Patterns of Intravaginal Boric Acid and Probiotics Use Among Patients With Chronic Vulvovaginal Symptoms

The study aimed to assess the use of boric acid and probiotics among patients treated at a tertiary care vulvovaginal health center.

The authors conducted a cross-sectional survey of 206 new patients from October 2024 and January 2025. Participants completed a questionnaire on demographics, vulvovaginal history, self-treatment practices, and a Vulvar Quality of Life Index. Descriptive statistics, bivariate analyses, multivariable logistic regression, and subgroup analyses were performed.

Fifty percent of participants reported use of boric acid, and 61.2% used probiotics. Only 2.9% used boric acid for the CDC guideline-recommended duration of >21 days. Among those with vulvovaginal candidiasis or bacterial vaginosis, 62.3% and 55.9%, respectively, reported prior boric acid use. Patients learned about boric acid and probiotics from healthcare providers (63.4% and 55.8%, respectively), followed by social media (29.0% and 24.2%). Primary treatment goals included pH balance, symptom relief, and treating infections. Patients spent an annual average of $397 on their condition, with an average of $23 on boric acid and $9 on probiotics. Higher Vulvar Quality of Life Index scores ( p = .042) and being single ( p = .015) were independently associated with boric acid use.

Boric acid and probiotics are widely used among patients with vulvovaginal conditions requiring tertiary care, almost always with unsupported reasons. Although nearly half of the respondents received treatment recommendations from providers, few reported use aligned with clinical guidelines. Given the significant financial burden and extensive misinformed use, there is a critical need for improved patient education and evidence-based counseling to prevent reliance on ineffective or misleading therapies.