Comparing the efficacy of herbal product and clotrimazole on the treatment of women with vaginal candidiasis: A systematic review of parallel randomized controlled trials

Candida vaginitis is one of the most common gynecological problems that besides clinical and physical problems can cause psychological trauma especially in chronic, untreated and recurrent cases.

This systematic review study was conducted to compare the efficacy of medicinal plants and clotrimazole on the treatment of women with vaginal candidiasis. This study intends to review the effect of randomized controlled trials on the efficacy of herbal product against clotrimazole in the treatment of vaginal candidiasis.

In order to identify interventions, Persian and English databases including Scopus, Science Direct, Web of Science, PubMed, Google Scholar, Medline, SID, Irandoc, Iranmedex, and Magiran were evaluated from April 2019 to May 2019. Manual searches in journals, abstracts of conferences, and conferences and dissertations were also conducted manually. The timeframe of the studies was considered between 2005 and the end of May 2019. Studies have been selected that were quantitative, original, and interventional, interventions to treat women with vaginal candidiasis with medicinal plants and clotrimazole as a major component or part of it, studies in Farsi and English, the study was done within the country and full text available. Case studies, short papers, cross-sectional and descriptive analytical studies, letters to the editor, and narrative and systematic review articles were omitted.

Findings from a review of 8 clinical trials on 734 women with vaginal candidiasis indicate that herbal remedies are a viable option in the treatment of vaginal candidiasis. Specifically, case plant, coconut oil, and evergreen flowers have better effects, and thyme and dill have similar effects to clotrimazole. Also, the case plant and black seed should be suitable supplements for clotrimazole to treat candidal vaginitis. However, the effects of clotrimazole were better than garlic extract.

Overall, the findings of this study indicate that medicinal plants should be given more attention more considered as an alternative or complementary treatment in the treatment of vaginal candidiasis.