Betadine Douche: A Guide to Vaginal Povidone-Iodine Use

Povidone iodine is an antiseptic liquid that has been used in wound care and hospitals for over 170 years, and is available as Betadine douche.

Betadine douche is the only povidone-iodine available as a douche, but any liquid diluted works just as well. Povidone-iodine is one of the most potent antiseptics available over the counter, with broad spectrum antimicrobial action against bacteria, fungi, protozoa and viruses.

Water or alcohol solutions of iodine alone are toxic and cause skin discolouration, pain, irritation and inflammation. This mean that new carriers for iodine had to be developed, with povidone-iodine one such mixture. The povidone-iodine solution reduces the side-effects caused by elemental iodine by itself.

Povidone-iodine (Betadine douche) neutralises many major groups of bacteria, fungi and protozoa in the vagina. The concentration of free iodine continuously released is above the level required to kill microorganisms, but below the level that would cause skin irritation.

Povidone-iodine or the Betadine douche is used vaginally and on skin without causing skin irritation, and is believed safe and effective as a topical and vaginal antiseptic.

Using povidone-iodine (Betadine douche) vaginally

Povidone-iodine douches used vaginally may be used to kill some groups of bacteria (gram-positive and gram-negative), at least temporarily.

Studies show that the douche kills bacteria, and has a positive effect on normal flora, since lactobacilli are the first to recover. Lactobacilli recovery usually takes about two hours after the vaginal Betadine douche has been applied.

It is after this two-hour mark that whatever microbes were present before the Betadine douche usually reappear. What this looks like in real life for you will be different to another woman, so you’ll need to figure out if a Betadine douche is simply symptom relief, or is curing your vaginal infection in any meaningful way.

If you want symptom relief from E. coli or E. faecalis, for example, this treatment may be helpful temporarily. You’ll need to be tested to see if the bacteria remain after your course of povidone-iodine.

Keeping the treatment in your vagina for longer than a douche permits, but not so long that too much iodine is absorbed

One of the issues with a rinse or douche is that it leaves the vagina quickly, possibly reducing its effectiveness as an otherwise sound treatment. This may mean using a Betadine-soaked tampon for a short time per day, possibly several times per day, for a more beneficial, long-lasting effect.

Do not use this for long periods of time, as it can affect your thyroid function. If you have thyroid dysfunction, do not use Betadine tampons. There are slow-release pessaries available.

There is plenty of research into using povidone-iodine to eradicate bacteria, but not that much on using Betadine to cure infections caused by aerobic vaginitis (the specifics of which vary somewhat) or bacterial vaginosis (also specific bacteria vary considerably). If you are strapped for cash or in a pinch, you may be able to relieve symptoms and give Betadine douches a go.

Can povidone-iodine (Betadine douche) cure my vaginal infection?

Povidone-iodine is not thought to be a cure for aerobic vaginitis, bacterial vaginosis, yeast infections, or other vaginal infections. But in saying this, there is also no real evidence saying that with a concerted treatment program it can’t make a dent in it.

How to do a treatment program using povidone-iodine (Betadine douche)

You need to know what you are treating, so if possible, get a PCR test so that you don’t waste your time with ineffective treatments. You can use multiple douches per day (as below) for seven days, while also taking a high-quality women’s probiotic.

Povidone-iodine doesn’t work on all bacteria, so check what you have versus what povidone-iodine is known to be effective against.

You are responsible for your own iodine intake and if you are sensitive, avoid this treatment. You may wish to try to find some povidone-iodine pessaries instead, which slow-release the iodine.

After using povidone-iodine vaginally, you should immediately use women’s probiotics to recolonise with healthy bacteria, since lactobacilli are the first to recover after a povidone-iodine douche. This gives you a great opportunity to jump in there with good bacteria, to put up a fight against the bad bacteria when they come back too.

We love Life-Space Women’s Microflora Probiotic, as it has the best collection of bacteria for vaginas. You can use it vaginally too, but you’ll need to switch the caps over to vegetable caps.

Warnings for vaginal use of povidone-iodine

Povidone-iodine is brown and stains! Keep away from nice underwear by rinsing your vulva (not vagina!) with water and using a panty liner after use.
Do not eat!
This douche is understood to be safe for use during pregnancy.
Do not constantly douche without addressing the underlying cause of your infection or symptoms – you are upsetting the ecology of your vagina further if you are not doing a concerted treatment program with an aim to stop use of douches.
Douching is bad if you use it all the time.
Do not mix povidone-iodine with hydrogen peroxide, silver, taurolidine or proteins – it makes it ineffective, useless for disinfecting metal piercings
Beware those with thyroid conditions – don’t be alarmed, but do your homework

How to douche using povidone-iodine 7 per cent

Fill up a 100ml syringe, douche or turkey baster with the 7 per cent solution. This is already diluted, so you do not need to dilute it further.
It’s best if you can lie down, propping your hips up to hold the solution in for as long as possible – the more surface area for longer, the better. A bath is great for this to avoid mess (remember, iodine stains!), but not everyone has a bath. You’ll need to figure out the best way for you, with your facilities and abilities.
If you are unable to lie down, you can do the douche over the toilet or in the shower.

References^1,2

1.
Martino JL. Vaginal Douching: Evidence for Risks or Benefits to Women’s Health. Epidemiologic Reviews. Published online December 1, 2002:109-124. doi:10.1093/epirev/mxf004
2.
Donders GGG, Ruban K, Bellen G. Selecting Anti-Microbial Treatment of Aerobic Vaginitis. Curr Infect Dis Rep. Published online April 22, 2015. doi:10.1007/s11908-015-0477-6