Vaginal treatments using povidone-iodine

Povidone iodine is an antiseptic that has been used in wound care and hospitals for over 170 years. It is one of the most potent antiseptics available over the counter, with broad spectrum antimicrobial action against bacteria, fungi, protozoa and viruses. Water or alcohol solutions of iodine are toxic and cause skin discolouration, pain, irritation and inflammation, so new carriers for iodine had to be developed. Povidone-iodine is one such mixture. The solution reduces the side-effects caused by elemental iodine.

Povidone-iodine neutralises many major groups of bacteria, fungi and protozoa, with the concentration of free iodine continuously released above the level required to kill microorganisms, but below the level that would cause skin irritation. Povidone-iodine is used vaginally and on skin without causing skin irritation, and is believed safe and effective as a topical antiseptic.

     Using povidone-iodine vaginally

Povidone-iodine douches in the vagina may have some use in killing some groups of bacteria (gram-positive and gram-negative), at least temporarily. Studies show that the douche kills bacteria, and has a positive effect on normal flora, since lactobacilli are the first to recover, usually taking about two hours. Whatever was present before usually reappears fully about this time, however how this looks in each of you will be different. If you want symptom relief from, say, E. coli or E. faecalis, this treatment may be helpful at least temporarily. You’ll need to be tested to see if the bacteria remain if you decide to do a course of povidone-iodine.

One of the issues with a rinse or douche is that it leaves the vagina quickly, possibly reducing its effectiveness as a treatment. This may mean using a povidone-iodine-soaked tampon for a few hours per day, possibly several times per day, may have a more beneficial effect. There is no research into using povidone-iodine to eradicate bacteria caused by aerobic vaginitis (the specifics of which vary somewhat) or bacterial vaginosis, but if you are strapped for cash or in a pinch, you may be able to relieve symptoms.

     Can povidone-iodine cure my vaginal infection?

Povidone-iodine is not thought to be a cure for aerobic vaginitis, bacterial vaginosis, yeast infections, or other vaginal infections, however there is also no real evidence saying that, with a concerted treatment program, it can’t make a dent in it.

     How to do a treatment program using povidone-iodine

You need to know what you are treating, so if possible, get a multiplex PCR test so that you don’t waste your time with ineffective treatments. You can use multiple douches per day (as below) for seven days, while also taking a high-dose women’s probiotic.

Iodine can be absorbed, so avoid using soaked tampons for treatment – it may affect your thyroid function, particularly in those who already have thyroid problems. A douche should be ok, but you are responsible for your own iodine intake and if you are sensitive, avoid this treatment.

If you do want to use soaked tampons, you can, but don’t overdo it. You may wish to try to find some povidone-iodine pessaries instead, which act to slow-release the iodine.

After using povidone-iodine vaginally, you should immediately use women’s probiotics to recolonise with healthy bacteria, since lactobacilli are the first to recover after a povidone-iodine douche. We love Jarro-Dophilus Women, as it has the best collection of bacteria for vaginas. You can use it vaginally too, but you’ll need to switch the caps over.

     Warnings:
+ Povidone-iodine is brown and stains! Keep away from nice underwear by rinsing your vulva (not vagina!) with water and using a panty liner after use.
+ Do not eat!
+ This douche is understood to be safe for use during pregnancy.
+ Do not constantly douche without addressing the underlying cause of your infection or symptoms – you are upsetting the ecology of your vagina further if you are not doing a concerted treatment program with an aim to stop use of douches.
+ Douching is bad if you use it all the time.
+ Do not mix povidone-iodine with hydrogen peroxide, silver, taurolidine or proteins – it makes it ineffective, useless for disinfecting metal piercings
+ Beware those with thyroid conditions – don’t be alarmed, but do your homework

     How to douche using povidone-iodine 7 per cent

  1. Fill up a 100ml syringe, douche or turkey baster with the 7 per cent solution. This is already diluted, so you do not need to dilute it further.
  2. It’s best if you can lie down, propping your hips up to hold the solution in for as long as possible – the more surface area for longer, the better. A bath is great for this to avoid mess (remember, iodine stains!), but not everyone has a bath. You’ll need to figure out the best way for you, with your facilities and abilities.
  3. If you are unable to lie down, you can do the douche over the toilet or in the shower.

     References