Activated charcoal as an effective treatment for bacterial vaginosis (2022)


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Personalized Medicine Universe

Volume 1, Issue 1,

July 2012

, Pages 54-57

Author links open overlay panelKunihikoTominagaaPersonEnvelopeShigehiroSatobEnvelopeMasayukiHayashic

(Video) The Most Powerful Candida Infection (Yeast Infection) Killer – Dr. Berg



Bacterial vaginosis is one of the most common infectious disorders that affect women of reproductive age. For many years, antibiotics have been used for the treatment of this infection. However, antibiotics may adversely affect the normal vaginal bacterial flora. Therefore, development of treatments without adverse effects is urgently required. The aim of this study was to evaluate the efficacy of activated charcoal in the treatment of bacterial vaginosis, and to estimate the changes of lactobacilli in the vagina.


1) An unblinded prospective randomized controlled 10-day trial was designed. This study included 64 women, aged 18–37 (mean age, 28 years) with newly diagnosed bacterial vaginosis. Bacterial vaginosis was diagnosed using the Amsel criteria. The subjects with complete lack of vaginal lactobacilli at baseline (6/70) were excluded from the study. Patients with bacterial vaginosis were divided in two groups, one group was treated with trans-vaginal tampons containing a 10% solution of activated charcoal, the other one as a control received a chloramphenicol (100mg) vaginal suppository.


1) In the group treated with chloramphenicol, lactobacilli were completely lost in 84.3% of the subjects (27/32), whereas only 3.1% (1/32) of the subjects treated with activated charcoal showed this loss; the difference was statistically significant (Fisher's exact test). 2) Both treatments successfully reduced the amount of vaginal secretion. 3) Both treatments showed significant improvements in the magnitude of malodor.


In the present study, a novel treatment with activated charcoal tampons showed remarkable improvements of the symptoms of bacterial vaginosis. This approach is a potentially promising treatment for this infection without adverse effects.


Bacterial vaginosis is one of the most common infectious disorders that affect women of reproductive age [1]. However, there are few epidemiologic studies of this infection. Shimano etal. examined 6083 pregnant women, and reported that the prevalence of bacterial vaginosis increased from 13.6% in 1993 to 21.4% in 2000 in Northern Japan [2].

In recent years, there has been growing public concern regarding bacterial vaginosis, because of its association with numerous health problems, including preterm birth [3], [4], pelvic inflammatory disease [5], [6], and susceptibility to HIV infection [7].

Although the causes of bacterial vaginosis are yet to be fully explored, it is known that women who have never been sexually active are rarely affected. On the other hand, the infection is associated with having multiple sex partners and douching; however, it is unclear whether it is a sexually transmitted disease.

The human vagina is a dynamic and complex microbial ecosystem in which the dominance of Lactobacillus species plays an important protective role in maintaining its health. It is widely accepted that microbial alteration in the vaginal flora is a major cause of bacterial vaginosis. A number of studies also reported that lack of vaginal lactobacilli is an important risk factor of bacterial vaginosis.

Clinically, bacterial vaginosis is a syndrome resulting from replacement of Lactobacillus species in the vaginal flora with high concentrations of anaerobic bacteria (e.g., Gardnerella vaginalis, Bacteroides sp., Prevotella sp., Mobiluncus sp., and Mycoplasma hominis). Among the Lactobacillus species, H2O2-producing Lactobacillus sp. play an important role in maintaining the normal vaginal bacterial flora because hydrogen peroxide (H2O2) can be toxic to organisms (e.g., G.vaginalis, Bacteroides sp.) that produce little or no H2O2-scavenging enzymes (e.g., catalase). Their absence could allow an overgrowth of catalase-negative organisms, such as those found in women with bacterial vaginosis [8]. Eschenbach etal. showed that H2O2-producing Lactobacillus sp. were found in 27 out of 28 normal women (96%) and 4 out of 67 women with bacterial vaginosis (6%), suggesting that the production of H2O2 may represent a nonspecific antimicrobial defense mechanism of the normal vaginal ecosystem [9]. Recent studies have also suggested that certain strains of H2O2-producing vaginal lactobacilli are able to inhibit the adherence of G.vaginalis to the vaginal epithelium and/or produce H2O2, lactic acid and/or bacteriocins, which inhibit the growth of bacteria causing vaginosis [10]. In summary, there seems to be an association between the absence or low concentrations of vaginal lactobacilli and the development of bacterial vaginosis.

The most common symptom of bacterial vaginosis is an excessive white-gray vaginal discharge with an unpleasant odor (especially after sexual intercourse). This malodorous discharge coats the walls of the vagina, but does not cause irritation. However, up to 50% of women with bacterial vaginosis may not be diagnosed as having the infection.

For the treatment of bacterial vaginosis, several antibiotics have been introduced such as metronidazole or clindamycin, given either orally or vaginally. In Japan, the treatment is based on the use of chloramphenicol given trans-vaginally. However, antibiotic treatment may affect the normal vaginal bacterial flora. Metronidazole and clindamycin are effective, but negatively affect the growth of Lactobacillus and therefore causes a higher risk of recurrences [11]. Introduction of treatments without antibiotics are urgently required.

For centuries natural charcoal has been used for the treatment of ailments and injuries [12]. Activated charcoal has also a role in the management of overdosed patients and is useful for the removal of bacteria and bacterial toxins [13], [14], [15], [16]. Routinely administered to reduce the gastrointestinal (GI) absorption of many drugs, repeated doses of charcoal have been shown to enhance drug elimination [17].

Nakata etal. analyzed the adsorption properties of activated charcoal on verotoxin-producing Escherichia coli, and showed that the adsorption was dose dependent. They also found that activated charcoal had lower binding capacity to Lactobacillus acidophilus [18].

Activated charcoal is a form of carbon produced from nutshells and wood chips, that has been processed to make it extremely porous and have a large surface area for adsorption. Due to its high degree of microporosity, just 1g of activated charcoal has a surface area of approximately 500m2. The structure of activated charcoal is constituted by various types of micropores and it can bind and absorb substances larger than the carbon particles.

We hypothesized that activated charcoal is an effective means for maintaining a predominance of Lactobacillus sp. in the vaginal flora and preserving a healthy microbial ecosystem.

Section snippets

Diagnostic criteria

Bacterial vaginosis was diagnosed using a speculum examination and subsequent swabs from the vagina. After exposing the vagina with a sterile non-lubricated vaginal speculum, samples were obtained by rotating a sterile cotton swab. These swabs should be also tested for the following (1): An excessive white-gray vaginal discharge (2): A characteristic “fishy” odor on wet mount. This test, called the whiff test (amine test), is performed by adding a small amount of potassium hydroxide (10% KOH)


The rise in vaginal pH interferes with the acidity of the lactobacilli that maintain vaginal acidity. Table1 shows the changes of vaginal pH after the two treatments. The activated charcoal group showed a significant reduction of the pH after treatment (p=0.002, paired t test, two-tailed), while the chloramphenicol group did not show any significant change (p=0.389). In contrast, we found that both treatments significantly improved the amount of vaginal discharge (Table2) and reduced the


Several attempts have recently been made to treat bacterial vaginosis using natural substances, such as yogurt and dietary supplements, which are acidic and also contain Lactobacillus strains. Ya etal. reported that short-term probiotic prophylaxis reduces the recurrence of bacterial vaginosis [22]. It is, therefore, recommended to introduce probiotics to prevent infections and in addition to antimicrobial treatments [23]. Moreover, Petersen etal. conducted a randomized, double-blinded


Although conventional treatments with antibiotics are effective in the short-term relief of the symptoms of bacterial vaginosis, they might have devastating effects on the normal bacterial flora. Therefore, non-antibiotic alternative therapies, such as trans-vaginal supplementation of Lactobacillus or vitamin C, have been proposed.

In the present study, we proposed activated charcoal as a useful novel treatment for bacterial vaginosis [25].

Conflict of interest

None of the authors have personal or financial conflicts of interest to declare.


References (25)

  • W. Ya et al.Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study

    Am J Obstet Gynecol


  • J. Jones et al.Repetitive doses of activated charcoal in the treatment of poisoning

    Am J Emerg Med


  • M.E. Falagas et al.Probiotics for the treatment of women with bacterial vaginosis

    Clin Microbiol Infect


  • H.Y. Xu et al.Antagonistic potential against pathogenic microorganisms and hydrogen peroxide production of indigenous lactobacilli isolated from vagina of Chinese pregnant women

    Biomed Environ Sci


  • S.L. Hillier et al.Role of bacterial vaginosis-associated microorganisms in endometritis

    Am J Obstet Gynecol


  • H. Leitich et al.Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis

    Am J Obstet Gynecol


  • J. WangBacterial vaginosis

    Prim Care Update OB Gyns


  • S. Shimano et al.

    Analysis of the prevalence of bacterial vaginosis and Chlamydia trachomatis infection in 6083 pregnant women at a hospital in Otaru

    Japan J Obstet Gynaecol Res


  • S.L. Hillier et al.

    The role of bacterial vaginosis and vaginal bacteria in amniotic fluid infection in women in preterm labor with intact fetal membranes

    Clin Infect Dis


  • J.F. Peipert et al.

    Clinical predictors of endometritis in women with symptoms and signs of pelvic inflammatory disease

    Am J Obstet Gynecol


  • H.L. Martin et al.

    Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition

    JInfect Dis


    (Video) Why women need probiotics

  • D.A. Eschenbach et al.

    JClin Microbiol


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    Is charcoal good for bacterial infection? ›

    For centuries natural charcoal has been used for the treatment of ailments and injuries [12]. Activated charcoal has also a role in the management of overdosed patients and is useful for the removal of bacteria and bacterial toxins [13], [14], [15], [16].

    What is a natural cure for recurrent BV? ›

    One research review found that receiving Lactobacillus acidophilus, Lactobacillus rhamnosus GR-1, and Lactobacillus fermentum RC-14 at a dose of at least 10 billion CFU per day for two months helped treat BV and prevent its recurrence.

    What is the strongest treatment for BV? ›

    Metronidazole — Metronidazole vaginal gel is one of the most effective treatments; it is applied inside the vagina at bedtime for five days. Metronidazole can also be taken in pill form, 500 mg twice daily for seven days.

    Can activated charcoal treat infection? ›

    Skin infection. Around the world, many different traditional medicine practitioners use activated charcoal powder made from coconut shells to treat soft tissue conditions, such as skin infections. Activated charcoal may have an antibacterial effect by absorbing harmful microbes from wounds.

    How long does activated charcoal take to work? ›

    This usually takes about 30 minutes. Do not take this medicine mixed with chocolate syrup, ice cream or sherbet, since they may prevent the medicine from working properly. If you are taking any other medicine, do not take it within 2 hours of the activated charcoal.

    Why am I getting BV all the time? ›

    However, we do know the condition most often occurs in those who are sexually active. BV is a result of an imbalance of “good” and “harmful” bacteria in a vagina. Douching, not using condoms, and having new or multiple sex partners can upset the normal balance of vaginal bacteria, increasing your risk for getting BV.

    Why do I keep getting BV all of a sudden? ›

    Bacterial vaginosis is caused by a change in the natural balance of bacteria in your vagina. What causes this to happen is not fully known, but you're more likely to get it if: you're sexually active (but women who have not had sex can also get BV) you have had a change of partner.

    What cause BV to keep coming back? ›

    Predisposing factors. Several factors are known to increase the risk of BV, including younger age,5 black ethnicity,6 douching,7 smoking,8 and the IUD as contraception.

    How do you get rid of stubborn vaginosis? ›

    Your healthcare provider can treat BV with antibiotics; the most common ones prescribed are Metronidazole, Metronidazole gel, or Clindamycin cream. Dean points out that while on any treatment for BV, you should refrain from having sex, as intercourse and other kinds of sexual activity could lead to discomfort or pain.

    What herb is good for bacterial vaginosis? ›

    officinalis or metronidazole. C. officinalis was effective for the treatment of BV in women of reproductive age, without any side effects. This herb could be recommended for women of reproductive age who uncomfortable with the potential side effects of synthetic drugs.

    What can I buy over-the-counter to treat BV? ›

    One study looked at garlic supplements and found they may be just as effective as oral antibiotics for treating BV. Study participants took two 500 mg tablets containing garlic powder every 12 hours for seven days. This OTC treatment was found to be just as effective as antibiotics in treating BV.

    How long does bacterial vaginosis last? ›

    While the infection may go away on its own, most doctors use antibiotics to treat it. You may have been prescribed pills or vaginal cream. With treatment, bacterial vaginosis usually clears up in 5 to 7 days. Follow-up care is a key part of your treatment and safety.

    Why won't my BV go away with antibiotics? ›

    Within a month, antibiotics clear up to 85% of bacterial vaginosis cases, yet for over half of these patients, BV will return within 6 months. This is thought to be in part because the antibiotics don't fully eradicate the pathogenic microbes, leaving BV-associated bacteria to regrow in the vagina following treatment.

    Can I take activated charcoal every day? ›

    It's important to note that charcoal can interfere with the body's absorption process. Charcoal shouldn't be consumed every day or less than 90 minutes before or after nutrient-dense meals, prescription medications, or vitamins.

    When is the best time to use activated charcoal? ›

    When consumed in tablet or capsule form, activated charcoal absorbs bacteria in the intestines and can relieve bloating, discomfort and flatulence. It works by binding with by-products within the intestines that cause the discomfort and is best taken two hours before a meal or one hour after eating.

    Can you take activated charcoal and probiotics at the same time? ›

    No interactions were found between charcoal and Probiotic Formula.

    What are the side effects of activated charcoal? ›

    Activated charcoal is safe for most adults when used short-term. Side effects of activated charcoal include constipation and black stools. More serious, but rare, side effects are a slowing or blockage of the intestinal tract, regurgitation into the lungs, and dehydration.

    Can you take too much activated charcoal? ›

    Note: It is possible to overdose from taking too much activated charcoal, but it's unlikely to be fatal. However, you should seek immediate medical attention if you believe you've overdosed on activated charcoal. Overdosing could present as an allergic reaction, vomiting, or severe stomach pain.

    How does activated charcoal detox your body? ›

    Charcoal binds to poison in the gastrointestinal tract and stops it from being absorbed into the bloodstream. The toxins are then passed out of the body in the stool.

    What foods to avoid when you have BV? ›

    Avoid refined sugar, and limit your intake of high glycaemic index fruits such as bananas and citrus fruits. Foods that dehydrate the body, including alcohol and caffeine, and highly processed and “junk” foods, should be avoided.

    What happens if you have BV for too long? ›

    Most often, BV does not cause other health problems. However, if left untreated, BV may increase your risk for: Sexually transmitted diseases (STDs) like herpes, chlamydia, gonorrhea, and HIV. Pelvic inflammatory disease where BV bacteria infect the uterus or fallopian tubes.

    How do you know if you have chronic BV? ›

    Symptoms may include:
    1. Strong fishy or unpleasant vaginal odor, which may be stronger after sex or menstruating.
    2. Increase in vaginal discharge (about 50 percent of the time)
    3. Vaginal discharge that is thin in consistency and milky white or gray.
    4. Vaginal itching, burning or pain when urinating.

    Can stress and anxiety cause BV? ›

    Any change in your immune health—like stress—can impact your vaginal pH level, making a yeast infection and/or bacterial vaginosis more common.

    How do you keep your pH balanced? ›

    However, there are several natural remedies that can help you maintain a healthy pH balance in your body, including making changes to your diet and lifestyle.
    Natural remedies
    1. Follow a well-rounded diet. ...
    2. Stay hydrated. ...
    3. Consider using probiotics. ...
    4. Avoid harsh soaps and skincare products.
    28 Sept 2020

    Can certain foods cause BV? ›

    Researchers suggest that high fat intake, particularly saturated fat may increase vaginal pH, thereby increasing the risk of bacterial vaginosis. As you can see in the associated video Bacterial Vaginosis and Diet, most saturated fat in the American diet comes from dairy, desserts, and chicken.

    Is BV caused by poor hygiene? ›

    Bacterial vaginosis (BV) is caused by the overgrowth of the natural vaginal bacteria. BV is a common infection, especially among pregnant women. The cause of BV is not fully understood; it is not caused by poor hygiene.

    Can BV be cured permanently? ›

    Is there a cure for bacterial vaginosis (BV)? Yes, BV is usually curable with prescription antibiotics that can help readjust the balance of bacteria in the vagina.

    Does chronic BV ever go away? ›

    Some women suffer from chronic (recurring) bacterial vaginosis. Medicine can clear up the infection, but it returns again after a few weeks. Some women report that bacterial vaginosis returns after their period each month. Or it can return after they have sex.

    What kills BV biofilm? ›

    Conventionally, BV is treated with metronidazole, clindamycin or tinidazole (Centers for Disease Control and Prevention, 2015). Presently, metronidazole is considered to be the drug of choice for BV treatment (Centers for Disease Control and Prevention, 2015).

    What does BV smell like? ›

    BV is a bacterial infection that occurs when your healthy lactobacilli get out of balance and grow too much. Symptoms include thin vaginal discharge that has a strong fishy smell and a little itching or burning when you urinate. BV is treated with an antibiotic.

    What can I use instead of metronidazole? ›

    For the treatment of trichomoniasis, alternatives include fura- zolidone, clotrimazole, nonoxynol-9 or paromomycin. Alternatives for bacterial vaginosis include clindamycin topically or systemically. For giardiasis, alternative options include paromomycin, nitazoxanide or the antihelminthic benzimidazoles.

    What vitamins help with bacterial infections? ›

    Vitamin C was found to be beneficial against various groups of infectious agents including bacteria, viruses, Candida albicans, and protozoa (Table 2).

    What Herb is a natural antibiotic? ›

    12 All Natural Antibiotics
    • Oregano/Oil of Oregano. We think of oregano as something to add to your favorite Italian dish, however, many go on without realizing how beneficial oregano is to your health! ...
    • Raw Apple Cider Vinegar, or ACV. ...
    • Honey. ...
    • Turmeric. ...
    • Grapefruit Seed Extract (GSE). ...
    • Garlic. ...
    • Echinacea. ...
    • Cabbage.

    Can I take charcoal while on antibiotics? ›

    A special formulation of activated charcoal could help, protecting your body from the side effects of antibiotics, and perhaps even aiding the fight against antibiotic resistance.

    Is charcoal an antifungal? ›

    The results thus demonstrate that the charcoal polymer has great potential for use as an antifungal material that results in a lower germination efficiency or smaller hyphae growth.

    What is the health benefits of activated charcoal? ›

    Activated charcoal is used to treat poisonings, reduce intestinal gas (flatulence), lower cholesterol levels, prevent hangover, and treat bile flow problems (cholestasis) during pregnancy.

    What are the side effects of activated charcoal? ›

    When you take it by mouth, activated charcoal can cause:
    • Black stools.
    • Black tongue.
    • Vomiting or diarrhea.
    • Constipation.
    5 Feb 2021

    Can you take activated charcoal with a probiotic? ›

    No interactions were found between charcoal and Probiotic Formula.

    Can I take activated charcoal every day? ›

    It's important to note that charcoal can interfere with the body's absorption process. Charcoal shouldn't be consumed every day or less than 90 minutes before or after nutrient-dense meals, prescription medications, or vitamins.

    When should I take activated charcoal? ›

    A lower daily dose of 4 to 32 grams is recommended for lowering cholesterol levels. Some doctors or naturopathic doctors might prescribe activated charcoal to be taken once or twice a day for detox purposes. Take activated charcoal apart from all foods, medicine, and supplements.

    What does activated charcoal do to your hair? ›

    When you use activated charcoal, you can quickly revive lifeless, thin, and dull hair, giving it the volume and bounce it deserves. The activated charcoal works to deeply cleanse your strands, effectively removing impurities so your hair feels instantly lighter.

    Is it good to take activated charcoal before bed? ›

    The activated charcoal in Insta Relief™ acts as a vacuum in your digestive tract by absorbing these toxins before they can make their way into your body. This in turn protects your brain from potential inflammation. With less inflammation in your brain, the better you will sleep!

    What's the difference between charcoal and activated charcoal? ›

    Activated charcoal is a powder comprised of wood, bamboo, coal or coconut shells that have been burned at a very high temperature. In contrast, regular charcoal combines coal, peat, wood pulp, petroleum and coconut shells. As the name tells us, activated charcoal is charcoal that is activated by exposure to high heat.

    Is activated charcoal good for kidneys? ›

    It can help patients with kidney disease.

    For patients with end-stage renal disease, activated charcoal may be a viable alternative to dialysis. The reason: It binds to urea and other toxins, reducing the number of waste products that filter through your kidneys.

    Does activated charcoal make you lose weight? ›

    While activated charcoal is safe to consume in some cases, there is no evidence that it promotes weight loss, and nutrition experts do not recommend it for this purpose. In addition, it may cause side effects.

    Is activated charcoal good for detox? ›

    Experts do not recommend activated charcoal detoxes for general use. Unless the levels of toxins are high, the body is typically able to detoxify itself. Activated charcoal is only effective against certain toxins in certain circumstances. Doctors use it to remove specific poisons from the body shortly after ingestion.

    Does activated charcoal interact with any medications? ›

    Taking activated charcoal along with medications taken by mouth can decrease how much medicine the body absorbs. This can decrease the effects of your medication. To prevent this interaction, take activated charcoal at least one hour after medications you take by mouth.

    Can activated charcoal damage your teeth? ›

    Research has found that activated charcoal can be abrasive on teeth and tooth-colored restorations, leading to loss of tooth structure. This abrasiveness may make your teeth look more yellow. If you wear away too much enamel, more of the yellowy dentin underneath will become exposed.

    What are the contraindications to the administration of activated charcoal? ›

    Charcoal is contraindicated in individuals with unprotected airways and decreased levels of consciousness if not intubated; ingestion of acids or alkalis; cases in which the risk or severity of aspiration is increased; or isolated ingestions of lithium, iron, heavy metals, or ethanol.


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