Women’s probiotics get marketed like they’re the cure-all for everything from recurring bacterial vaginosis (BV) and yeast infections to “mystery” discharge. Walk into any drugstore, and you’ll be confronted with shelves of them, often wrapped in pink and described as supporting women’s health or vaginal health. Here’s the catch. Supplements like probiotics are not FDA-regulated, and research supporting their use isn’t conclusive. So should you be taking one?
What Are Probiotics?
Probiotics are live microorganisms (usually bacteria, sometimes yeast) that provide health benefits. They’re present in fermented foods and as oral or suppository supplements. Probiotic supplements have different strains of bacteria depending on what they support. For example, digestive-supporting probiotics are not the same as vaginal health probiotics. Also worth clearing up: Probiotics are not the same as prebiotics, which are fibers that act as food for microorganisms, encouraging healthy microbiomes.
Probiotics and the Vaginal Microbiome
So how can probiotics help your vaginal health? Your vaginal microbiome is a constantly shifting ecosystem of microorganisms and bacteria. In many healthy vaginas, lactobacilli species are dominant. They produce lactic acid and hydrogen peroxide, which guard against infections and harmful organisms. Researchers have found that when there isn’t enough good bacteria, like lactobacilli, the microbiome becomes disrupted. That leaves the vagina vulnerable to infections. That’s why probiotics get so much attention. In theory, adding “helpful” bacteria could support a healthier balance and reduce the likelihood of infections. .
Sorting Probiotic Fact from Fiction
Let’s sort out what’s true and what isn’t:
Do probiotic supplements make a difference?
The honest answer is that the evidence is limited. There’s not enough data to definitively say probiotics prevent or treat infections or symptoms. That’s further complicated by the fact that probiotics aren’t regulated. So while they can’t claim to “cure” anything, they can make a lot of other promises. However, there is some promising research that probiotics could be helpful if you struggle with recurrent infections or if you’re recovering from infections. And some have found that probiotics can help reduce discomfort from BV.
So should I take one?
Maybe. Vaginal microbiomes are picky and personal. A probiotic that helps your friend may not help you. Also, probiotics are supplements, not medication. They’re not regulated the same way or tested to confirm contents. That said, there aren’t a lot of downsides to probiotics. If you start a new supplement, just be sure to loop in your doctor.
Which probiotic should I take?
Not all probiotics are the same. Start by asking your clinician for recommendations. For vaginal health, look for Lactobacillus strains found in a healthy vagina: Lactobacillus crispatus, Lactobacillus gasseri,, Lactobacillus jensenii, Lactobacillus reuteri, and Lactobacillus rhamnosus. (Lactobacillus iners is detected by the MyPathAdvantage test kit, as it may be present in some healthy microbiomes but is generally not used in probiotic formulations.) Choose a probiotic that contains 1 to 50illion CFUs and sports a USP or NSF certification. If the product meets these organization’s standards for potency and purity, they’re allowed to show the verified logo on their bottle.
When should I take them?
- You might ask your doctor about probiotics if:
- You’re about to take antibiotics to support vaginal microbiome balance.
- You’re being treated for BV or a yeast infection and think probiotics could help your recovery or support comfort.
- You struggle with chronic or recurrent vaginal infections.
- You want a maintenance option, to support a healthy, balanced microbiome.
When should I NOT take them?
If your vaginal microbiome already has a high count of lactobacilli, then probiotics may cause irritation…especially for those diagnosed with cytolytic vaginosis (CV), or an overgrowth of lactobacilli Because these organisms produce a protective acid, too many of them might lead to an excessively acidic vaginal pH which can cause symptoms that present similarly to a vaginal infection.
A vaginal health test like our MyPathAdvantage evaluates your vaginal microbiome and gives an overview of your entire vaginal microbiome, and to determine your community state type. This might help guide you on which strains of lactobacilli in certain probiotics might aid you, or if you don’t need any at all. The MyPathAdvantage kit also tests for two of the most commonly supplemented strains of Lactobacilli; L. rhamnosus and L. reuteri.
The Bottom Line
Probiotics may help… but they’re not miracles. The research is still catching up, they are not FDA regulated, and plenty of brands make unsubstantiated health claims. But probiotics can be a helpful add-on, especially if you’re trying to support your microbiome after treatment or reduce infections. Start by assessing your vaginal health with a test like MyPathAdvantage and sharing the results with your doctor to see if a probiotic might work for you.
