Hormonal shifts that occur during perimenopause and menopause can bring about vaginal changes that may increase the risk for vaginal yeast infections and bacterial vaginosis (BV), as well as more noticeable vaginal odor or discharge. Using boric acid, an antibacterial agent derived from the mineral salt borax, may help manage these common issues.
Using boric acid for addressing certain vaginal symptoms isn't a new concept,1 and it's become increasingly popular thanks to social media. But before trying this popular over-the-counter remedy yourself, some education is in order. Here's what you need to know about using boric acid vaginally and how to do it safely.
Can Boric Acid Be Used Vaginally?
Boric acid may be useful for supporting a healthy vaginal environment by promoting a normal vaginal pH in the acidic range. "So many things can alkalize the vagina, including hormone changes, ejaculate, infections, as well as external irritants, like douching," explains Bonafide Chief Medical Officer Dr. Alyssa Dweck.
Lifestyle adjustments, like avoiding irritating personal care products and not douching, can help keep vaginal pH optimal. But even with these good habits in place, shifting estrogen levels that occur during perimenopause and menopause can still send vaginal pH into more alkaline territory. That can potentially increase the risk for problems like yeast infections and bacterial vaginosis, as well as unpleasant vaginal odor or itching.
Boric acid can be inserted vaginally via suppositories, which are easy to find in drugstores or online. However, it should never be taken orally, as ingestion could be toxic.2
Boric Acid for Yeast Infections and Bacterial Vaginosis
A healthy vaginal pH supports the body’s unique vaginal microbiome, keeping the balance of good and bad bacteria in check. That, in turn, makes it harder for infection-causing microbes to thrive, and may reduce the risk for problems like yeast infections and bacterial vaginosis.
Many healthcare providers find that boric acid regiments can be used preventively to reduce the risk for BV or yeast infections, especially when these problems are recurring. Whether it's helpful for treating existing infections is less clear. Some research has shown that boric acid may be an effective alternative to standard antifungal medications for yeast infections.3 But ultimately, "the jury is still out," advises Dr. Dweck.
Regardless of whether you want to use boric acid preventively or to treat an existing infection, you should talk with your healthcare provider first. Together you can decide whether it's the best option for you.
Boric Acid Side Effects to Know About
Using boric acid vaginally is generally considered safe but again, you should never ingest it. In rare instances, boric acid could irritate the skin around your vulva or vagina or cause a rash. “But people usually get those reactions because they’re using too much or using it too frequently,” Dr. Dweck says.
There are some important things to consider with regards to sex, too. Boric acid can damage condoms and diaphragms and might make vaginal spermicides less effective, so, you shouldn't rely on them to prevent pregnancy or sexually transmitted infections while using it.4 It's also crucial to avoid receiving oral sex while using boric acid, since your partner could potentially ingest it. "If you're using boric acid every day for a set period, I'd recommend abstaining from receiving oral sex. If you're using it twice a week, allow at least 24 to 48 hours before receiving oral sex," cautions Dr. Dweck.
How to Use Boric Acid Vaginally
There's no one-size-fits-all dosing regimen for using boric acid. So, if you're thinking about trying it, start by talking with your healthcare provider. "Some people use it nightly for a week or two if they're experiencing symptoms that they find concerning, like itching, irritation, or odor," Dr. Dweck says. "Those who have culture-proven bacterial vaginosis, or a yeast infection may be advised to use a course for one week per month for up to six months." Most women are typically advised to use a nightly 600 mg capsule, vaginally.5
You can use your fingers to insert the boric acid suppository into your vagina. (Just make sure to wash your hands before insertion and after.) Boric acid can be used at any time of day, but most women prefer to insert the capsule at night before bed. "Most people don't like the feeling of drainage if they insert it during the day. They might also prefer to wear a panty liner if they experience leakage," explains Dr. Dweck.
When to Talk to Your Healthcare Provider
It's a good idea to ask your healthcare provider about boric acid before you start using it. Together you can talk about your symptoms and decide whether the suppositories are the right choice, or if there's another treatment option you should consider first. "Especially if you're someone who is going to use boric acid on a regular basis, you want to get to the bottom of the problem before you start treating it yourself," Dr. Dweck says.
Let your provider know, too, if you continue to experience symptoms even after using boric acid. That could be a sign that you need to try something else to manage your vaginal discomfort or infection.