Apple cider vinegar has a reputation as a magical cure-all that will remedy everything from allergies to dandruff to… yeast infections? A quick google search reveals plenty of blogs recommending yeast infection "treatments" such as apple cider vinegar baths, douching with apple cider vinegar, and even soaking a tampon in apple cider vinegar and inserting it. We talked to Jennifer Linhorst, MD, an OB/GYN practicing in Denver, about whether apple cider vinegar actually works to remedy yeast infections.
“There is little evidence related to the efficacy of apple cider vinegar to treat yeast infections, and the studies that are out there are not robust,” Dr. Linhorst says. Although one study has shown a potential, though minor, effect, she points out, "this study was performed 'in vitro' (lab setting/petri dishes), not 'in vivo' (in a living organism)," and when it comes down to it, “more research is certainly needed to determine route, dose, etc."
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Because apple cider vinegar is acidic, using it topically on your vulva (or soaking your tampon in it) “may actually make symptoms worse by irritating the area further,” Dr. Linhorst says. And if you do self-treat a yeast infection with apple cider vinegar, “one harmful aspect comes from the potential delay that treating a presumed case of yeast with apple cider vinegar can create. While for the vast majority of people, this is not going to pose a health risk, anyone who has every had some form of vulvovaginitis (aka inflammation of the vulva and vagina) can tell you that quality of life is diminished substantially for the duration of symptoms.”
That's because what you think is a yeast infection might not actually be a yeast infection. “There is some evidence that women are not actually that great at diagnosing what is causing the irritation down there,” Dr. Linhorst adds, pointing to a study that found that only 33.7% of self-diagnosed yeast infections by cis women were actually yeast infections — and that women who had previously had a clinic-based diagnosis were no better at self-diagnosis than others.
Other common causes of vulvodynia that may be misdiagnosed as yeast infections include contact dermatitis (aka a rash caused by something your vulva was in contact with), bacterial vaginosis, sexually transmitted infections (like trichomoniasis), dermatological causes, a reaction to decreased estrogen during menopause, a response to a foreign body (like forgetting a tampon), or a combination of some of these factors. “Each of these conditions is treated very differently and proper treatment relies on a proper diagnosis,” Dr. Linhorst says.
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So if you think you might have a yeast infection, check with your OB/GYN to make sure that’s really the case. Even if you’re right, if you have recurrent yeast infections, “one should evaluate for possible risk factors,” Dr. Linhorst says. A change such as decreasing the dose of estrogen in your birth control pill might make your yeast infections a whole lot less frequent.
Along with visiting a doctor if you think you have a yeast infection, you can take steps to prevent vulvovaginitis in the first case, like avoiding scented products such as tampons or detergent; changing out of sweaty clothing after working out; peeing after sex; wearing loose, breathable clothing; cleaning your sex toys properly; and avoiding douches and other “feminine hygiene" products.
Dr. Linhorst adds, “I am certainly not against complementary and alternative medicine (CAM). They have their place. I also am certainly not against women desiring and seeking to take their health into their own hands. However, when it comes to apple cider vinegar, if one wants to try it out, I would recommend restricting its use to the oral route. I would not recommend actually putting vinegar in or near the vagina.” If you do decide to take apple cider vinegar orally, make sure you dilute it with water — otherwise, the acid can harm your teeth, mouth, and esophagus.