician for guidance on the dose that is appropriate for you.
Regularly take supplements containing "healthy" (i.e., normal digestive) bacteria, such as Lactobacillus acidophilus.
To help prevent bacterial infections of the vagina, avoid using commercial deodorants for the vagina, as these products can destroy healthy bacteria in the vagina.
To help prevent bacterial infections of the vagina, avoid using commercial douches, as these products can destroy healthy bacteria in the vagina. If you want to douche once or twice each month at times other than during your menstrual period, you can use a mixture of either 1 Tbsp white vinegar diluted in 1 pint of warm water, or 1 Tbsp baking soda diluted in 1 quart of warm water. To restore the level of healthy bacteria in the vagina after each vinegar or baking soda douche, insert either 1 Tbsp of unsweetened, live culture yogurt into the vagina, or douche with 1 to 2 tablets of Lactobacillus acidophilus, Bifidobacillus bifidum, or Bifodobacterium longum diluted in 2 cups of tepid water.
Avoid the use of devices, such as menstrual sponges and pessaries, which can irritate the vaginal lining.
If you are using birth control, use a method that does not irritate the vaginal lining, does not increase the susceptibility of the vaginal lining to bacterial infections, and does not increase the likelihood of introduction of bacteria into the vagina. For example, avoid the use of diaphragms, cervical caps, and spermicidal-containing foam, as these devices can irritate the mucous membranes in the vagina. Also, the use of intrauterine devices increases the risk of introduction of bacteria into the vagina and uterus. Furthermore, birth control pills can increase the vulnerability of the vaginal lining to bacterial infection. If you use birth control pills and are experiencing recurrent bacterial infections, consult your integrative medical physician or gynecologist about different methods of birth control that do not make the vaginal lining more susceptible to bacterial infections.
Wear underpants made of cotton, rather than nylon.
Avoid wearing pantyhose for long periods of time.
Avoid wearing wet or tight clothing (such as spandex material or nylon underwear) tin the pelvic area. Clothes that are tight or wet in the pelvic area can lead to prolonged exposure to moistness in the pelvic area and can irritate the areas of the vulva (i.e., outer and inner parts of the vagina), making them more vulnerable to bacterial infection.
During menstruation, avoid using tampons, which can irritate the vaginal areas and make them more vulnerable to bacterial infections. Instead, wear sanitary pads during menstruation.
Avoid taking frequent bubble baths, which can irritate the areas of the vulva (i.e., outer and inner parts of the vagina), making them more vulnerable to bacterial infections.
After a bowel movement, wipe from front to back. Avoid wiping from back to front, which can spread bacteria from the anal area to the vaginal area.
After urinating, wipe downwards (i.e., from front to back). Avoid wiping upwards (i.e., from back to front), which can spread bacteria from the anal area to the vaginal area.
To help prevent bacterial infections of the vagina, avoid the use of antibiotics for prevention and treatment of other types of infection. The use of antibiotics for prevention and/or treatment of other diseases can reduce the amount of healthy bacteria (including Lactobacillus) in the vagina. Consult your integrative medical physician for guidance.
Insert suppositories of vitamin A, vitamin E, calendula, or other types of soothing herbal suppositories designed for vaginal use into your vagina. For example, vitamin E, has lubricating, soothing, and healing properties. If you are allergic to glycerin, do not use suppositories containing glycerin. If you are using latex condoms during intercourse later, do not use suppositories containing glycerin, as it can cause disintegration of latex condoms.
Apply a 1:1 mixture of vitamin E, which has lubricating, soothing, and healing properties, and either a water-soluble lubricant for the vagina, or petroleum jelly to your vulva and the inside of your vagina. If you are using latex condoms during intercourse, use either pure vitamin E or a1:1 mixture of vitamin E and a water-soluble lubricant, as the petroleum jelly can cause disintegration of latex condoms. If you are allergic to glycerin present in water-soluble lubricants, use either pure vitamin E or a 1:1 mixture of vitamin E and petroleum jelly. Consult with your integrative medical physician for guidance on the dose of vitamin E that is appropriate for you.
Apply soothing calendula cream to the external part of the vagina if you do not have a simultaneous yeast infection.
Applying a small amount of natural progesterone cream twice a day to the vagina can balance your hormone levels. Consult your integrative medical physician for guidance on the dose and consideration of whether the treatment is appropriate for you.
To restore a healthy pH (ratio of acidity and alkalinity) in the vagina, you can insert 1 capsule of boric acid powder into the vagina every morning except during the menstrual period. You can test the pH of your vagina and urine using pH testing strips (also called pH paper). Consult your integrative medical physician or gynecologist for instructions on proper pH, testing of pH, and obtaining pH testing strips.
o To restore the level of healthy bacteria in the vagina, you can insert 1 to 2 capsules of either Lactobacillus acidophilus bacteria or a combination of Lactobacillus acidophilus and Bifidobacillus bifidum bacteria at bedtime each night or twice daily, except during the menstrual period.
Do not have unprotected sexual intercourse with a partner whose sexual history or medical history you do not know. If you are having sexual intercourse with a partner whose sexual history or medical history you do not know, use a condom. Remember that some people can have chlamydia infections or gonorrhea infections without experiencing symptoms.
If you are sexually active and have recurrent bacterial infections of the vagina, use condoms during sexual intercourse to prevent against re-infection by your partner.
When having sexual intercourse, use water-soluble lubricants and practice safe sex using latex condoms, as otherwise, you could be re-infected with bacteria from your sexual partner. Be aware that petroleum jelly can cause disintegration of latex condoms. For more information on lubrication and treating dryness of the vagina, see our Q&A called Treatment of Dry Vagina.
Just prior to having sexual intercourse, use products that provide adequate lubrication of the vagina.
If you use a vibrator as a sex toy inside the vagina, be sure to wash and dry the toy thoroughly before and after each use.
If you touch the anus with a finger or sex toy during sex, wash the finger or sex toy thoroughly with soap and water before inserting the finger or sex toy into the vagina.
After having protected anal intercourse using a condom, remove the condom and place another condom on the penis before allowing penetration into the vagina.
After having unprotected anal intercourse, wash the penis thoroughly with soap and water before allowing penetration into the vagina.
As soon as possible and within 10 minutes after having sexual intercourse, go to the bathroom and urinate. Next, use water to rinse off your genital area. Then, to promote healing of any small abrasions that could occur due to sexual intercourse, apply a small amount of pure vitamin E to the areas of your urethra, clitoris, and between your labia (lips of the vagina).
To treat bacterial infections that are present on the external vaginal region including the external labia and are not present inside the vagina, apply a mixture of vinegar diluted 1:1 with water to the external vaginal region and external labia.
Take a homeopathic remedy orally, such as Apis mellifica, Argentum nitricum, Arsenicum album, Aurum metallicum, Caladium, Calcarea carbonica, Cypripedium, Kreosotum, Lycopodium, Mercuris corrosivus, Natrum muriaticum, Platinum metallicum, Pulsatilla, Sanicula, sarcodes, Sepia, Staphysagria, Sulfur, and Thuja. Consult with a homeopath, a healthcare professional experienced in the use of homeopathy for guidance on selection of the homeopathic remedy and dose that is appropriate for you.
Perform yoga postures that involve pelvic motion to increase circulation of blood and channel energy into the pelvic area.
If you are experiencing recurrent bacterial vaginitis, consider psychological counseling to work on any negative attitudes towards the relationship with a romantic partner, which may contribute to the occurrence of neurogenic (i.e., caused by the nervous system) irritation and inflammation of the lining of the vagina after intercourse and, therefore, can make the lining of the vagina more vulnerable to infection by bacteria.
If you are experiencing vaginitis, or if you think that you have a bacterial infection, consult your integrative medical physician or gynecologist for proper diagnosis and treatment.
If you are a pre-menopausal woman and the self-care, naturopathic, homeopathic, and psychological approaches discussed above do not resolve the symptoms of bacterial vaginitis, consult your integrative medical physician and gynecologist to discuss other treatment options, including: the following types of prescription medications:
Topical antibiotic (e.g. clindamycin) preparations (e.g., as creams) applied to the inside of the vagina
Oral antibiotics (e.g., metronidazole)
If you are a post-menopausal woman and the self-care naturopathic, homeopathic, and psychological approaches described previously, do not resolve the symptoms of bacterial vaginitis, consult your integrative medical physician or gynecologist for consideration of use of prescription medications including:
Topical (i.e., applied to the lining of the vagina) estrogen; Estring (i.e., device worn in the upper part of the vagina); transdermal (i.e., patch applied to the skin) estrogen; or oral (i.e., pills containing) bio-identical estrogen
Topical antibiotic (e.g., clindamycin) preparations (e.g., as cream) applied to the inside of the vagina
Oral antibiotics (e.g., metronidazole)
Regardless of your age, if you have been diagnosed with a sexually-transmitted disease (STD) such as chlamydia, consult your integrative medical physician or gynecologist immediately for treatment with oral or injected antibiotics. Prompt and proper treatment with antibiotics can prevent the development of the potential complication, pelvic inflammatory disease (PID), in women. If you have been diagnosed with a chlamydia infection or other sexually-transmitted bacterial infection, your sexual partner(s) also need to be diagnosed and, if infected, treated with oral or injected antibiotics.
1. L. Streicher. Bacterial vaginosis presents vexing problems. Chicago SunTimes. 09/05.
2. J. Reichenberg-Ullman. Whole Woman Homeopathy. 2004. Edmonds, WA: Picnic Point Press.
3. I.Ikenze. Menopause & Homeopathy: A Guide for Women in Midlife. 1998. Berkeley, CA: North Atlantic Books.