You know that probiotics can be good for your gut, but does your vagina also need one? You would think so, based on probiotic marketing nowadays. Probiotics are in everything from drinks to pills and powders, and in many cases they are promoted as a means to improve 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 extremely popular. This includes both probiotic pills and suppository capsules that are inserted into the vagina using an applicator.
But the evidence of effectiveness is scarce. “There is almost no evidence that these have benefits for vaginal health. The studies are usually poorly done and do not adhere to strict reporting standards, even if they are randomized studies, “says Dr. Mitchell. But that has not prevented companies from promoting products for that purpose.
Although today’s vaginal probiotic products need to be viewed with a healthy dose of skepticism, that may change as scientific knowledge grows. Meanwhile, here is what is known – and unknown – about probiotics and your vaginal health.
Sorting facts about fiction probiotics
Vaginal probiotics are advertised as a way to bring living microorganisms into your vagina to improve health. It is true that your vagina, like your digestive tract, is full of useful bacteria and other microorganisms. When it comes to vaginal health, it is thought that some common gynecological conditions are caused by an imbalance of bacteria in the vagina. More often than not, when women look for probiotics, they do it in an effort to reduce discomfort caused by two of them: bacterial vaginosis and fungal infection, Dr. says. Mitchell.
Bacterial vaginosis is the most common vaginal infection in women of childbearing age. There is still much that experts do not understand the condition, but it is associated with an overgrowth of harmful microorganisms (such as Gardnerella vaginalis or Prevotella), which surpass healthier types of vaginal bacteria, including a common organism called Lactobacillus.
Vaginal fungal infection also results from an imbalance in the vagina. But in this condition, the problem is a fungus called Candida, which overcomes healthy bacteria. Candida can normally exist in the vagina without a problem, but can cause problems if it surpasses other microorganisms.
“There are some women who can benefit from probiotics – at least in theory,” Dr. says. Mitchell. Among them are women with bacterial vaginosis or fungal infection. For example, when it comes to recurrent bacterial vaginosis, the idea is that introducing more of the useful lactobacilli can protect against that overgrowth of harmful organisms and therefore reduce recurrent infections. However, there is no evidence, says Dr. Mitchell. If that theory proves to be true, a probiotic can be useful, but no one knows for sure. And it is not at all clear that an oral probiotics helps the vagina.
There are also unknowns related to vaginal fungal infection. “In the vagina, yeast and lactobacilli co-exist very happily, while in the laboratory lactobacilli can kill yeast,” Dr. Mitchell. Taking probiotics is therefore not a scientifically supported strategy, because the actual circumstances do not match what is happening in the laboratory.
For now, the only proven treatments for bacterial vaginosis and fungal infection are antibiotics or antifungal treatments, Dr. Mitchell.
A solution comes from frustration
But sometimes women do not respond to standard treatments and they experience recurring problems, which means they look for solutions. Dr. Mitchell says that some women she encountered try not only probiotic supplements, but also alternative treatments that they have found on the internet. These include immersing yogurt-soaked tampons, tea tree oil, and even garlic cloves in their vagina in an effort to introduce beneficial bacteria. According to her, these solutions are not only ineffective, but also highly advisable.
“It is true that a laboratory has shown that a compound in garlic, allicin, kills yeast. But you can’t put enough cloves of garlic in your vagina – or take enough oral garlic capsules – to achieve the same effect, “Dr. says. Mitchell. Tea tree oil also has no proven benefit and can cause irritation. Tampons soaked with yogurt also do not work. Many probiotic supplements and most yogurt contain Lactobacillus bacteria, but it is generally not the same type of Lactobacillus that you find in your vagina. L. crispatus and L. iners are the most common species in the vagina. Most probiotics and yogurt contain other species, such as L. rhamnosusor L. acidophilus, which are more common in the gut.
Benefit or damage?
There is also not enough information to determine whether introducing new bacteria with probiotics can do more harm than good. A study published in September 2018 in the journal Cell showed that when people were given an antibiotic after antibiotic treatment, their natural gut bacteria actually needed more time to recover than the gut bacteria from people who did not use the probiotic.
What I tell people is that vaginal probiotics are generally a waste of money, “Dr. Mitchell. “But if you choose one and you really want to try one, then the probiotics that appear to show some benefit in studies are those with Lactobacillus rhamnosus GR-1.”
Keep in mind that supplements, unlike drugs, are not FDA regulated. “Studies have shown that when these products are grown, they often do not have as much of what is on the label as promised, or do not even contain what is on the label,” Dr. Mitchell. The FDA has also determined that some supplements contain potentially dangerous contaminants.