Topical Preparations for Treating Vulvovaginitis

Sitz Baths, Peri-Washes, and Suppositories

The most common forms of topical applications used in the treatment of vulvovaginitis are sitz baths, peri-washes, and suppositories. Instructions for each of these preparations are found in Chapter 3.

Sitz baths may be done either in the bath tub with the water filled to hip height or in a purchased sitz bath, which is a small basin that fits over the bowl of the toilet and which may be purchased at most pharmacies. When prepared with anti-inflammatory and antimicrobial herbs, they provide a soothing relief to vulvar / urethral irritation. The bath water and herbs should be used only once, and prepared fresh each time. The water may be hot or tepid, according to the patient’s comfort.

For a Soothing Sitz Bath: Combine equal parts of dried thyme, calendula, lavender, and uva ursi leaf. Place one ounce of the herb blend into a quart glass jar or pot with a close fitting lid. Cover with 1 quart of boiling water, close the vessel, and steep for 30 minutes. Strain the entire contents into a sitz bath filled with water to the desired level. Add 2 tablespoons of sea salt per bath and soak. Repeat up to twice daily for 2 weeks.

Peri-rinses provide an excellent alternative to sitz baths if there is a lack of time to soak, and also make a soothing, antiseptic rinse after using the toilet. They can be done anytime during the day if vulvar itching or irritation becomes uncomfortable (or unbearable as some women find it does!). The same infusion described for sitz baths can be used to fill peri-bottles, small, pointed-top squeeze bottles also available at most pharmacies. The peri-bottle can be kept filled and left near the toilet. Add 1 tsp of sea salt to each bottle. Use as frequently as needed, patting dry after each rinse.

Suppositories prepared with a blend of herbs specific for vulvovaginitis can provide effective, soothing relief, heal tissue, and have antiseptic action. They can either be custom purchased through naturopathic pharmacies, or must be made by the practitioner or the patient. Although this may cause some inconvenience, they can be prepared in large batches and kept in the freezer for many months and the refrigerator for many weeks, ready for use.

An effective suppository blend for bacterial vaginosis and candidiasis includes a vulnerary herb, antimicrobial herbs, and a demulcent herb in a base of cocoa butter and coconut oil. The following is a highly reliable formula:

  • 1 cup cocoa butter ΒΌ cup coconut oil
  • 3 tbs calendula oil
  • 2 tsp thyme oil
  • 1 tsp lavender oil
  • 4 tbs marshmallow root powder finely ground
  • 2 tbs goldenseal root powder

Suppositories are applied nightly for 7 to 14 days. It is advisable to wear a light pad and old underwear while sleeping because the suppository will melt at body temperature. The oils and herbs may stain bedding or clothes.