Diluted apple cider or other vinegar is commonly used as a local management strategy or treatment for bacterial vaginosis and other vaginal infections.
Treatments methods include apple cider vinegar baths, direct vaginal treatment via tampons or douches, and may extend to drinking ACV daily as a tonic.
How to use ACV vaginally for BV
Studies into using ACV vaginally – or lack thereof
Using apple cider vinegar (ACV) vaginally hasn’t been studied, despite a long traditional use by humans for everything under the sun.
We’ve found some research to back up the use of ACV as an antimicrobial and immune modulation tool, but beware – we don’t know how this works in the vagina! Use at your own risk and never use undiluted apple cider vinegar in your vagina.
Many of the studies into apple cider vinegar are lab studies (in vitro) or in animals (in vivo) and it’s unclear how they apply to vaginas. But, we reckon everything is worth a try.
Please see your healthcare professional if your symptoms don’t go away – you may need more help than humble apple cider vinegar can offer.
ACV as an antimicrobial agent
ACV has antimicrobial properties against different species, affecting several elements of a microbe that disable or kill. The dilution matters – some microbes succumb to weaker dilutions than others.
In a lab study into Braggs apple cider vinegar, the minimum dilution to restrict the growth of specific microbes was:
- Candida albicans – undiluted (5 per cent acidity)
- Staphylococcus aureus – 50:50 dilution (2.5 per cent acidity)
- Escherichia coli – 1:50 dilution (0.1 per cent acidity)
It is believed that ACV causes certain responses in human cells too, in particular, an anti-inflammatory effect.
The science stuff
This lab study also shows that ACV suppresses cytokines and improves phagocytic responses in human cells.
Cytokines are what circulates to trigger the inflammatory response in our tissues, and phagocytic refers to phagocytes, which are cells that eat up bacteria and dead cells. Microbes underwent significant impairment after the introduction of ACV.
ACV damages cell integrity, structural and metabolic proteins, and nuclear material in microbes.
Other studies show that when taken orally ACV can modulate certain aspects of our immune systems and has an impact on digestive flora and cells.
If you’re into the science stuff, we recommend going straight to the source. This journal article takes a much closer look.
Why people use ACV for vaginal problems
There are many types of vinegar, with apple cider vinegar being one of the most popular ‘healthy’ kinds of vinegar, especially if it still includes the ‘mother’.
Vinegar is used commonly as a douche for many reasons, including:
- Acidic pH – 4.2 (healthy vaginal pH is 3.5-4.5, often above 4.5 in BV and other infections/imbalances)
- Antimicrobial activity
- Antifungal activity
- Cheap
- Very accessible in supermarkets globally
- Easy to apply as a douche or a soaked tampon or in a bath
What are the active ingredients in apple cider vinegar?
- Acetic acid
- Flavanoids (gallic acid, tyrosol catechin, epicatechin, benzoic acid, vaninilin, caftaric acid, coutaric acid, caffeic acid and ferulic acid)
- Apple polyphenol
When ACV isn’t strong enough
Depending on what’s wrong, however, vinegar may not be strong enough to solve it. It’s not safe for your healthy vaginal flora to be douching regularly with vinegar.
If you have ongoing symptoms, and vinegar is not keeping symptoms at bay for more than a week, you may need a stronger or longer treatment.
References
Yagnik D, Serafin V, J Shah A. Antimicrobial activity of apple cider vinegar against Escherichia coli, Staphylococcus aureus and Candida albicans; downregulating cytokine and microbial protein expression. Sci Rep. 2018;8(1):1732. Published 2018 Jan 29. doi:10.1038/s41598-017-18618-x
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