Dr. Lissa Rankin's medical blog is based on her upcoming book What's Up Down There? Questions You'd Only Ask Your Gynecologist If She Was Your Best Friend, which you can preorder here. If you have a question you'd like Dr. Lissa Rankin to answer in her blog, please join the What's Up Down There posse in our Owning Pink community, or contact us.

Q: Every summer I experience at least one bout of bacterial vaginosis. Antibiotics usually knock it out, but I’d rather avoid the whole ordeal. I went searching online for a remedy and found a message board where women were talking about a vaginal product called Aci-Jel. Apparently it cures chronic BV by creating an acidic environment where bacteria can’t survive. Could this cure work for me?

Oooh. The dreaded bacterial vaginosis (BV), which lent someone I know the not-so-nice nickname of “Tina the Tuna.”  Yes, antimicrobials like metronidazole and clindamycin are effective at eradicating BV, but unless the underlying issues are addressed, it can creep back up, especially in the summertime, when we’re hanging out in wet bathing suits. 

BV arises whenever the vaginal pH rises, as the normally acidic vaginal environment becomes more alkaline.  Because good bacteria (lactobacillus) like an acidic vagina and bad bacteria (Gardnerella vaginalis) don’t, anything that acidifies the vagina- such as Aci-Jel- would seem like an effective strategy for prevention, but clinical data to support its use is limited.  A better way to help naturally support healthy vaginal flora is to avoid douching, have your partner wear condoms during sex, and take probiotics. 

Another option is boric acid suppositories, which can be found at compounding pharmacies and health food stores.  Research shows that boric acid in the vagina traps ammonia, a natural component of the vaginal ecosystem that infectious bacteria would otherwise use for fuel. Many who suffer from recurrent bacterial vaginosis find relief with a 14 day course of boric acid suppositories, so talk to your doctor.

Know that you're not alone, love -- summertime can be a doozy down there and I get this question all of the time.  Sending you healing!