Probiotics for Vaginal Health: Are They Really Good for You?

When it comes to vaginal health, there’s no one-size fits all. Everyone’s vaginal microbiome is unique, meaning that what works for some people might not be right for you. And nothing is more frustrating than spending money on probiotics for vaginal health without knowing if they'll do anything. 

Probiotics are often advertised as a cure-all for health issues, from digestion to skincare and even vaginal infections like bacterial vaginosis (BV) or yeast infections. So you’re not alone if you’ve hoped that a probiotic supplement may be all you need to make vaginal symptoms like odor or unusual discharge go away. 

We rounded up the available (albeit minimal and conflicting) research to dig into the nuance of probiotics for vaginal health, including which ones are most effective and who might benefit from using them.   

What are vaginal probiotics?

Probiotics are live bacteria you can consume or administer to yourself (as food, a pill, topical, or a suppository) to support your microbiome health. Vaginal probiotics are simply probiotic supplements specifically designed to support the vaginal microbiota. You can find them sold as oral tablets or suppositories that can be inserted vaginally. 

You may have heard that probiotics can be beneficial for your gut health. It’s important to note that probiotics designed for the gut have different strains of bacteria than those meant to support vaginal health. The most common strains of bacteria found in “women’s health” focused probiotics belong to the Lactobacillus and Bifidobacterium genera. These are some of the same species of bacteria also naturally found in fermented foods (think yogurt, kombucha, kimchi, etc.).  

There are also “prebiotics,” which are non-living compounds that act as a food source for the bacteria that live in your body. Some products, called synbiotics, combine both prebiotics and probiotics.

How do probiotics help vaginal health?

Your vagina has a unique microbiome –– a complex ecosystem of organisms (some good, some not as much), including bacteria and fungi. 

Your microbiome can shift over time due to several factors, including sex, your period, and medication. Sometimes, those changes lead to decreased Lactobacilli, allowing harmful bacteria and other microorganisms to overgrow and change your normal vaginal flora. This is called vaginal dysbiosis. 

Probiotics work by promoting the growth of healthy bacteria, such as Lactobacillus, in the vaginal microbiome. Lactobacillus bacteria promote a balanced vaginal environment in a few ways: 

1. They can physically attach themselves to the surfaces in your vagina, taking up space so that less-desirable microbes can't live there too. 
2. They produce lactic acid and hydrogen peroxide to keep the vaginal pH acidic. The acidic environment keeps out some less desirable microbes since they prefer neutral surroundings. 
3. They can also produce molecules that attack and kill other potentially harmful microbes nearby. 

Lactobacillus are the local heroes of a healthy vagina, and probiotics may help to promote them so they can do their thing.  

What probiotics are good for vaginal health?

Investment in human microbiome research has increased significantly in the last decade. As a result, you might have heard people talking more about the benefits of probiotic supplements or fermented foods. While these types of probiotics can be beneficial for your gut microbiome, several studies have concluded that taking oral probiotics probably won't have much of an impact on your vaginal microbiota. 

Another issue is that there are millions of probiotic strains, and no two vaginal microbiomes are the same, which makes researching probiotics' effect on vaginal bacteria pretty tricky. Ultimately, we need more high-quality, placebo-controlled research on which probiotic strains are effective in maintaining vaginal health (and at which doses).

This doesn't mean that all oral probiotics are totally useless for the vaginal microbiome, though. Some studies suggest that taking oral probiotics with a high dose of bacteria over an extended period may help. 

Excitingly, there may also be more efficient approaches in the form of vaginal suppositories or other direct applications. Because bacteria are administered directly into the vaginal canal, they are less likely to die before colonizing — which can happen when probiotics have to journey through the digestive tract to get to the genitals. 

One way to access medical-grade vaginal probiotics is through Evvy’s Clinical Care programs, which may include compounded vaginal probiotic suppositories if an Evvy-affiliated provider prescribes them in your treatment plan.

When should I consider using probiotics for vaginal health?

Although there’s no consensus on whether probiotic supplements can improve the balance of your vaginal microbiome, existing research shows that there are specific instances in which using a vaginal probiotic could be beneficial.  

1. After taking antibiotics: If you take antibiotics (orally or vaginally), it’s possible that the antibiotic can mess with your vaginal ecosystem. While antibiotics are excellent for clearing out vaginal infections like bacterial vaginosis or urinary tract infections (UTIs), they can kill both bad and healthy bacteria. Probiotics can save the day by helping replenish the beneficial bacteria that may have become diminished from antibiotic treatment.
2. If you have bacterial vaginosis: If you’re dealing with chronic bacterial vaginosis, probiotics may become your new best friend. A clinical study from 2010 showed that after oral antibiotics, once-a-week vaginal treatment with Lactobacillus rhamnosus for six months helped keep bacterial vaginosis symptoms from returning for one year. Another 2010 study also saw that just five days of treatment with a vaginal probiotic after antibiotic treatment helped keep bacterial vaginosis symptoms away longer. While more clinical trials are needed, the research currently suggests that lactobacilli-containing vaginal probiotics have promise for preventing bacterial vaginosis in conjunction with traditional antibiotic treatment. It’s something worth asking your gyno about if you are struggling with recurrent bacterial vaginosis. 

Most people don't need to do anything special to keep their vaginal health in check. Your vagina is pretty good at fixing itself if anything goes out of whack — that's precisely what the vaginal microbiota is there for.

That said, if you're someone who deals with recurrent yeast infections or BV regularly, taking a probiotic might give you a better chance of preventing these uncomfortable and unpleasant conditions. As we said above, everyone's vaginal environment is unique, so treatment and prevention should be designed with your provider and tailored to your specific needs. 

When should I not take probiotics? 

Even though probiotics can be a great addition to your vaginal health toolkit, they aren’t necessarily suitable for everyone. If you already have a high amount of vaginal lactobacilli, then adding more may cause irritation. In the world of microbiomes, you can have too much of a good thing. 

People who have been diagnosed with cytolytic vaginosis (CV) should also stay clear of probiotics. CV is caused by an overgrowth of lactobacilli, which causes unpleasant symptoms like pain while peeing or during sex, itching or burning, and increased vaginal discharge (frustratingly, many of the same symptoms as bacterial vaginosis and yeast infections). CV is treated by decreasing the amount of lactobacilli in your system, and since probiotics do the opposite, it’s best to stay away. 

Taking an Evvy vaginal microbiome test is a great first step to determine the levels of Lactobacilli in your vaginal environment.

How to choose a vaginal probiotic

In general, when choosing a probiotic, look for one that includes a probiotic combination of Lactobacillus strains that specifically target vaginal health. Research suggests that brands that include one of the two combinations would be most effective, based on the results of these strains in human trials:  

•  Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 
•  Lactobacillus rhamnosus HN001, Lactobacillus acidophilus GLA-14 + lactoferrin 

All of Evvy’s probiotic options through Clinical Care with Evvy contain strains optimized for vaginal health. 

Keep in mind that products classed as “supplements” in the U.S. aren’t regulated by the FDA, so many other brands take advantage of this and embellish their probiotic’s efficacy. 

If you’re looking for an OTC option, two of the brands we typically recommend are Optibalance Probiotic and RepHresh Pro-B Probiotic. That said, your OBGYN is the best person to ask about probiotics. So, if you're considering taking one, it's always a good idea to check with your healthcare provider first. They can help you decide if it's right for you and how to take it safely as a supplement.

‍Finding out more about your vaginal microbiome with an Evvy test can take some of the guesswork out of whether or not you would benefit from using probiotics, and if so, connect you with a provider who can prescribe the most effective vaginal probiotic for you. Finding the best probiotic routine for you may take some trial and error, but we’re here to help every step of the way! 

Does Evvy recommend probiotics? And if so, which ones?

Evvy recommends talking to your doctor about probiotics only if you need to increase healthy bacteria (specifically the most optimal Lactobacillus strains) in your vaginal microbiome. 

An Evvy vaginal microbiome test can give you a comprehensive report of 700+ bacteria and fungi in your microbiome, including all strains of lactobacilli, and their relative amounts (meaning you can see how much of each type of bacteria/fungi you have.) This can help illuminate your levels of beneficial bacteria and whether a probiotic might be beneficial! Remember, there are cases when probiotics can make irritation worse, so having a microbiome report can help guide your decision. 

 If you’re eligible for Clinical Care with Evvy, a provider will review your results and determine a custom set of treatments for you. This can include prescription medication and research-backed supplements, like probiotics.

Because our probiotics are prescribed by a doctor, they can come in both an oral pill and a vaginal suppository format. If you’re prescribed a vaginal probiotic suppository, that means those helpful lactobacilli strains can make it straight to your vagina without a trip through your gut!  

FAQs

Do probiotics flush out yeast? 

There’s no evidence that vaginal probiotics treat yeast infections. Some research shows that taking probiotics might help support your vaginal health by promoting the growth of good bacteria, mainly Lactobacillus species. This can help restore the vaginal pH, keeping infections and uncomfortable symptoms at bay, but more research is needed to determine how effective this strategy is. The most effective way to treat yeast infections is with OTC or prescription antifungal medication. 

Should a woman take a probiotic daily?

It’s not necessary to take a probiotic to maintain good vaginal health, but if you want to, go for it! There’s still no consensus on whether probiotic supplements can do much for your vaginal health, but some research shows they could be helpful after a course of antibiotics, or if you experience recurring bacterial vaginosis.

Will vaginal probiotics cure BV? 

There’s no evidence that probiotics are effective for treating bacterial vaginosis. The only proven treatments for bacterial vaginosis are antibiotics. Some studies show that taking Lactobacillus-based probiotics in combination with antibiotics can reduce the likelihood of bacterial vaginosis coming back after treatment (which it has a habit of doing). That said, it’s still an emerging area of research!

Can putting yogurt in your vagina help vaginal health?

No — putting yogurt in your vagina can cause more harm than good. While yogurt does contain probiotics, the sugars in yogurt can actually feed bacteria and yeast, which is bad news for your vaginal health. Most store-bought yogurts also don’t have a measurable amount of Lactobacilli. Just remember: nothing should go into your vagina that was not designed specifically for that purpose!