This article is a systematic review of the literature regarding the most commonly used complementary and
alternative medicine (CAM)
therapies for yeast
vaginitis and
bacterial vaginosis. A search was conducted of all published literature on conventional search engines (PubMed, EMBASE, the Cochrane Registry, CINAHL, LILACS) and
alternative medicine databases (Natural Medicines Comprehensive Database, Longwood Herbal Taskforce, and
Alternative Medicine Alert), for all studies of the five most commonly used CAM treatments of
vaginitis. Inconsistencies in definition of
vaginitis, type of intervention, control groups, and outcomes prevented performance of a meta-analysis, and paucity of high-quality studies made ranking by evidence-based scales unsuitable. Lactobacillus recolonization (via yogurt or capsules) shows promise for the treatment of both yeast
vaginitis and
bacterial vaginosis with little potential for harm.
Boric acid can be recommended to women with recurrent vulvovaginal Candidal
infections who are resistant to conventional
therapies, but can occasionally cause vaginal burning. Because of associated risks in the absence of well-documented clinical benefits, douching remains a practice that should not be recommended for the treatment of
vaginitis. Finally,
tea tree oil and garlic show some in vitro potential for the treatment of
vaginitis, but the lack of in vivo studies preclude their recommendation to patients for the time-being. The available evidence for CAM treatments of
vaginitis is of poor quality despite the prevalent use of these
therapies. Well-designed randomized, controlled trials investigating the efficacy and safety of these
therapies for
vaginitis are needed before any reliable clinical recommendations can be made.
TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians.
LEARNING OBJECTIVES: