When a woman has a vaginal infection, antibiotics or antifungals are usually the go-to medication prescribed by healthcare professionals.
Depending on the type and severity of the infection, these medicines are available as creams, suppositories or pills.
However, these drugs kill both the bad and good bacteria.
Often, the infections recur, indicating pH imbalances in the vagina, or issues with the immune system or sexual health.
In a world’s first, a collaboration between a local biotechnology company and public universities has led to the discovery of an anti-infective technology using the by-product of charcoal (wood vinegar) derived from mangrove wood.
Called Sateera, the technology is designed to selectively inhibit harmful bacteria while preserving beneficial bacteria.
Unlike conventional broad-spectrum antimicrobial formulations that act indiscriminately, this approach is structured around targeted microbial modulation.
Originally developed within Universiti Malaya’s (UM) research ecosystem more than a decade ago, the technology evolved through laboratory refinement, patent development and industry translation before its first commercial application as a feminine hygiene (foam wash) product.
According to project lead researcher Professor Dr Lai Chin Wei, a combination of alcohol, acid and sodium compounds is highly effective at killing a broad spectrum of bacteria, but it is not guaranteed to kill all types of bacteria, particularly resistant bacterial spores.
“We cannot see bacteria with our naked eyes as they are smaller than red blood cells, so we utilised a technique to differentiate good and bad bacteria.
“Within three minutes of Sateera’s application, the bad bacteria reduced and decomposed, while the lactobacillus (good bacteria) strain was preserved.
“When we first observed the impressive results, our team was amazed as we had never seen anything like this before,” he shares.
Maintaining balance
One of the most common beneficial bacteria in the human body is lactobacillus and they reside in high numbers in the gut, mouth, skin and vaginal tract.
This species are primary producers of lactic acid, and in doing so, they control the acidity (pH) of their environment.
They use lactic acid production as a mechanism to inhibit the growth of competing or harmful bacteria by lowering the pH level, which is essential to promote vaginal homeostasis (balance) and to prevent infections like bacterial vaginosis.
The UM team tested five different harmful bacterial strains, including specific imported variants, and the results were similar.
“We also expanded the bacteria chain to those that cause urinary tract infections and others, and we found that Sateera was 99.9% effective against the 16 strains tested in in-vitro studies.
“Since the anti-infective mechanism selectively targets the bad and protects the good, we can set a new hygiene standard with this technology.
“The pH range of 4.5-5 is anti-inflammatory, stabilises the flora, reduces the discomfort and is able to boost the immune defence in women,” says Prof Lai.
He adds: “This is something we can truly benefit from – intimate health should be guided by science and not by feel.
“Now, we’re doing more scientific validations and expanding our data collection.
“Moving forward, we hope to embark on clinical evaluations and trials.”
He was speaking at a recent ceremony to formalise a Memorandum of Agreement (MOA) between UM and the Malaysian biotechnology company.
The ceremony was witnessed by Science, Technology and Innovation Minister Datuk Chang Lih Kang, who said the collaboration reflects the growing importance of academia- industry partnerships in translating research into real-world impact.
“This collaboration shows how Malaysia’s universities and industry can work together to translate research into real-world solutions.
“Innovation must move beyond the laboratory and into application.
“By championing science-based, targeted approaches in biotechnology, we strengthen national capability, while improving health and quality of life in line with Malaysia Madani and our National Biotechnology Policy,” he said.
Too embarrassed to seek help
Lactobacillus bacteria are integral to our health and well-being.
When we don’t have them, we typically buy and consume probiotics containing this bacterial strain.
“The problem with the medical fraternity is that we always prescribe antifungal and antibacterial medicines to treat vaginal infections, and this can wipe out lactobacillus.
“When the environment is acidic, we treat it by killing everything (bacteria) and don’t replace back the good flora, so the problem is going to happen again and again,” points out consultant obstetrician and gynaecologist Dr Quek Yek Song.
Doctors advise against washing (with water) or douching during a vaginal infection as it can significantly worsen the condition, cause the infection to spread, and increase the risk of serious, long-term health complications such as pelvic inflammatory disease.
Good vaginal hygiene – defined by a balanced, self-cleaning environment that is generally free from discomfort, persistent odour and infection – is important to prevent the majority of problems.
Women are often shy or embarrassed to discuss vaginal matters with anyone, including their partner and/or doctor.
For example, if they have the fungal infection candidiasis, symptoms include intense itching, burning, redness and a whitish, cottage cheese-like discharge that comes out of the vagina.
“Other infections may smell like dead fish, and as gynaecologists, when we get this foul smell, we know it’s a bacterial infection.
“As a male partner, you lose interest in sex and the woman loses self-confidence,” says Dr Quek.
If the woman’s hygiene is poor, it can also lead to viral infections because their immunity is low.
Stubborn infections
Dr Quek has treated many recurrent cases in his clinic, and he admits that in some cases, no matter how hard and how much he treats the infection, these patients return after a few months.
“I don’t have all the answers because there are a few grey areas.
“First, I don’t know anything about their partner – whether they have one or multiple.
“Second, I don’t know how hygienic the person is, whether she is a HIV carrier, diabetic, immunocompromised, etc.
“If all is good, and their infection is still recurrent, then I feel sad that as a doctor, I’m not able to treat them.
“They also lose confidence in the medicines because they’ve repeatedly taken them with no improvement – sometimes they shout at me!” he shares.
One time, the consultant was at his wits’ end and took out samples of a foam wash containing Sateera and passed it to these patients.
He was expecting them to return and yell at him again, but they never came back!
Later, he found out that their infection cleared up after using the foam wash.
“Initially, I was sceptical about this anti-infective technology, but it offers new hope to patients with recurring infections.
“In the future, we need more clinical trials, so we have more evidence to share with the world,” he says.
Sateera has also undergone independent validation by Universiti Teknologi Malaysia (UTM) and SGS Malaysia – an independent inspection, verification, testing and certification service provider.
While mangrove trees are found abundantly in Malaysia, harvesting is permitted only in certain areas, as a significant portion of mangrove forests are protected and gazetted as permanent forest reserves.
Who would have thought that wood vinegar used by a man to treat his itchy scalp could have such promising potential?
