Suppositories, what’s the deal?

People look a little shy when talking about vaginal suppositories, but the truth is; they are well studied, highly effective & nothing to be scared of. So let’s break it down.

Suppositories are medications designed to be inserted directly into the rectum or vagina. Suppositories have been around for a long time in mainstream medicine and are particularly beneficial for treating localised issues. In this blog, we will specifically be discussing the uses and benefits of vaginal suppositories.

How do they work? Suppositories are usually solid, small and oval or bullet shaped, consisting of compacted medication, sometimes with an easy-to-dissolve protective coating such as gelatine. Suppositories can also be a cream or liquid, inserted with an applicator. The suppository is broken down, melted and absorbed by the tissue inside your vagina. Depending on the contents, suppositories get to work modulating the vaginal environment via different mechanisms.

What are they used for? Vaginal suppositories can be used to treat or manage local conditions such as Bacterial Vaginosis, Thrush, pelvic pain, some STIs & vaginal dryness/atrophy. Vaginal suppositories can also be used as a preventative treatment, by helping to maintain an optimal vaginal microbiome which works as a protective barrier against infection. As they are dissolved in the vaginal canal, majority of the action is seen there, however a portion will be absorbed into the body via peripheral circulation and work systemically to address the issue.  Here are some examples of common suppositories and their uses.

Probiotics, specifically, the Lactobacillus strains, are used in cases of dysbiosis, recurrent infections & post-STI treatment. This helps to supplement depleted beneficial bacteria which play the most pivotal protective role in vaginal health.

Boric acid is used in cases of recurrent infections and candida overgrowth. Boric acid restores the acidic environment of the vagina, preventing the growth of undesirable bacterium, funghi and helping to prevent STIs. Normally, Lactobacillus species produce enough lactic acid to keep the vaginal environment naturally acidic (with an optimal pH range of around 3.6-4.5), however in some instances where lactobacillus levels are depleted, boric acid may be useful until balance is restored.

Pain relief, there are some suppositories on the market that are designed to give relief for conditions such as chronic pelvic pain, endometriosis, severe period pain and pelvic floor dysfunction. They typically consist of drugs Diazepam or Valium. CBD suppositories are also hitting the scene as an alternative.

Naturopathic suppository creams/flushes. Some naturopaths prescribe creams or flushes containing specific liquid herbs, vitamins and acids to address issues such as vaginal dryness & atrophy (typically experienced during menopause) and to rid any undesirable bacterial presence. Typically, these treatments come with an applicator for easy use.

What’s the benefits? Because suppositories bypass the digestive system and are absorbed directly in the vagina, they provide relief at the source of the issue and can get to work much faster.

Several studies on Bacterial Vaginosis, vaginal dryness and vulvovaginal candidiasis have found suppositories to be just as, if not more effective than oral treatments, especially when it came to post-treament outcomes (check out references below for some great studies). This is particularly significant as many of these conditions have high recurrence rates (50% for BV with antibiotic treatment!!!), so finding effective long-term treatments is a huge win for women’s health.

Safety concerns? Suppositories are very safe when used correctly. Most studies conducted on vaginal suppositories have reported zero negative side effects. It’s important to ensure your hands are clean before using and to seek guidance from your healthcare professional upon prescription if you are unsure of how to properly insert the suppository or the frequency of which it should be used. Factors such as pH, where you are in your cycle and vaginal fluid will affect how quickly a suppository is broken down. Never insert a medication that isn’t labelled as a suppository. Sometimes increased vaginal discharge may be observed after use of a suppository, this is usually nothing to be concerned about and is just some excess contents leaking out. Wearing a light pad & inserting the suppository before bed may help reduce this. Speak to your health professional if you are at all concerned about this.

Much love,

Floozy <3 xx

References

Costantino, D., & Guaraldi, C. (2008). Effectiveness and safety of vaginal suppositories for the treatment of the vaginal atrophy in postmenopausal women: an open, non-controlled clinical trial. European Review for Medical & Pharmacological Sciences, 12(6).

Homayouni, A., Bastani, P., Ziyadi, S., Mohammad-Alizadeh-Charandabi, S., Ghalibaf, M., Mortazavian, A. M., & Mehrabany, E. V. (2014). Effects of probiotics on the recurrence of bacterial vaginosis: a review. Journal of lower genital tract disease, 18(1), 79-86.

Murina, F., Graziottin, A., Vicariotto, F., & De Seta, F. (2014). Can Lactobacillus fermentum LF10 and Lactobacillus acidophilus LA02 in a slow-release vaginal product be useful for prevention of recurrent vulvovaginal candidiasis?: a clinical study. Journal of clinical gastroenterology, 48, S102-S105.

Sarebani, Z., Alimoradi, Z., Aali, E., Mirzadeh, M., Chegini, V., Abbaspour, M., & Griffiths, M. D. (2020). Investigating the effect of vitamin D vaginal suppository on sexual function among postmenopausal women: study protocol for a randomized controlled trial. BMC Women's Health, 20, 1-8.

Danaboina, S. (2024). A Review on Suppositories and Application of Vaginal Drug Delivery System. UPI Journal of Pharmaceutical, Medical and Health Sciences, 22-28.