Dr. Ron’s Research Review – August 17, 2011

This week’s research review focuses on boric acid for chronic vaginitis; and the hypothesis that ascorbic acid may be a “frisky” vitamin.

A recent review found that boric acid is a safe, alternative, economic option for women with recurrent and chronic symptoms of vaginitis when conventional treatment fails because of the involvement of non-albicans Candida spp. or azole-resistant strains. (Iavazzo, Gkegkes et al. 2011)

A randomized controlled clinical trial showed that high-dose ascorbic acid (3000 mg/day Cetebe, a time-release vitamin C supplement) increases intercourse frequency and improves mood. (Brody 2002)

An older study provides a possible mechanism of action: ascorbic acid may stimulate oxytocin secretion. (Luck and Jungclas 1987)

Dr Ron


Abstracts

High-dose ascorbic acid increases intercourse frequency and improves mood: a randomized controlled clinical trial

            (Brody 2002) Download

BACKGROUND: Ascorbic acid (AA) modulates catecholaminergic activity, decreases stress reactivity, approach anxiety and prolactin release, improves vascular function, and increases oxytocin release. These processes are relevant to sexual behavior and mood. METHODS: In this randomized double-blind, placebo-controlled 14 day trial of sustained-release AA (42 healthy young adults; 3000 mg/day Cetebe) and placebo (39 healthy young adults), subjects with partners recorded penile-vaginal intercourse (FSI), noncoital partner sex, and masturbation in daily diaries, and also completed the Beck Depression Inventory before and after the trial. RESULTS: The AA group reported greater FSI (but, as hypothesized, not other sexual behavior) frequency, an effect most prominent in subjects not cohabiting with their sexual partner, and in women. The AA but not placebo group also experienced a decrease in Beck Depression scores. CONCLUSIONS: AA appears to increase FSI, and the differential benefit to noncohabitants suggests that a central activation or disinhibition, rather than peripheral mechanism may be responsible.

Catecholamines and ascorbic acid as stimulators of bovine ovarian oxytocin secretion

            (Luck and Jungclas 1987) Download

The effects of catecholamines and ascorbic acid on cultured bovine granulosa cells have been examined to assess their possible role in the initiation and maintenance of luteal oxytocin secretion. The actions of these agents have also been compared with the previously reported ability of follicular theca tissue to enhance oxytocin secretion. Using granulosa cells cultured in serum-supplemented medium, we observed a highly significant enhancement of oxytocin secretion in the presence of adrenaline and noradrenaline, particularly over the concentration range 1-10 mumol/l. This effect was accompanied by smaller and less consistent changes in progesterone secretion and did not involve any change in the time-course of oxytocin secretion. Acetylcholine was without effect. Ascorbic acid stimulated oxytocin secretion when used alone over a range of concentrations, but was also able to synergize with adrenaline. Lactic acid was ineffective. The stimulation of oxytocin secretion by adrenaline could be blocked by equimolar propranolol, but the stimulation of progesterone was not blocked. Propranolol had a variable effect on the ability of theca tissue to stimulate oxytocin secretion by granulosa cells but the results also suggested the presence of some beta-agonistic activity in the culture medium. We conclude, first, that catecholamines may be involved in the regulation of ovarian oxytocin secretion, secondly, that ascorbate may regulate oxytocin secretion through its involvement in the biosynthesis of oxytocin but also through interaction with catecholamines and, thirdly, that the stimulatory action of theca tissue probably does not involve the action of beta-agonists.

Boric Acid for Recurrent Vulvovaginal Candidiasis: The Clinical Evidence

            (Iavazzo, Gkegkes et al. 2011) Download

Abstract Background: Recurrent vulvovaginal candidiasis (VVC) remains a challenge to manage in clinical practice. Recent epidemiologic studies indicate that non-albicans Candida spp. are more resistant to conventional antifungal treatment with azoles and are considered as causative pathogens of vulvovaginal candidiasis. Methods: We searched PubMed and Scopus for studies that reported clinical evidence on the intravaginal use of boric acid for vulvovaginal candidiasis. Results: We identified 14 studies (2 randomized clinical trials [RCTs], 9 case series, and 4 case reports) as eligible for inclusion in this review. Boric acid was compared with nystatin, terconazole, flucytosine, itraconazole, clotrimazole, ketoconazole, fluconazole, buconazole, and miconazole; as monotherapy, boric acid was studied in 7 studies. The mycologic cure rates varied from 40% to 100% in patients treated with boric acid; 4 of the 9 included case series reported statistically significant outcomes regarding cure (both mycologic and clinical) rates. None of the included studies reported statistically significant differences in recurrence rates. Regarding the adverse effects caused by boric acid use, vaginal burning sensation (<10% of cases), water discharge during treatment, and vaginal erythema were identified in 7 studies. Conclusions: Our findings suggest that boric acid is a safe, alternative, economic option for women with recurrent and chronic symptoms of vaginitis when conventional treatment fails because of the involvement of non-albicans Candida spp. or azole-resistant strains.


References

Brody, S. (2002). "High-dose ascorbic acid increases intercourse frequency and improves mood: a randomized controlled clinical trial." Biol Psychiatry 52(4): 371-4.

Iavazzo, C., I. D. Gkegkes, et al. (2011). "Boric Acid for Recurrent Vulvovaginal Candidiasis: The Clinical Evidence." J Womens Health (Larchmt).

Luck, M. R. and B. Jungclas (1987). "Catecholamines and ascorbic acid as stimulators of bovine ovarian oxytocin secretion." J Endocrinol 114(3): 423-30.