Should you use probiotics for your vagina?

You know probiotics can be good for your gut, but does your vagina need one too? You might think so, based on probiotic marketing these days. Probiotics are in everything from drinks to pills and powders, and in many cases, are being promoted as a means of improving your vaginal health.

Women seem to be listening, says Dr. Caroline Mitchell, assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School. Vaginal probiotic supplements are hugely popular. This includes both probiotic pills and suppository capsules that are inserted into the vagina using an applicator.

But evidence of effectiveness is scant. “There is almost no evidence that these have benefit for vaginal health. The studies are mostly poorly done and don’t adhere to rigorous reporting standards, even if they are randomized trials,” says Dr. Mitchell. But that hasn’t stopped companies from promoting products for that purpose.

However, while today’s vaginal probiotic products should be viewed with a healthy dose of skepticism, that may change as scientific knowledge builds. Meanwhile, here’s what’s known — and unknown — about probiotics and your vaginal health.

Sorting facts about probiotics from fiction

Vaginal probiotics are touted as a way to introduce live microorganisms into your vagina to improve health. It’s true that your vagina, like your digestive tract, is teeming with beneficial bacteria and other microorganisms. When it comes to vaginal health, some common gynecological conditions are thought to be caused by an imbalance of bacteria inside the vagina. More often than not, when women seek out probiotics, they’re doing it in an attempt to ease discomfort caused by two of them: bacterial vaginosis and yeast infection, says Dr. Mitchell.

Bacterial vaginosis is the most common vaginal infection in women of childbearing age. There’s still a lot that experts don’t understand about the condition, but it is associated with an overgrowth of harmful microorganisms (such as Gardnerella vaginalis or Prevotella), which outnumber healthier types of vaginal bacteria, including a common organism called Lactobacillus.

Vaginal yeast infection also stems from an imbalance in the vagina. But in this condition, the problem is a fungus called Candida, which overcomes healthy bacteria. Candida can exist normally in the vagina without any problem, but may cause trouble if it outnumbers other microorganisms.

“There are some women who could benefit from probiotics — at least in theory,” says Dr. Mitchell. Among them are women with bacterial vaginosis or yeast infection. For example, when it comes to recurrent bacterial vaginosis, the thinking is that introducing more of the helpful lactobacilli might protect against that overgrowth of harmful organisms, and consequently reduce recurrent infections. However, proof is lacking, says Dr. Mitchell. If that theory is shown to be true, a probiotic could be beneficial, but no one is sure. And it’s not at all clear that taking a probiotic orally will help the vagina.

There are also unknowns related to vaginal yeast infection. “In the vagina, yeast and lactobacilli coexist quite happily, while in the laboratory, lactobacilli can kill yeast,” says Dr. Mitchell. So, taking probiotics isn’t a scientifically based strategy, because real-life circumstances don’t match what happens in the laboratory.

For now, the only proven treatments for bacterial vaginosis and yeast infection are antibiotic or antifungal treatments, says Dr. Mitchell.

A solution springs from frustration

But sometimes women don’t respond to the standard treatments and experience recurrent problems that leave them searching for solutions. Dr. Mitchell says that some women she’s encountered are trying not only probiotic supplements, but also alternative treatments they’ve found on the Internet. These include putting yogurt-soaked tampons, tea tree oil, and even garlic cloves into their vaginas in an effort to introduce beneficial bacteria. These solutions, she says, are not only ineffective but highly inadvisable.

“It’s true that a compound in garlic, allicin, has been shown to kill yeast in a laboratory. But you cannot put enough cloves of garlic in your vagina — or take enough oral garlic capsules — to achieve the same effect,” says Dr. Mitchell. Tea tree oil also has no demonstrated benefit and can cause irritation. Yogurt-infused tampons don’t work either. Many probiotic supplements and most yogurts do contain Lactobacillus bacteria, but it’s generally not the same type of Lactobacillus found in your vagina. L. crispatus and L. iners are the most common species found in the vagina. Most probiotics and yogurt contain other species, such as L. rhamnosus or L. acidophilus, which are more common in the gut.

Benefit or harm?

There also isn’t enough information to determine if introducing new bacteria using probiotics might do more harm than good. One study published in September 2018 in the journal Cell found that when people were given a probiotic after antibiotic treatment, their natural gut bacteria actually took longer to recover than did the gut bacteria of people who didn’t take the probiotic.

What I tell people is that over all, vaginal probiotics are probably a waste of money,” says Dr. Mitchell. “But if you are going to pick one and you really want to try one, the probiotics that seem to show some benefit in studies are ones containing Lactobacillus rhamnosus GR-1.”

Keep in mind that supplements, unlike medications, are not FDA-regulated. “Studies have shown that when these products are cultured, they often don’t have as much of what is on the label as promised, or don’t even contain what is on the label,” says Dr. Mitchell. The FDA has also found that some supplements contain potentially dangerous contaminants.

Related Information: Harvard Women’s Health Watch

Comments:

  1. Lisa Morrison

    In this case ladies, common sense prevails over waiting until the scientific community delivers a proper study.

    As a woman who has experienced both bacterial vaginosis (BV) and Candida overgrowth, supplementing with probiotics, specifically ones containing Lactobacillus rhamnosus GR-1, is beneficial. In addition, I omit sugar, yeast, fungus and fermented foods from my diet until these conditions clear (for 10 – 30 days), as these things feed the growth of unhealthy bacteria present in the body.

    I do agree that inserting garlic or tea tree oil in your vagina will not be effective and can potentially be harmful to the sensitive tissue in this area.

    Maintaining a proper balance of healthy bacteria in your body is done most effectively with a healthy lifestyle, rather than taking antifungal medication or antibiotics after the problem arises (which is a bandaid solution).

    Keep your sugar intake low and eat foods low in acidity and high in alkaline to maintain proper balance in your gut flora, the foundation of good health in your body.

    In summary, my common sense approach to BV and Candida overgrowth is to omit foods that feed the unhealthy bacteria while increasing the healthy bacteria in my body with probiotic supplements.

    It has worked for me and other women I’ve talked to. In any case, this approach is not harmful and worth trying before turning to prescribed medications that have negative side effects. In the long run, this natural approach is more effective and sustainable.

  2. Keteva Hobbs

    This article was very interesting. I am a 32 year old mother of 2. I’ve struggled with yeast infections as well as bacterial infections for over a decade. I would have to treat both BV as well as yeast infection which followed the treatment as it killed the good bacterial as well. Over the years my doctor has prescribed me a monthly renewal of Metronidazole, vaginal cream form, which I was told to take nightly. Obviously it helped prevent the reoccurring BV but it was messy and affected my sex life, and the husband didn’t like that. I was also taking flagyl, pill form, to treat the BV. My BV and yeast infections were occurring so frequently I was taking the prescriptions every 4-6 weeks.

    Overtime my body began to become immune to the medications. The original dosage amount, twice daily for 7 days, was increased to 10 day supply. Then eventually that turned into 2 weeks,14 day supply. Over the years my dosage had doubled! It seemed nothing was working but instead it was getting worst. Even while practicing abstinence, while single and not sexually active, BV would still occur. I tried everything.

    Finally after all those years I was told by a physician to take probiotics daily to control a ph balance in my body. I found out that women’s complete feminine balance probiotics existed. I decided to try it and began to take it. After only 1 week I not only saw a change, I felt a change and of course I smelt a change of scent in my vagina flora. I’ve been taking the women’s complete feminine balance now daily for 4 months and I’ve been both BV and yeast infection free. I had never been so long without getting Bacterial Vaginosis in over 10 years. I was ecstatic! I’ve tried everything possible from healthy to unhealthy treatments and nothing has yet to work except the complete women’s probiotics. I’m no expert, but it worked for me so maybe it will work for other as well.

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