Probiotics for Vaginal Health: Do They Work?

Probiotics for Vaginal Health: Do They Work?

This review considers whether probiotics are effective agents for the treatment and/or prevention of bacterial vaginosis (BV). There seems to be an association between the absence of, or low concentrations of, vaginal lactobacilli and the development of BV. Many studies have suggested that the presence of H2O2-producing vaginal lactobacilli may protect against BV, although some studies do not support this hypothesis. In-vitro studies have suggested that certain specific strains of lactobacilli are able to inhibit the adherence of Gardnerella vaginalis to the vaginal epithelium and/or produce H2O2, lactic acid and/or bacteriocins, which inhibit the growth of bacteria causing BV. Clinical trials showed that intra-vaginal administration of Lactobacillus acidophilus for 6-12 days, or oral administration of L. acidophilus or Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14 for 2 months, resulted in the cure of BV (defined as a 0-1 positive score according to Amsel’s criteria), and/or reduced the recurrences of BV, and/or caused an increase in vaginal lactobacilli and restoration of a normal vaginal microbiota, significantly more frequently than did a placebo, acetic acid or no treatment. However, several trials have found no significant difference in the cure rate of BV and in the number of vaginal lactobacilli after intra-vaginal instillation of lactobacilli when compared with the effect of a placebo or oestrogen. Thus, although the available results concerning the effectiveness of the administration of lactobacilli for the treatment of BV are mostly positive, it cannot yet be concluded definitively that probiotics are useful for this purpose.

“There has been promising research in the past few years indicating that probiotics may be effective in treating some conditions precipitated by changes in vaginal pH balance,” says Mindy Haar, PhD, RDN, CSN, of the New York Institute of Technology’s Department of Interdisciplinary Health Sciences.

The microbiome

More than 50 different species of tiny organisms (called microbes) live inside your vagina. Many of these microbes are a type of bacteria called lactobacilli. These bacteria help keep the vagina healthy and free of infection.

A lack of lactobacilli and an overgrowth of some other microbe can cause an imbalance in the vagina. This imbalance can occur for a number of reasons, including when a woman:

  • has unprotected sex with a male partner
  • experiences changes in hormones
  • is having her period
  • does not maintain good hygiene habits

A vaginal imbalance can result in a:

  • fishy odor
  • discharge
  • discomfort
  • itching

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