Do Probiotics Help Vaginal Health?

Probiotics are live microorganisms that improve your health. Probiotics improve vaginal health and prevent infections from taking hold.

Probiotics are live microorganisms that improve your health. When you eat a probiotic like yogurt, its microorganisms start living in your intestines and provide health benefits. Intestinal probiotics improve digestion, get rid of disease-causing bacteria, and enhance gut health. Probiotics and vaginal health may have a similar relationship. Your vagina has bacteria, too, and the balance of microorganisms can be altered in many vaginal disorders. Probiotics may be a way for you to improve your vaginal health.

Over 50 species of bacteria live in the vagina when it is healthy. Most of these are Lactobacillus species, mainly L. crispatus, L. gasseri, L. iners, and L. rhamnosus. Other bacteria like Escherichia coli and Streptococcus species may also live in the vagina. Fifty species of bacteria in the vagina seems like a lot, but consider that your intestines harbor 800 types of bacteria while you enjoy good health and digestion.

These bacteria live in the vagina without causing any disease or discomfort. Lactobacillus produces lactic acid, acetic acid, and hydrogen peroxide. They keep the pH of the vagina at around 4.5 and hamper the growth of Candida and bacteria that cause disease. Lactobacilli also produces chemicals called bacteriocins. These substances hamper the growth of bacteria that cause bacterial vaginosis.

After menopause, hormonal changes alter the vaginal mucosa and environment, and the number of friendly bacteria in the vagina decreases significantly. This might be why postmenopausal women have more vaginal infections.

Hormone replacement therapy (HRT) has important effects on vaginal health and bacteria. Women taking HRT have only one to three species of bacteria inhabiting their vagina. They are almost always Lactobacilli. But postmenopausal women not taking HRT are more likely to have disease-causing bacteria like Bacteroides, Gardnerella, Prevotella, Escherichia coli, and Enterococcus.

Some women use vaginal probiotics as a way to improve their vaginal health. In general, you should only use a treatment to cure a definite disorder. Some vaginal disorders are unpleasant and last for a long time. Conventional medical treatment doesn't provide relief, or you find it cumbersome. Probiotics may offer you an alternative way to relieve your vaginal symptoms.

Bacterial vaginosis

This is a troublesome condition caused by bacteria, most often Gardnerella vaginalis, Mycoplasma hominis, or Prevotella species. The normal bacteria in a healthy vagina are Lactobacilli, which get replaced by these disease-producing bacteria. You may notice a change in the color, amount, and smell of your vaginal discharge. Your doctor will prescribe a course of antibiotics (usually clindamycin or metronidazole) to cure the infection and restore vaginal health. Bacterial vaginosis has high recurrence rates. 

Vaginal fungal infections

Fungi (yeasts) can cause unpleasant and long-lasting infections in the vagina. Fungal vaginitis causes itching, burning, and a white discharge from the vagina. Most such infections are caused by fungi called Candida. These yeasts can live in the vagina without causing any problem. When there is an overgrowth, they overwhelm your normal vaginal bacteria and cause disease. A fungal infection generally requires a course of antifungal medicines. Your doctor may prescribe medicated pessaries for you to insert in your vagina for a few days.

Antibiotics and antifungal medicines often work, but not always. Bacterial vaginosis tends to occur again after you've taken treatment. If you've taken one or more courses of these medicines but are still uncomfortable, you may think of trying alternative therapies like vaginal probiotics. Be aware that probiotics are not sold to treat any specific disease. Claims of disease cure have to be proven. Probiotics are sold as food supplements.

While medicines can cure bacterial infections, they don't restore the vagina to normal health. Besides, medicines have a short duration of activity. The body gets rid of them within hours of the last dose. Yeast and bacterial infections tend to occur again and again.

The advantage of probiotics is that they improve vaginal health and prevent infections from taking hold. Probiotic organisms like L. rhamnosus GR-1 and L. fermentum RC-14 produce substances that oppose the growth and attachment of harmful bacteria to the vaginal wall. This reduces your likelihood of bacterial and fungal vaginal infections.

Probiotics to improve vaginal health are available as oral supplements and vaginal products like capsules and suppositories. These products replace harmful bacteria with friendly bacteria in some women. 

Products containing L. crispatus, L. rhamnosus BMX 54, and others for vaginal use have been tried in women. These women had fewer recurrences of bacterial vaginosis.

Vaginal microorganism transplantation is another promising approach. Women with repeated bacterial vaginosis not responding to regular treatment received vaginal flora harvested from healthy women. Women recipients reported long-term relief over 5 to 12 months.

An alternative approach is to take probiotics by mouth. This might seem safer than inserting bacteria into your vagina. Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14 taken by mouth in skim milk has been shown to appear in the vagina. This could be a safer, more acceptable way of restoring vaginal health. 

Probiotics and antibiotics may be best used together. A course of antibiotics for bacterial vaginosis eliminates the disease-causing bacteria. But the normal bacteria of the vagina are also destroyed, leaving the field open for another infection. Inserting probiotics after the antibiotics could repopulate your vagina with harmless bacteria and help the normal bacteria to return.

Vaginal probiotics are not medicines and are not regulated by the Food and Drug Administration (FDA). The products are not tested for their contents. They may contain more, less, or none of the contents on the label. They're sold as food supplements, and manufacturers have considerable freedom in making claims of safety and efficacy.

Remember that your vagina is different from everyone else. Vaginal flora composition is unique to every woman and varies with diet, age, lifestyle, hormone status, and medicine intake. The probiotic that solved someone else's vaginal health problems may not work for you. You may have to try several products until you find one right. 

You'll see thousands of probiotics on the supermarket shelves. Look for those that contain Lactobacillus rhamnosus and Lactobacillus fermentum. These have been shown to have some benefits for vaginal health. 

Probiotics are known to be safe and have almost no adverse effects or dangers for people in good general health. But you must still use them wisely. Don't use probiotics meant for the intestines in your vagina. The organisms are different. Inserting tampons soaked in yogurt or tea tree oil is unwise. Use only probiotics specifically made for vaginal health.