When I mentioned I would be taking questions for a weekly column, several people asked about Good Clean Love’s Vaginal Suppositories. As this product has also generated a lot of questions recently via DM on Instagram, I thought it deserved a deep dive.
The name should be Scampository.
What Is It?
On their website Good Clean Love claims their Bio.pHresh® Vaginal Homeopathic Suppositories help “relieve symptoms related to bacterial vaginosis, including itching, irritation, vaginal odor, or abnormal discharge” and “promotes urinary tract health.” They also claim it will help “maintain a healthy vaginal pH.”
There are no clinical trials of this product, meaning there is zero data to support these assertions.
What is Bacterial Vaginosis?
Bacterial vaginosis or BV is a common cause of vaginal discharge, irritation and odor and is associated with a disturbance in the vaginal microbiome. BV is more than an annoyance, women with BV are at increased risk for acquiring HIV, gonorrhea, chlamydia, and genital herpes if exposed. BV is also associated with serious pelvic infections as well as complications after abortion and hysterectomy, and with premature delivery.
While BV responds well to antibiotic therapy, there is a high recurrence rate — up to one-third of women with BV can have a recurrence in 3 months and by 12 months that number rises to about 50%. Even though there is a lot of research in this area, BV remains poorly understood. The underlying issue with BV appears to be a problem with the vaginal microbiome, meaning the vaginal bacteria are not reducing the pH sufficiently and/or producing enough of the substances that keep harmful bacteria in check.
What’s in the suppositories?
This is what’s listed on the website:
The “active” ingredient in Good Clean Love’s Bio.pHresh® Vaginal Homeopathic Suppositories are homeopathic. Homeopathy rests on the principle that “like treats like” and “less is more.” The theory is that the active ingredient in any homeopathic treatment is diluted so much that the few molecules remaining (that is if any remain) are more potent than the original. This is due to the belief that the “memory” of the original substance remains. In addition, the concept that “like treats like” means that, for example, saliva from a rabid dog can be diluted and subsequently used as a remedy for children with anger issues. Get it, because rabid dogs are angry, their saliva can be used to treat anger. I am not making this up.
If you have been using homeopathic remedies because you thought they were natural, and never really read into the details of what those little pills under your tongue are all about, you are not alone. That is the allure of homeopathy. It is presented as “natural” which sounds very appealing, but once you read what it is actually all about, it also makes no sense. So if you reread the previous paragraph, and are thinking, WTF, that can’t be right!? Then think again. Homeopathy not only doesn’t make scientific sense, it doesn’t even make common sense. But the big homeopathic brands (and make no mistake, this is a huge industry) are hoping you never do any research into how it is supposed to work, or never read an article like this one.
No study has shown homeopathy works for any condition and the principle of dilution is not consistent with the laws of chemistry and physics. The homeopathic ingredients in Good Clean Love’s Bio.pHresh® include the following:
Kreosotum, according to HomeopathyPlus! is beechwood creosote. You can read all about its toxicity here at the US Department of Health and Human Services Public Health Service Agency for Toxic Substances and Disease Registry. I have no idea how a hazardous product created by high-temperature treatment of beechwood is like a vagina with bacterial vaginosis. But hey, I’m willing to learn.
Nitricum Acidum, although you might be more familiar with its grown up name, nitric acid. It’s very toxic if inhaled and is also quite corrosive. Also, not sure how this fits in with the whole “like treats like” thing either. Apparently it’s a “remedy” for “offensive discharges.”
Thuja Occidentalis, which I gather is some part of a white cedar tree
Pulsatilla Vulgaris, a flower which is apparently good for almost everything from car sickness, to shifting leg pain, to PMS.
Sepia Officinalis, which is juice or extract from a cuttlefish. Yes, juice of cuttlefish is used to treat your vagina. Remember, “Like treats like.”
These ingredients are listed as a 6C dilution, that is one part in one trillion if I did the math right, meaning the ingredients are so diluted as to be undetectable. Let’s repeat that, Good Clean Love wants you, the consumer, to believe that they have managed to dilute these substances so the few active ingredient molecules that remain are so diluted they will not harm you, but at the same time are so potent that they will successfully hack your vaginal microbiome. All for for $1.49 a capsule.
The Inactive Ingredients
Inactive ingredients typically means inert ingredients — the stuff brought along for the ride so the active ingredients stay active and are dispersed in a way that they reach their target tissues. In a surprising twist, probiotics are listed on the website as an inactive ingredient. But probiotics are an active ingredient, that is why we are studying them to see if they can be helpful in preventing BV. I am not sure if listing probiotics as an inactive ingredient was a way to skirt FDA regulations or perhaps they don’t know what an inactive ingredient means?
The idea that probiotics, meaning live beneficial bacteria like those found in the vagina (such as lactobacillus crispatus, lactobacillus rhamnosus, and lactobacillus reuteri, etc), could be used to help with BV is an active area of research. Unfortunately, so far the results have been underwhelming. The last Cochrane Review on the subject in 2009 concluded the following. “The results do not provide sufficient evidence for or against recommending probiotics for the treatment of BV.” Most studies published since then have not produced any dramatic or meaningful results, largely due to the lower quality of the studies.
One recent quality study in the New England Journal of Medicine looked at lactobacillus crispatus administered vaginally (one of the ingredients in Good Clean Love). Women with bacterial vaginosis received standard antibiotic therapy and then were randomized to the vaginal probiotic lactobacillus crispatus or placebo. At 12 weeks the rate of recurrence for BV was 30% in the probiotic group and 45% in placebo. So not a knock out of the park, but perhaps a piece of the puzzle.
It’s important to point out that this study in the NEJM I just referenced in no way supports the use of Bio.pHresh®. The study confirmed the diagnosis of BV, there was active treatment with antibiotics, and there was only one ingredient, the lactobacillus crispatus. You can’t compare a tested product with a single ingredient with an untested product with multiple other ingredients.
Low quality studies aside, the other reason that we have not made a lot of traction with probiotics and BV is the vaginal microbiome is very complex. There are 5 community states of vaginal bacteria — meaning a woman can have one of 5 different vaginal microbiomes or groupings of bacteria. Might one community state respond better to probiotics than others? Then there are other factors, such as the ecosystem is dynamic and we don’t even really know what we should be replacing. Then there is the issue that a significant percentage of probiotics don’t contain the bacteria colonies that they claim.
It could hurt you
Medically-speaking, the way a person should relieve symptoms of bacterial vaginosis is not with an untested over-the-counter product, but rather they should see a medical provider to get a correct diagnosis and a prescription of antibiotics. BiopHresh® claims it treats symptoms of bacterial vaginosis but does not claim it treats the actual condition bacterial vaginosis itself. Do most consumers notice the careful choice of language? Might someone use this product and delay appropriate therapy as they mistakenly believed it could treat BV? What if they are then exposed to a STI?
As I detailed in a previous post, many studies show untested vaginal products can be harmful, even cleaning intravaginally with water. Good Clean Love should not be given the benefit of the doubt that this suppository is safe for the vagina.
Finally, many so-called natural products are adulterated, so you are taking the word of a company that believes in homeopathy that their product contains what it claims and nothing else.
Give these Scampositories a Pass
It’s not surprising to see companies selling homeopathic products for the vagina, it seems everyone wants a piece of the $1.2 billion homeopathic market. Add that with the money to be made in vaginal shame, plus the fact that recurrent BV is a complex condition and many women are desperate for solutions, and you’ve got a gold mine.
Women who think they have BV should see a health care provider so they can get the right diagnosis (BV has identical symptoms to the sexually transmitted infection trichomonas) and treatment. If they have recurrent BV they should see a provider who is knowledgeable in that area.
What about taking probiotics? I no longer recommend them given the low quality of available data, the lack of improvement that I’ve seen with these products, and the cost — some of them are $30-60 a month. If any company can produce quality data, show me and I would eagerly recommend a product that has proven benefits. However, I can’t ask desperate patients to spend large amounts of money on hypotheses and unproven products.
There is no proof that Good Clean Love’s Bio.pHresh® Vaginal Homeopathic Suppositories can help, and frankly, anything that is homeopathic is based on a scam. So think of this not as a vaginal homeopathic suppository, but a vaginal scampository. And I would never recommend trusting your health to a company or a provider that believes in homeopathy.
Women deserve medicine, not magic.