Probiotics for vaginal health: When you should take them - Insider

• Probiotics for general vaginal health don't do much and won't help if you don't have an issue.
• But probiotics may help if you have a condition like bacterial vaginosis or a yeast infection.
• The bacterial balance in your vagina can be thrown off by douching, unprotected sex, and more. 
• Visit Insider's Health Reference library for more advice.

Your vagina is a haven for bacteria that exist in a delicate balance. Of these, over 70% are helpful strains of Lactobacilli. 

These bacteria maintain the pH of your vagina, keeping it below 4.5 and acidic enough to fight off infections of bad bacteria or fungus. 

But your bacterial balance can be can be thrown off by:

• Having sex without a condom
• Using scented soaps to clean your vulva
• Using a douche

Note: Many supplement manufacturers offer general "women's health" or "vaginal health" probiotics for general wellbeing. However, if you aren't experiencing any symptoms like itching or unusual discharge, you probably don't need to take supplements, says Christine Greves, MD, an OB-GYN at Winnie Palmer Hospital.  

This imbalance causes a number of conditions that taking probiotics may help treat. 

Bacterial vaginosis

Bacterial vaginosis (BV) is a condition that causes symptoms like a foul odor and watery, grey discharge.

It happens when "bad" bacteria overgrow in your vagina and outnumber your "good" lactobacilli bacteria. To treat it, a doctor will usually prescribe you antibiotics to kill off the bad bacteria.

But antibiotics kill indiscriminately, so the medicine has the potential to wipe out the good bacteria along with the bad. Without the protection of your good bacteria, it's common for BV to come back.

Probiotics may help by helping to restore the balance of your good vaginal bacteria, but only if the probiotic contains the particular strains found in your vagina, like L. crispatus, Mitchell says.

In a 2020 study, people who had recently finished antibiotic treatment for BV received vaginal suppositories of L. crispatus (Lactin-V) twice per week. After 12 weeks, people who got the probiotic treatment were 15% less likely to have a recurrence of BV, compared with those who didn't get treatment.

Yeast infection

A yeast infection occurs when too much of a fungus called Candida albicans grows in your vagina. This can cause soreness, itching, and thick, white discharge.

Yeast infections are often triggered when there isn't enough good bacteria in your vagina. This can happen after taking antibiotics or can just be part of your natural vaginal environment.

You can generally treat a yeast infection using over-the-counter antifungal medications. However, yeast infections often come back when your levels of good bacteria aren't fully restored.

A small 2015 study compared people with chronic yeast infections who were treated for four months with only antifungal medication and those who took probiotic suppositories along with their treatment. 

One year after the study began, people who had received the probiotic treatment were nearly 20% less likely to have gotten another yeast infection, compared with those who only took anti-fungal medication.

However, large-scale research is still needed to see if probiotics are an effective treatment for yeast infections.

How to take probiotics

Most probiotics on the market for vaginal or women's health are oral, which is a problem because "there's very little data suggesting that taking a probiotic by mouth will impact the vaginal bacterial community," says Caroline Mitchell, MD, MPH, the director of the Vulvovaginal Disorders Program at Massachusetts General Hospital.

Taking probiotics through a vaginal suppository is likely to be more effective, though research on products is still in the early stages, Mitchell says.

Lactin V, a product currently moving toward FDA approval, uses 2 x 10⁹ colony forming units in each dose, which is similar to the doses used in current published studies. The manufacturers suggest taking using it daily for five days, starting two days after finishing antibiotic or antifungal courses, and then twice weekly for 3 months to renew your normal levels of good bacteria.

Insider's takeaway

A proper balance of good and bad bacteria is important for your vaginal health and probiotics may be helpful when this balance is upset.

More research is still needed, but taking vaginal probiotic suppositories may help you prevent an illness like bacterial vaginosis or yeast infection from coming back after you get treatment.

If you're not having any vaginal symptoms, you probably don't need to take any probiotics — you can let your vagina take care of itself.

Madeline Kennedy

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