We often hear about the benefits of probiotics for gut health and cognitive well-being. These supplements are known to aid digestion and enhance mood, and they tend to get a lot of hype.
Yet there is another part of your body that might benefit from probiotics too – your vagina. Just like our gut, your vagina hosts a complex ecosystem of bacteria that plays a significant role in maintaining health and balance.
Today, vaginal probiotic supplements line shelves and online stores. These include probiotic pills and suppositories that are placed into the vagina directly. They promise to improve vaginal health, but do these products really live up to their promises?
We spoke with Debra Wickman, MD, an OBGYN and vulvar medicine specialist with Banner – University Medicine, who broke down the different types of flora in the vagina and whether the hype of vaginal probiotics matches reality.
Vaginal health 101
The vagina has its own ecosystem, often referred to as the vaginal microbiome. It’s home to many microorganisms like bacteria, fungi and viruses. The most prominent bacteria or vaginal flora in a healthy vagina are Lactobacillus species.
“Lactobacilli produces lactic acid and hydrogen peroxide, allowing for an acidic environment,” Dr. Wickman said. “Most disease-causing bacteria thrive at a much higher pH (alkaline), so maintaining an acidic pH of the vagina discourages the growth of these harmful bacteria.”
When vaginal pH balance goes out of whack, it can lead to conditions like bacterial vaginosis, urinary tract infections or yeast infections. “The natural flora can be easily killed off by taking antibiotics or using products that alter the vaginal pH,” Dr. Wickman said.
Good bacteria can also be killed off or reduced by autoimmune conditions, chronic stress and products like lubricants, spermicides, body washes and soaps.
What are vaginal probiotics?
Vaginal probiotics are based on the idea of supporting and maintaining a healthy balance of good bacteria in the vagina. The thought is to introduce helpful bacteria like Lactobacillus to increase the population and shield against unfriendly bacteria.
Today, you can find both oral probiotics (which are made to pass through the intestines and make their way to the vagina) and vaginal suppositories (which are placed directly into the vagina).
Are vaginal probiotics safe?
Because vaginal probiotics are sold as dietary supplements, they are not regulated by the U.S. Food and Drug Administration (FDA). There is also little evidence to suggest these products do what they claim.
“The FDA does not regulate vaginal probiotics, and they don’t need to be prescribed by a health care provider,” Dr. Wickman said. “They are sold directly to consumers, often with many promises in their ads.”
There have been a few studies – some showing a reduction in vaginal odor and others confirming lower rates of returning bacterial vaginosis. But overall, the reports are unclear on whether or not adding vaginal probiotics will help the situation or even do more harm than good. It depends on the quality of the product and whether it is used correctly.
Dr. Wickman noted that many oral types of probiotics are destroyed in the acidic stomach and never make it to the vagina. Many suppositories are created by heating in molds to form a bullet shape. During this process, the bacteria may be killed before being placed in the vagina.
Who might benefit from vaginal probiotics?
Vaginal probiotics might benefit people who suffer from chronic autoimmune conditions that cause vulvovaginitis, such as those with lichen sclerosus or lichen planus, those on long-term antibiotics or people who are postmenopausal – especially if they aren’t taking hormone therapy.
“Healthy flora have difficulty maintaining colony counts in the presence of inflammation,” Dr. Wickman said. “Taking long courses of antibiotics can also kill off flora and may allow growth of harmful bacteria instead.”
However, it’s essential to speak with your health care provider before starting vaginal probiotics.
Should I try a vaginal probiotic?
Never start a dietary supplement without first checking with your health care provider, ideally a gynecologist or vulvar specialist (a health care professional who treats conditions of the vulva, vagina and cervix). A specialist can help treat any infections and strategize on the best treatment plan for you, including probiotics or lifestyle changes.
“There are a few vaginal probiotics that are reliable, like Clairvee by Bonafide,” Dr. Wickman said. “I’ve found it has the best track record, supportive clinical trial data, and a unique overall strategy for delivery of the flora to the vagina.”
Other ways you can boost good flora naturally in your vagina are to:
- Eat a healthy diet: Avoid refined sugars, processed foods and dietary causes of inflammation like dairy and gluten. Eat foods rich in fiber (like carrots, apples and celery) and probiotics (such as yogurt and kefir and fermented foods like kimchi).
- Use good vaginal lubricants: Look for products without propylene glycol or other harsh preservatives.
- Drink plenty of water: Drinking enough water supports overall health, including the health of your microbiome.
- Avoid unnecessary antibiotics: Only take antibiotics when prescribed by your provider, as they can disturb the balance of good bacteria in the vagina.
Taking certain probiotics has been shown to help with gut and brain health, but the research is still out on how they can help with vaginal health.
Before jumping on the vaginal probiotic bandwagon, consider talking to your health care provider or a Banner Health specialist first. They can make sure the product aligns with your unique health care needs.