Bacterial vaginosis (BV) is a common but often uncomfortable condition that can significantly affect quality of life. While it is a sensitive topic, it’s important to speak openly and professionally about it so those affected can access the right treatment and support. At National Custom Compounding, we regularly receive requests for assistance from patients who have found little relief from standard treatment options.
This fact sheet includes:
BV occurs when there is an imbalance in the natural bacteria within the vagina. A healthy vaginal environment contains a balance of “good” bacteria that help maintain a slightly acidic pH. When this balance is disrupted, symptoms such as unusual discharge, odour, and discomfort can occur.
While antibiotics are often the first line of treatment prescribed by doctors, they are not always a perfect solution. This is because antibiotics can also kill the beneficial bacteria that help maintain vaginal health. This loss of balance can sometimes lead to recurring symptoms.
When conventional treatments fail or cause unwanted side effects, compounded medicines can offer a personalised alternative. One of the most common compounded products for BV is boric acid in capsule or pessary form.
Boric acid has been safely used for many years and works locally in the vagina, meaning it does not affect the rest of the body. It helps restore balance by making the environment less hospitable to problem bacteria, while also providing mild antifungal and antibacterial effects. Treatment is typically done at night to allow the medicine to work uninterrupted.
Because boric acid is a prescription-only medication in Australia, patients must first consult their doctor before obtaining it from a compounding pharmacy.
In addition to prescription treatments, there are other ways to support vaginal health:
Compounding pharmacies like National Custom Compounding can create tailored formulations that may not be available in standard pharmacies. This allows for more targeted and personalised treatment, especially in persistent or recurring cases.
If you suspect you have BV, it is important to see your GP for an accurate diagnosis and to discuss treatment options. With the right medical advice and a customised approach, you can find relief and improve your vaginal health.
If you have questions about boric acid or other compounded options, our team at National Custom Compounding is here to help guide you through the process.
About the Author
This article was written by Matt Bellgrove, Founder and Compounding Pharmacist at National Custom Compounding. With years of experience helping patients access personalised medicine, Matt is passionate about finding solutions when standard treatments aren’t enough.
Hi, I’m Matt. I’m the founder and one of the pharmacists here at National Custom Compounding. I wanted just to chat to you about bacterial vaginosis. It is obviously a very sensitive topic, so I want to be as respectful as I can and professional as I can as a pharmacist.
It’s something that we get a great deal of number of requests for in an average week at NCC. I think that predominantly happens because it’s one of those situations where it can cause someone a great amount of discomfort, and it is difficult to find a solution if traditional over-the-counter solutions fail.
Also, sometimes you find that general types of antibiotics or prescriptions, even though they’re normally the first port of call, may not provide the resolve or the solution that a patient requests. So that is what we at National Custom Compounding do. We can make a great deal of medicines for patients who are in situations where a typical medicine may not have done what it needs for them.
So, what is BV? It is basically that balance of bacteria in the vagina that, when not balanced properly and when there is no homeostasis, the disruption can lead to discomfort, discharge, and other symptoms like odour. It is a very sensitive topic, like I said to start with, so the goal really is to improve the microbiome.
Traditionally, antibiotics have been used by prescribers to treat it. The challenge with antibiotics, as you have probably seen, is that they are not specific enough to just kill the bacteria causing the problem. They could kill the good bacteria, which help maintain that homeostasis.
There are a few other natural or alternative options that could be considered by a patient to improve the conditions. Here in our compounding pharmacy, one of the big ones we see regularly is a product called boric acid. It is in a capsule form and has been one of the most common compounded products for a long, long time. It is very safe.
The capsule or pessary is inserted, and that insertion means the effect only works locally. What it does is reduce the natural acidic environment, which makes it more difficult for problem bacteria to grow. It has antifungal and slightly antibacterial properties. Because of its safety record and long history, it is generally well tolerated.
One of the things to overcome is just being familiar with how to insert the pessary. Normally it is used at night so it works overnight. Using it in the morning can disrupt its effect in the local area.
There are other options too. Some companies produce probiotics specifically for this type of imbalance. They can help repopulate the healthy bacteria in the vagina, which supports homeostasis and returns it to its normal state. Probiotics can be used orally or intravaginally.
Lifestyle tweaks can also make a difference. This might include choosing breathable rather than synthetic clothing, or reviewing whether other medications a person is taking could be contributing to discomfort or disruption.
I just wanted to bring it all together to share that compounding pharmacies like ourselves are highly skilled in putting together formulations like this one, which may not exist in mainstream medicine or mainstream pharmacy, to give a patient a benefit that they really need.
To wrap things up, BV can be very uncomfortable and frustrating in many cases. With the right advice and a bit of personalised therapy, speak to your GP. We can certainly be a pharmacy there to assist you along the way.
Boric acid is a prescription-only medicine. You do need to talk to your doctor about using it, and you will need to present a script to a compounding pharmacy. If you have got any questions, feel free to reach out to our team. Otherwise, I hope this was informative and helpful. Thanks so much.