Some of my patients with abnormal Pap smears attributable to the high-risk HPV virus claim to have “healed” their cervixes with herbal vaginal suppositories. Are these products safe and/or effective?—KAREN A. BEESLEY, CNM, Roseburg, Ore.

One placebo-controlled clinical trial has demonstrated a statistically significant effect for indole-3-carbinol (I-3-C) on the progression of cervical dysplasia. (Gynecol Oncol. 2000;78:123-129). I-3-C, a vegetable-derived compound, is generally taken orally and is well tolerated. For more information, see www.mskcc.org/mskcc/html/69263.cfm. As far as vaginal suppositories, randomized controlled studies demonstrate a small effect for vaginal suppositories of retinoids for cervical intraepithelial neoplasia 2 only (Cochrane Database Syst Rev. 2007;4:CD003296). No demonstrable harm has been shown in any study. As with any supplement, patients should be cautioned to only purchase from a reputable supplier and to check ConsumerLab.com or another database for reviews.—Lisa Stern, APRN (147-1)