Known for its anti-fungal and antimicrobial properties, boric acid, in the form of vaginal suppositories, is a natural booster for vaginal health when recurring yeast infections and bacterial vaginosis (BV) arise. Especially helpful to quickly ease the uncomfortable symptoms of both infections, boric acid suppositories also restore vaginal pH to ensure a repeated infection doesn’t take hold.
Honey Pot and AZO are two widely available and recognized brands with their own versions of boric acid suppositories. Each has added ingredients that can be soothing for some vaginas but also irritating for others.
Here at Middlesex MD, we believe in the power of pure boric acid suppositories for restoring vaginal health, particularly during menopause when hormone changes can frequently alter vaginal pH and cause infections. And we don’t want any women to be put off or miss out on the healing abilities of boric acid suppositories due to extra ingredients from some brands.
Read on to find out how additional ingredients in boric acid suppositories can be irritating for some, why pure boric acid suppositories like those from Intimate Rose, may be more comfortable and fast-acting, as well as what you can do to ease the slight but harmless tingling that sometimes happens.
Honey Pot and AZO Boric Acid Suppositories
AZO is a widely available pharmacy-type brand sold over-the-counter in several drugstores and online stores. It is an effective and trusted brand in many aspects of health, and particularly popular for its urinary pain relief product.
The Honey Pot, co-founded by CEO Bea Dixon, was established as a plant-derived feminine care company in 2014 that is largely powered by herbs. And their organic body cleansers, panty liners, tampons, and feminine wipes are favored over synthetic products by lots of women.
While the boric acid suppositories from AZO and The Honey Pot are effective and non-irritating for many, there are reasons why they can be irritating for some women.
For instance, AZO Boric Acid Suppositories contain the clinically recommended 600 mg of boric acid per capsule, but they’ve added aloe vera for soothing purposes. While this is understandable, given that boric acid suppositories can cause drying and tingling for some, blending boric acid is not recommended by medical experts.
The same applies to The Honey Pot, who add cocoa butter and tea tree oil to moisturize and hydrate the vaginal skin while boric acid is released. Furthermore, The Honey Pot boric acid suppositories only contain 240 mg of boric acid, which is well below the clinically recommended amount per dose.
Naturally, as we outlined earlier, some women’s vaginal skin is more sensitive to boric acid than others. However, boric acid that is blended with other ‘soothing’ or ‘comforting’ ingredients before being encased in suppository capsules could also be the source of your irritation.
Therefore, when any intense side effects are experienced, patients should always stop using the suppositories and seek medical guidance as to whether a pure boric acid suppository could provide the benefits without the irritation.
Evidence on Pure Boric Acid Suppositories vs Blended Versions
Studies and clinical trials on the use of boric acid for yeast infections and BV recommend 600 mg of pure boric acid, and gynecology guidelines advise that pure boric acid suppositories are more effective than blended versions.
Boric acid blended with extra ‘soothing’ ingredients may sound and even feel gentler for some women, but they carry more risk of irritation for such a sensitive body part and are not as well-researched as pure boric acid suppositories.
Similarly, the Centers for Disease Control & Prevention (CDC) 2021 guidelines for the treatment of recurring vulvovaginal candidiasis (yeast infections) and the American College of Obstetricians & Gynecologists guidelines on vaginitis in nonpregnant patients (2019) also recommend 600 mg of pure boric acid.
What Pure and Effective Boric Acid Suppositories Are Recommended?
With no added ingredients, Intimate Rose Boric Balance suppositories are pure, safe, effective, and our most highly recommended boric acid products for recurring yeast infections and BV.
As well as focusing on purity, Intimate Rose uses vegan capsules to deliver boric acid to the vaginal canal, which dissolve quicker and more evenly than gelatin capsules to provide relief of symptoms within 24 hours. (Full disclosure: While AZO and The Honey Pot also use plant-based capsules, their added ingredients remain an irritating problem for many.)
As experts in the field of intimate female health, and because they understand that boric acid suppositories can cause mild vaginal dryness or tingling for some, Intimate Rose developed a 100% natural vulvovaginal moisturizer that can be used between boric acid treatments.
Enchanted Rose Vulvar Balm blends moisturizing and hydrating natural ingredients to provide support for vaginal skin irritation and dryness. In addition to easing dryness due to improper vaginal pH and after using boric acid suppositories, it also relieves irritation after genital shaving, breastfeeding, and vaginal dryness during menopause.
What is Vaginal pH and Why Is It Important for a Clean and Healthy Vagina?
As a self-cleaning organ, the vagina creates its own natural defense system by maintaining a mildly acidic pH of 3.8 – 4.5 during the reproductive years, and increases slightly to 5.0 during menopause due to hormonal changes.
This slightly acidic environment is naturally maintained to protect the balance of the vaginal microbiome, where a mix of defensive and harmful microorganisms coexist. In this balanced environment, good (defensive) bacteria, predominantly Lactobacillus, produce lactic acid to support the mildly acidic vaginal pH.
However, when the vaginal pH changes or becomes basic (alkaline), the environment becomes more ideal for harmful microorganisms (bacteria, fungi, parasites, and more) to thrive over the protective ones.
This can result in an unpleasant vaginal odor, changes in vaginal discharge, or vaginal irritation. If left untreated, and harmful bacteria outnumber friendly bacteria, BV can occur. And when harmful fungi are allowed to thrive, a vaginal yeast infection can set in.
When antibiotics or antifungal medication curb the overgrowth of harmful bacteria and fungi, the lactic-acid-producing lactobacillus becomes the dominant bacterium again. However, when a mildly acidic vaginal pH is not fully restored after a yeast infection or BV, recurring infections often happen.
Sometimes extra help is required to restore the perfect levels of acidity for a healthy vaginal pH. And this is where boric acid suppositories can help.
How Does Boric Acid Prevent Recurring Yeast Infections and BV?
Boric acid is a compound white powder made from three natural elements, boron, oxygen, and hydrogen. To restore vaginal pH and ease the symptoms of yeast infections and BV, boric acid is delivered in a soluble capsule that is inserted once per day into the vaginal canal.
Although each of the natural elements in boric acid is instrumental in re-establishing a balanced vaginal environment, it is only when they are bonded together to form boric acid that their benefits truly shine.
Boron, with its antifungal and antimicrobial properties, can weaken the cell walls of the bacteria that cause BV and the overgrowing fungi that cause vaginal yeast infections. Curbing the growth of these harmful microbes encourages a healthier vaginal environment, where mildly acidic vaginal pH levels begin to re-stabilize.
The oxygen and hydrogen atoms in boric acid also help restore the ideal vaginal pH, which further supports the growth of lactobacilli, thereby re-establishing a balanced and protected vaginal microbiome.
These improvements in vaginal pH and the vaginal microbiome can not only quickly ease the uncomfortable symptoms of yeast infections and BV, they can also prevent recurring infections.
Does Boric Acid Clear BV and Yeast Infections?
What’s important to note about boric acid suppositories is that even though they help restore the vagina to full health after infection, they sometimes don’t cure a yeast infection or BV on their own. Although boric acid suppositories help weaken the cell walls of harmful microorganisms, antibiotics or antifungal medication are often required to destroy the overgrowth.
Are There Side Effects to Boric Acid Suppositories?
When using boric acid suppositories, some women may experience a mild tingling or drying sensation. Although it’s rare, women with severely sensitive vaginal skin can experience spotting or light bleeding from using boric acid suppositories. This could also occur for women who suffer from vaginal dryness and experience microtears during intercourse.
Allergic reactions are also rare, but they can happen and typically result in an intense burning sensation, vaginal swelling, or a rash.
While mild tingling and a slight sense of vaginal dryness can be expected and easily eased, intense symptoms like burning, inflammation, or an itchy rash are symptoms you should have checked by your gynecologist or healthcare provider.
Spotting or light bleeding could mean your body needs time for microtears or sores to heal. However, if it continues, it’s wise to have it checked.
Boric acid suppositories should never be ingested orally, used during pregnancy, or when open wounds are present on the skin that comes in contact with boric acid.
Conclusion
Even though The Honey Pot and AZO are well-recognised brands, some women experience irritation from using their boric acid suppositories due to added ingredients like aloe vera, cocoa butter, and tea tree oil. They may sound like soothing ingredients; however, the vaginal is a particularly sensitive body part, and clinical research shows boric acid is best delivered pure rather than blended.
For 100% pure boric acid suppositories, look no further than Intimate Rose, who also use vegan capsules for faster dissolving and quicker 24-hour relief. If boric acid suppositories cause mild vaginal tingling or drying, which they sometimes do, the 100% natural Enchanted Rose Vulvar Balm can be used for soothing between boric acid applications.
If boric acid suppositories cause severe burning, pain, spotting, or bleeding, stop using them and consult with a healthcare provider.
References
Centers for Disease Control and Prevention - About Bacterial Vaginosis - https://www.cdc.gov/bacterial-vaginosis/about/index.html
Office on Women's Health – Vaginal Yeast Infections - https://womenshealth.gov/a-z-topics/vaginal-yeast-infections
National Institutes of Health - Vaginal pH Value for Clinical Diagnosis and Treatment of Common Vaginitis - https://pmc.ncbi.nlm.nih.gov/articles/PMC8618584/
Biospace - pH-D Feminine Health Launches First FDA-Cleared Phase 3 Clinical Trial for Boric Acid Suppositories - https://www.biospace.com/press-releases/ph-d-feminine-health-launches-first-fda-cleared-phase-3-clinical-trial-for-boric-acid-suppositories
Centers for Disease Control & Prevention - Vulvovaginal Candidiasis (VVC) - https://www.cdc.gov/std/treatment-guidelines/candidiasis.htm
American College of Obstetricians and Gynecologists - Vaginitis in Nonpregnant Patients
ACOG Practice Bulletin – https://journals.lww.com/greenjournal/abstract/2020/01000/vaginitis_in_nonpregnant_patients__acog_practice.49.aspx
National Institutes of Health - Clinicians’ use of Intravaginal Boric Acid Maintenance Therapy for Recurrent Vulvovaginal Candidiasis and Bacterial Vaginosis - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878170/
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.