For Your Own Good

There is a cure for yeast infections, but you don't know what it is. Almost nobody knows what the real cure is. It's not available at CVS. Your gynecologist will not prescribe it to you, or tell you about it. You may ask, how do *I* know what the cure is, then, if it's such a big secret? Well, I learned it from a super old Wall Street Journal article, of all places. The article is probably archived now. If you are industrious and you have a paid WSJ subscription, I assume you can find it. For me, anyway, it no longer shows up on Google results.

Throughout my late teens, and twenties, every few years, I went on hormonal birth control, only to be plagued by recurring yeast infections. BC rendered me always on the verge of a yeast infection. As soon as I had sex with anyone, which was infrequently, BAM: The odorless cottage cheese, the burning vag, the abdominal cramps, the diarrhea... Sick of the shame, the creams, the pain, I would eventually stop taking the birth control, and everything would return to normal. Needless to say, constant yeast infections were a wet blanket that repeatedly extinguished the fire of my longing, and made me feel broken and worthless.

It wasn't until I moved to New York City, and became old enough to see a doctor my own age, that I got the first important clue. I found the doctor on ZocDoc, and I don't remember her name. Who knows if I can ever find her again. All I know is that she was "young" (in her thirties, like me) and hip. I came in to get back on birth control. But I expressed reservations that hormonal birth control seems to give me endless yeast infections. "It changes your vaginal pH," she replied. "It's not just you. A LOT of women have this problem. I see it all day long everyday," she said, with the lovable candor of a true New Yorker.

"If hormonal birth control changes your vaginal pH, which causes yeast to grow out of control, then there isn't really a cure, right? Like, doesn't that mean that you're doomed to use creams every six weeks, or what not?" I asked. "Well," she replied, "It really depends on your body's natural pH equilibrium. Some women are naturally more acidic, so even with the added hormones, the yeast doesn't reach an inflection point where it kind of takes over. There's an oral anti-fungal you can take, but that has so many side effects, I really don't recommend it."

"If millions of women are constantly using azole creams, over and over, isn't that gonna cause anti-fungal resistance?" I puzzled. Asking doctors grand questions is one of my fortés. "Oh yes," she said, "the creams are definitely breeding resistant fungus. It's kind of like antibiotic-resistant bacteria, but less well-known. It's a huge problem!" I left the gyno's office in a daze, with my prescription for Nuvaring in hand. Why was it decided that in order for women to have equal access to low risk sex, they must suffer constant yeast infections? Who made this decision? Why aren't there hormonal dose optimization options for different pH equilibria?

Frankly, recurring yeast infections nullify the purpose of birth control, in my view. I realize that some women and girls take birth control to mitigate health conditions like endometriosis, etc. For me, the only reason I have ever wanted to use birth control is to have hot sex, aka condomless sex. Personally, I find latex to be an anti-aphrodisiac. My lady parts recoil from the rubbery texture of condoms, making condom sex about as erotic as a pelvic examination. I would rather be celibate than have condom sex all the time, and that is precisely what I have resorted to in life.

Each time I got a yeast infection, it started out as a murmur. A little itch, a wave of dull abdominal cramps mild enough to make me question whether I was imagining it. Each time, I turned to Google in terror and desperation. The Internet, of course, is unmatched in its ability to provide insane and ineffective medical remedies: Remove sugar from your diet, don't eat carbs, eat yogurt, don't eat dairy, go on a keto diet, wear cotton underwear... These are all harmless enough. Then there were the weirder suggestions, like inserting coconut oil, yogurt, vinegar, or crushed garlic into the vagina (supposedly all natural anti-fungals).

As the years wore on, I googled deeper and harder each time. Eventually, on the third or fourth page of Google results, I came across a Wall Street Journal article (possibly an op-ed) in which a retired OB-GYN with decades of experience gave his unfiltered opinion... I wish I had saved the article at the time, but I know it's out there (unless the azole cream companies sued to get it removed from the Web). "Boric acid suppositories are a first line treatment for candida infections," the doctor said... "What?!?" I thought to myself, "Did someone slip me LSD? Am I tripping? What the f*ck is a boric acid suppository?"

The Internet harms but the internet also heals, and in this case, it was a big win; as I immediately reverted to Google and typed in "boric acid suppository." On Amazon (oh Amazon, light of my life, fire of my loins) there it was. For sale. A sketchy looking pill bottle, the kind you might find in a "natural foods" store in Santa Cruz, California. It was called pHd. I immediately ordered one.

"Boric acid?" my future husband, at the time my live-in boyfriend, said. "Isn't that rat poison?" he laughed. "Are you sure you want to put rat poison in your vagina?" Naturally, I was terrified. I had refused to put crushed garlic in my vagina, and rat poison sounded even less advisable. Yes, it was in the Wall Street Journal, but they're not infallible. Maybe this retired doctor was a crank... Again, I googled hard: Apparently boric acid is fatal if it gets into your bloodstream, but it only causes mild irritation on the skin. As long as the vagina endothelium (inside skin) is intact, there is no risk of poisoning yourself, or so said various PubMed articles.

Further, I found an online resource published by University of Washington Medicine, which not only recommended boric acid suppositories for yeast infections, but provided instructions on how to make your own. Apparently, before the advent of the Wild West marketplace Amazon, which we all know and love, there was no way to buy gel capsules filled with rat poison, except to make them yourself? At the time that I bought my rat poison suppositories on Amazon, there was only one kind available for purchase. Almost a decade later, there are a ton of options.

I'm waiting for the UW link to get taken down from the web, but here it is: https://www.uwmedicine.org/sites/stevie/files/2018-11/Boric-Acid-for-Recurrent-Vaginal-Yeast-Infections.pdf

And a screenshot for posterity:

My sketchy Amazon pill bottle arrived, and for a brief moment, I thought about putting it straight in the garbage. The headlines flashed before my mind's eye: "NYC Woman Puts Rat Poison in her Moldy Vagina, Dies." I was scared. But I waited until the next time that the yeast returned. Before bedtime, I slipped a gel cap all the way in, placing it right below my cervix, and I crossed my fingers.

Amazing things happened, as soon as I administered the rat poison. First of all, my diarrhea stopped, immediately. I still don't understand the science of why or how that works, but it does. The dull abdominal cramping went away. The vaginal and vulvar itching stopped immediately. When I woke up the next morning, the cottage cheese was entirely gone, and was replaced with the happy slippery sensation of an ovulating vag, even though I was on birth control, and could not be ovulating.

Everything I read online suggested that I should use the rat poison suppositories everyday for at least a week for recurrent infections, so that is what I did. The UW resource suggests going much longer than a week, but by the end of that week, the lady bits were happy as a clam, and I considered myself cured, and stopped the medication regimen. Perhaps the most amazing thing was that I went another eight months or so without even the faintest hint of a yeast infection. Even then, if I ever felt the familiar itch, I would pop in a capsule for a day or two, and be cured again for months and months.

Really, though, the biggest change for me was the mental transformation. Yeast infections seemed always to come with an antsy inflamed kind of brain fog. Again, I don't understand the science behind it, but I would hypothesize that the yeast or some byproduct of the yeast gets into your bloodstream and affects your brain function. The acid pills totally cured the brain fog. All of this felt miraculous to me. My years of suffering, shame, celibacy, and even an unwanted pregnancy, were all cured.

Soon my excitement began to fade and melt into a slow simmering rage. Why in god's name had no gynecologist ever told me about this? Why had every godforsaken doctor simply written me a prescription for useless azole creams, which they knew would not cure the underlying pH issue, and which they know to be breeding resistant fungus, to the incomparable detriment of all humanity? Are we really going to consign ourselves to a future of unnecessary death and disease, due to unkillable fungus, which we created because we were too chicken to tell women the truth?

I don't know why boric acid suppositories are not approved by the FDA. I assume that doctors don't tell you about the acid pills because they can't, because licensed doctors are probably not allowed to recommend medications that are not FDA approved. I strongly suspect that it's paternalistic misogyny: The majority of doctors think women and girls are simply too incompetent to know whether they have lacerations in their vaginas, and therefore they are too incompetent to insert a substance that can kill you if it gets into your bloodstream.

There is a theoretical future in which I will pursue this question in a thorough, journalistic fashion. But for now, I will let the question linger like a bad yeast infection.