Boric Acid and Bacterial Vaginosis (BV)

Twenty years ago, I worked with a nurse practitioner who advocated inserting boric acid capsules inside the vaginas of patients with recurrent bacterial vaginosis (BV). About that same time, an article even appeared in Glamour magazine suggesting the same thing; however, this remedy continued to be deemed merely an unsupported, anecdotal suggestion.

Recently, however, the Centers for Disease Control and Prevention (CDC) supported the notion that boric acid can indeed be used for this purpose. So now I can tell my patients with alacrity that boric acid works as a treatment for BV! Let’s talk about it.

What is bacterial vaginosis?

BV is an overgrowth in the vagina of a variety of normally occurring bacteria. Although most of these already happen to reside in the vagina naturally, they become a problem when they multiply to the point where they disturb the fine acidic balance (pH) of the vagina. When the vagina’s all-important level of acidity is spoiled, then the less-savory types of bacteria gain the advantage, become overgrown, and cause bacterial vaginosis.

The pH level of the vagina

The good bacteria that reside naturally in the vagina are called lactobacillus and it’s their job to help maintain the vagina’s correct level of acidity. If the numbers of lactobacillus are in decline or deficient, or if the vagina is exposed to alkaline substances, then the vagina can become too alkaline—and bacterial vaginosis can be the result.

What can damage the healthy acidity of the vagina?

Certain substances inside the vagina can lessen its acidity and contribute to its alkalinity—menstrual blood and semen, for example, are common factors. And, as I said, once the pH of the vagina becomes alkaline, the other bacteria in the vagina can become overgrown, leading to BV.

The symptoms of BV

The common symptom of BV is a thin, foul-smelling discharge that often conveys a fishy smell. This unpleasant odor gets even more disagreeable when the region is exposed to soap. BV is not sexually transmitted, and men do not carry it, but it has been shown to contribute to the development of uterine and pelvic infections in women.

How is BV treated?

The most common treatment for BV is the antibiotic metronidazole (Flagyl)—taken either orally or intravaginally. The antibiotic clindamycin can also be used to treat BV. The problem with BV, however, is that once the vaginal pH has been disturbed, it is difficult to correct, meaning that women who have had BV are prone to getting it repeatedly.

What happens if it recurs?

Recurrent BV can become a source of great frustration for any woman trying to get rid of it for good. Therefore, anything that decreases exposure to alkaline substances will help in the battle—tampons to wick away menstrual blood, condoms to catch semen. But what about simply increasing the acidity of the vagina itself? This is where the boric acid comes in!

What is boric acid?

Boric acid is a powder that is mildly acidic and antiseptic. It has a variety of uses—including as a roach poison!—but don’t let that scare you. Placed inside the vagina in very small amounts, it can actually be very helpful in acidifying the vagina.

How to use boric acid to cure BV

The expert recommendations are

  1. First, use 1 of the antibiotics mentioned above to clear the infection.
  2. Then, as a preventative measure, place a large (size 00) capsule of boric acid inside the vagina.
  3. You can even make these capsules yourself by putting boric acid powder inside empty gelatin capsules bought at the pharmacy or online.

The CDC doesn’t specify how much boric acid to introduce into the vagina, but I usually tell my patients to try 1 capsule once or twice a week at bedtime. If, however, a patient feels she is developing BV, she can increase this dose to 1 capsule nightly for 3 nights in a row, and then go back to once or twice a week. Last, just to be safe, I always emphasize to my patients that they're not to swallow the capsules—only to insert them into the vagina!

The good news is that I rarely see these women return with this complaint because their problem usually disappears after using the boric acid. So, if you have recurrent BV, see your healthcare provider to clear the infection, and then consider using boric acid capsules to prevent the return of BV ever again!

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