Many people seek home remedies, such as apple cider vinegar (ACV), to treat bacterial vaginosis (BV). BV is a widespread gynecological concern that affects many people assigned female at birth, causing noticeable and unpleasant symptoms. While ACV is widely touted for its potential health benefits, its effectiveness and safety as a treatment for BV remain largely unproven by scientific research. Evaluating this popular home remedy requires understanding the nature of BV and the proposed mechanism of ACV.
Understanding Bacterial Vaginosis
Bacterial vaginosis (BV) results from an imbalance in the vaginal microbiome. Normally, the vagina is dominated by Lactobacilli, which produce lactic acid to keep the pH low and protective. BV occurs when these protective species are replaced by an overgrowth of certain anaerobic bacteria.
This bacterial shift changes the vaginal chemistry, resulting in a higher, less acidic pH value. Common symptoms include a thin, gray, or whitish-green discharge and a strong, fishy odor, often more pronounced after intercourse. While many individuals experience symptoms, some may have no noticeable signs. BV is not considered a sexually transmitted infection, but sexual activity is a risk factor.
The Proposed Mechanism: ACV and Vaginal pH
The theory for using ACV for BV relies on its highly acidic nature and its potential to restore the vaginal pH. A healthy vaginal pH is moderately acidic, typically between 3.8 and 4.2, which prevents the growth of harmful pathogens. BV is associated with a higher pH, usually above 4.5.
ACV contains acetic acid and sometimes lactic acid, both acidic compounds. Proponents suggest that introducing this acidity could lower the vaginal pH back into the healthy range, inhibiting the overgrowth of BV-associated bacteria. Laboratory studies show ACV has general antimicrobial effects against some bacteria and fungi.
However, this does not translate directly to effective treatment in the complex vaginal environment. There is a distinct lack of robust clinical trials supporting ACV as a reliable treatment for BV in humans. The antimicrobial studies cited are in vitro, meaning they were performed in test tubes and did not target the complex mix of bacteria in a living system. Therefore, the current evidence does not support ACV as an effective medical intervention for bacterial vaginosis.
Methods of Use and Associated Safety Risks
People attempting to use ACV for BV commonly employ methods like diluted douching, sitz baths, or oral ingestion. Douching involves rinsing the inside of the vagina with a mixture of water and ACV. A sitz bath means soaking the external genital area in a diluted solution. Oral consumption is also sometimes tried, usually diluted in water, hoping to influence the body’s internal pH.
Healthcare professionals strongly discourage douching, even with diluted ACV, as it disrupts the natural balance of the vaginal flora. This disruption may worsen the condition or increase the risk of infection. Because ACV is highly acidic, direct or insufficiently diluted topical application can cause significant irritation, burning, or damage to sensitive vaginal tissues. There is no standardized, medically recognized dosage or method for using ACV to treat BV, making self-treatment highly risky.
When Professional Medical Treatment is Necessary
If symptoms of BV appear, such as a strong odor or unusual discharge, it is imperative to seek diagnosis from a healthcare professional. A proper diagnosis rules out other conditions with similar symptoms, such as a yeast infection or a sexually transmitted infection, which require different treatments. Diagnosis usually involves a pelvic exam, a whiff test, and testing the vaginal pH.
Bacterial vaginosis requires prescription antibiotics, which are the medically proven treatment. These often include oral medications like metronidazole or tinidazole, or topical gels and creams inserted into the vagina. Relying solely on unproven remedies like ACV delays effective treatment, allowing the infection to persist and potentially lead to serious complications. Untreated BV increases the risk of contracting sexually transmitted infections and is associated with complications in pregnancy, such as premature birth.