Over-the-counter and alternative medicines in the treatment of chronic vaginal symptoms

OBJECTIVE: To investigate the use of over-the-counter and alternative medicines in women with chronic vaginal symptoms. METHODS: One hundred five patients, referred by their gynecologists for evaluation of chronic vaginal symptoms, were interviewed about their use of over-the-counter and alternative medicines during the preceding year, the amount of money spent on each, and whether or not their physicians had been informed of these treatments. RESULTS: The mean age was 36 years, and one-half had finished college. The median symptom duration was 2 years. Seventy-seven (73. 3%) patients had self-treated with over-the-counter medications such as miconazole (74% of over-the-counter users), clotrimazole (38. 2%), or povidone-iodine (13. 2%). The median expenditure for over-the-counter use was %0 (range 2-1000). Forty-four (41. 9%) had used alternative medicines, most frequently acidophilus pills orally (50%) vaginally (11. 4%), yogurt orally (20. 5%) or vaginally (18. 2%), vinegar douches (13. 6%), and boric acid (13. 6%). The median expenditure for alternative medicines was 35 (range 0-1200). Fewer physicians were aware of the use of alternative (70. 5%) that of over-the-counter medicines (88. 3%). Although most patients thought that vulvovaginal candidiasis was the cause of their symptoms, the most common diagnoses at initial presentation were candidiasis in 29 (27. 6%), vulvar vestibulitis in 18 (17. 1%), irritant dermatitis in 16 (15. 2%), and bacterial vaginosis in 11 (10. 5%). Women who actually had candidiasis were more likely to have used alternative medicines (odds ration 2. 31, 95% confidence interval 1. 00, 5. 42) than other patients. CONCLUSION: Women with chronic vaginal symptoms often use over-the-counter and alternative medicines that add to health care costs and are unlikely to be of benefit.