Do vaginal probiotics in the form of pills and suppositories work?

These live microorganisms have been helping us with various kinds of diseases. There’s even a type that directly benefits the vaginal microbiome but a recent study shows otherwise.

What are probiotics?

Probiotics are live microorganisms publicised with claims to provide health benefits when consumed, typically by restoring or improving gut flora. They are deemed generally safe to consume but may induce bacteria-host interactions and undesirable side effects in rare cases. 

Microbiome and vaginal health

There and over 50 various species of tiny organisms (microbes) in the vagina, many of which are a type of bacteria called lactobacilli – these bacteria aid in keeping the vagina healthy and infection-free [2].

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

• Experiences shifts in hormones
• Has unprotected intercourse with a male partner
• Is on her period
• Does not keep good hygiene habits

A vaginal imbalance can result in a:

• Discharge
• Discomfort
• Fishy odour
• Itching

Probiotics and vaginal health

As of recent, vaginal probiotic supplements are hugely prevalent, including both pills and suppository capsules or pessaries, which are introduced into the vagina using an applicator. While evidence of effectiveness is scant, it hasn’t stopped corporations from advertising products for that pursuit.

Nevertheless, while it would be good to view some of these products with a healthy dose of scepticism, that may adjust as scientific knowledge builds. Meanwhile, here’s what’s known – and unknown – about probiotics and your vaginal health.

Vaginal probiotics are promoted as a way to introduce live microorganisms into your vagina to improve health [1]. Although there is a truth that the vagina, like a digestive tract, is overflowing with beneficial bacteria and other microorganisms, when it comes to vaginal health, some common gynaecological conditions are believed to be caused by imbalance of bacteria inside the vagina.

Evidence supporting probiotics

Some scientific evidence suggests probiotics in capsules, vaginal suppositories and yoghurt may help prevent and address vaginal flora imbalance. In a small 1996 study, doctors discovered that women who consumed probiotic yoghurt with lactobacillus acidophilus had more lactobacillus bacteria in their vaginas than those who did not [3]. 

The women who consumed this probiotic yoghurt were also less likely to experience bacterial vaginosis (a common type of inflammation from the overgrowth of bacteria naturally found in the vagina) than those who did not. These results indicate the probiotics had some protective outcomes against vaginal imbalance.

New research data

Although, a recent study shows that probiotics are inadequate in improving poor vaginal health. New research has concluded that probiotics do not enhance unhealthy vaginal flora when dispensed vaginally in a daily capsule to patients for ten days before fertility treatment [4]. 

In spite of the fact that the study has fertility in focus, no significant difference was seen between these women and those taking a placebo. However, more than one-third (34%) of the women participants showed progress between a month to three months after, regardless of whether they took a probiotic or not.

The authors suggest that postponing fertility treatment among patients with an ‘unfavourable’ vaginal microbiome may be valuable until a normal balance is achieved.

If you are taking probiotics or not, one thing’s certain: eating a healthy, balanced diet is beneficial, and regular visits to your health practitioner won’t hurt. In the future, there may be research-backed methods to strengthen the vagina’s bacterial defences, perhaps by incorporating effective probiotics with antibiotics or performing vaginal microbiome transplants [5] [6].

[1] https://bit.ly/3P2Y3A6
[2] https://www.healthline.com/health/vaginal-health/probiotic-vaginal-health#the-microbiome
[3] https://www.ncbi.nlm.nih.gov/pubmed/8930233
[4] https://www.news-medical.net/news/20220704/Probiotics-do-not-improve-unhealthy-vaginal-flora-study-shows.aspx 
[5] https://www.nytimes.com/2022/04/27/well/vagina-probiotics-supplements.html
[6] https://clinicaltrials.gov/ct2/show/NCT04046900