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Iodine Research

Resource Network of The Iodine Movement


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Iodine and the Body

Vagina

Antimicrobial effect of chlorhexidine and povidone-iodine on vaginal bacteria.
Vorherr H, Vorherr UF, Mehta P, Ulrich JA, Messer RH.
J Infect. 1984 May;8(3):195-9.
[abstract only]

"The antimicrobial potency of 4 per cent chlorhexidine gluconate was compared with that of 10 per
cent povidone-iodine (1 per cent free iodine) on the vaginal bacteria of 150 premenopausal,
non-pregnant women. From 30 of the women blood samples were taken before and at either 15, 30
or 60 minutes after vaginal cleansing with chlorhexidine for chlorhexidine analysis. Five minutes
after applying either chlorhexidine or povidone-iodine almost 99 per cent of bacteria present on the
lateral wall of the vagina were killed. Chlorhexidine was significantly more effective than
povidone-iodine. Serosanguineous , mucoid or white-yellowish vaginal discharge did not alter the
effectiveness of either antimicrobial agent. In contrast to povidone-iodine, vaginally applied
chlorhexidine was not absorbed in measurable amounts (sensitivity of detection method: 0 X 1 mg/l)
into the bloodstream. Chlorhexidine may therefore prove of value for treating vaginitis especially
during pregnancy and also for combating microbes such as Group B streptococci which are
potentially harmful to the newly-born child."


Vaginal absorption of povidone-iodine.
Vorherr H, Vorherr UF, Mehta P, Ulrich JA, Messer RH.
JAMA. 1980 Dec 12;244(23):2628-9.
[abstract only]

"In 12 nonpregnant women, total iodine, protein-bound iodine, inorganic iodine, and thyroxine
values were measured in serum before and 15, 30, 45 or 60 minutes after a two-minute vaginal
disinfection with povidone-iodine (Betadine). Only 15 minutes after application, serum iodine levels
were raised and remained significantly elevated 30, 45 and 60 minutes after disinfection. Serum
concentrations of total iodine and inorganic iodine were increased up to fivefold to 15-fold,
respectively; during the relative short period of observation, thyroxine levels were not altered. An
overload of iodine can suppress thyroid hormonogenesis, and the fetal and neonatal thyroid glands
are especially sensitive. In pregnant women, vaginitis should not be treated with povidone-iodine
because of the possible development of iodine-induced goiter and hypothyroidism in the fetus and
newborn. The risk is especially high when povidone-iodine is used repeatedly."


Efficacy of povidone-iodine vaginal suppositories in the treatment of bacterial vaginosis.
Wewalka G, Stary A, Bosse B, Duerr HE, Reimer K.
Dermatology. 2002;204 Suppl 1:79-85.
[abstract only]

"A prospective, randomized clinical trial was performed to study the efficacy of povidone iodine
(Betadine) suppositories for the treatment of bacterial vaginosis (BV) in comparison to capsules
containing lactobacilli (Doderlein Med). Seventy patients with BV included in the study were
randomly assigned to be either treated with povidone iodine suppositories or lactobacilli. Patients
were treated once a day for 5 days. Initial examinations took place on the first day of the study with
follow-up examinations on days 8 and 15. The examinations included clinical parameters, patient
evaluation, secretion screens, and quantitative and qualitative microbiological tests of vaginal flora.
Both treatment groups showed improvement of clinical parameters, condition of secretions and
subjective state of health. At day 15 there was a trend towards a better efficacy of the treatment with
povidone iodine but this was not significant. However, patients with acute BV treated with povidone
iodine had significantly better scores after 15 days. Both treatments were well tolerated. The
microbiological examinations showed an increase of the mean number of lactobacilli in the vagina on
day 8 after initiation of treatment with lactobacilli, but a decrease on day 15. Contrary to that the
lactobacilli counts from patients treated with povidone iodine suppositories decreased after the first
week but increased in the second one. Potentially pathogenic germs, e.g. Gardnerella, Bacteroides
and Enterobacteria were reduced in a higher extent and with a longer lasting effect after treatment
with povidone iodine suppositories than with capsules containing lactobacilli. The results of this
study show that native lactobacilli rapidly re-colonize after the antiseptic treatment with povidone
iodine. Therefore, there is no need to use lactobacilli in addition. "

Local treatment of vaginal infections of varying etiology with dequalinium chloride or povidone
iodine. A randomised, double-blind, active-controlled, multicentric clinical study.
Petersen EE, Weissenbacher ER, Hengst P, Spitzbart H, Weise W, Wolff F, Dreher E, Ernst U, Della
Casa V, Pohlig G, Graf F, Kaiser RR.
Arzneimittelforschung. 2002;52(9):706-15.
[abstract only]

"This randomised, double-blind, multicentric clinical study compared the efficacy and tolerability of
the two vaginal antiseptics, 10 mg dequalinium chloride (CAS 522-51-0, Fluomycin N) and 200 mg
povidone iodine (CAS 25655-41-8), in a parallel-group design. A total of 180 patients with vaginal
infections of varying etiology participated in this study (bacterial vaginosis, fluor vaginalis,
vulvo-vaginal candidiasis, trichomoniasis). Patients were randomly allocated to one of the two
treatment groups and were treated once per day for 6 days. Control examinations took place 5 to 7
days after the end of treatment, and 3 to 4 weeks after the first control examination. The total
symptoms score, a summary score for the clinical symptoms, discharge, burning, pruritus, redness
of vulva/vagina, was defined as primary efficacy parameter. The treatments at the first control
examination were compared in the full analysis set using the Wilcoxon-Mann-Whitney U-test,
2-sided, thereby proving equivalence of both treatments at the 5% level. Both treatments strongly
improved the symptoms of vaginal infections both on short-term and long-term follow-up. Descriptive
analysis of the secondary parameters, vaginal pH, degree of purity of the vaginal flora, and number
of lactobacilli in the wet mounts, supported the comparable efficacy of both therapies to restore the
vaginal milieu. Analysis of the diagnostic subgroups indicated that irrespective of the diagnosis, both
treatments improved the efficacy criteria as observed for the entire population. The global
assessment of the therapeutic efficacy by investigators and patients supported the results of the
efficacy analysis with good to very good ratings in 70-90% of the cases. A good tolerability of both
preparations was observed in this study with a low number of adverse events in the test group
(5.8%)."


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