Probiotics for Vaginal Health: How Are They Different From Gut Probiotics?

In today’s world, the term “probiotics” has become a regular part of discussions around healthy living. Probiotic-rich yogurts splash across our TV screens and fill the shelves of grocery stores. You can even find sodas with probiotic formulas. 

The benefits of probiotics for gut health are well known and we can quickly reach for a probiotic formula when digestion goes awry. But our guts are not the only home to microbiomes in our bodies. 

So why does our use of probiotics stop there? 

For half the population, another very important microbiome lies just beneath the gut: the vaginal microbiome. Just like the gut microbiome, the vaginal microbiome has billions of microorganisms that can help, or sometimes hurt, our health. 

Just like the gut microbiome, an imbalance in the vaginal microbiome can lead to discomfort, infection, and could even increase the risk of gynecological cancers.^[1]

The vaginal microbiome may also be able to greatly benefit from probiotics—though not quite the same probiotics as those for your gut. 

Read on to learn all about probiotics for vaginal health, how they differ from gut probiotics, and which could be the best for you to use for your vaginal health. 

What Exactly Is a Probiotic?

We talk about and consume probiotics all the time. But many of us don’t actually know what a probiotic is. 

Let’s break it down.

According to the International Scientific Association for Probiotics and Prebiotics, probiotics are “live microorganisms that, when administered in adequate amounts, confer a healthy benefit on the host.”^[2]

This essentially means that they are microorganisms, for example bacteria, fungi, and viruses, just like those that reside in your various microbiomes, that can improve your health when taken correctly.^[3] 

Inside each of your microbiomes, like your gut or vaginal microbiome, is a certain balance of billions of microorganisms, including bacteria, yeast, and fungi. These microbiomes are made up of both “good”, or helpful, microorganisms, and “bad”, or harmful, microorganisms.^[4] In the most basic sense, when good microorganisms dominate, your microbiome tends to be healthy and generate good health outcomes; when bad microorganisms dominate, your body can become susceptible to infection or disease. This state is known as dysbiosis.^[5]

When we consume probiotics, we’re simply adding more of the “good” microorganisms to our microbiomes. The microorganisms that we ingest join the existing microorganism communities within us. In doing so, we add to our existing populations of the good microorganisms in our microbiomes. This bolsters populations and helps them dominate over the bad microorganisms.^[6] This is true for your gut microbiome, your vaginal microbiome, and any other microbiome within your body. 

Probiotics are important because our microbiomes are always changing. The vaginal microbiome experiences fluctuations during the menstrual cycle, after sexual activity, and during menopause. The longer the vaginal microbiome remains in a state of dysbiosis (or imbalance), the more susceptible we can become to infections and disease.^[5] Probiotics can help support a healthy balance during these shifts in the microbiome. 

Gut Probiotics vs. Vaginal Probiotics

Probiotics are not a one-size-fits-every-microbiome solution. While there is some overlap, each of our microbiomes has its own specific mix of microorganisms.

However, many bacteria present in the gut can also be present in the vagina; for example, when you take an oral probiotic supplement, it passes through the gut, before making its way externally to the vagina.

Both the gut and the vaginal microbiomes contain Lactobacillus, a “good” bacteria that’s prominent in probiotic products. Lactobacilli creates an environment in which it is difficult for harmful bacteria to thrive. 

A good vaginal probiotic should contain the specific strains of lactobacilli that are present in the vagina. Some strains include:^[7,8]

• L. iners
• L. crispatus 
• L. gasseri
• L. jenesenii
• L. acidophilus 
• L. fermentum
• L. plantarum
• L. brevis
• L. casei
• L. vaginalis 
• L. delbrueckii
• L. salivarius
• L. reuteri
• L. rhamnosus

Types of Vaginal Probiotics

Vaginal probiotics come in many forms: oral supplements, vaginal suppositories like capsules, gels, or tablets, and even yogurt. Each of these forms of probiotics contains live bacterial strains that also live in your vagina. By ingesting or inserting them, they add to the populations in your microbiome.

How Vaginal Probiotics Could Support Vaginal Health

Studies have shown that the vaginal microbiome is related to many different facets of overall health, and probiotics may assist in these factors.^[9]

• Bacterial vaginosis: An extremely common vaginal infection, BV is caused by an imbalanced vaginal microbiome. Historically, treatment includes antibiotics, after which recurrence is extremely likely. Studies suggest that a mixture of probiotics and antibiotics may be more effective in reducing the risk of recurrence of BV versus just antibiotics alone.^[9]
• Genitourinary Syndrome of Menopause: After menopause, many females experience symptoms like vaginal dryness, increased urination, UTIs, and more, commonly treated by introducing estrogen. Research shows GSM may be associated with a decrease in lactobacillus and that combining estrogen treatment with probiotics can create much better outcomes.^[9]

Choosing the Right Probiotic

It’s clear that probiotics can make a significant difference in vaginal health—but it’s vital to choose the right probiotic for your needs. Consider the following when selecting a probiotic:^[10] 

• Types of bacterial strains: As discussed, in order for a probiotic to be effective, it should contain bacteria that naturally occur in your vaginal microbiome. Always check the list of strains included in your probiotic and ensure that you’re introducing the right bacteria that can thrive.
• Dosage and CFU: CFU, or colony-forming units, refers to the number of microorganisms that you’ll receive in each dose of probiotic. It’s generally recommended to introduce at least 1 billion CFU with each dose. 
• Storage information: Probiotics are alive, so some may need to remain in conditions that will help keep them alive. Most probiotics need refrigeration but there are shelf stable options that can be just as effective.^[11] Plus, it’s important to always pay attention to the expiration date. Probiotics with inulin are even better, as this is a food source that can help sustain the microorganisms. 
• Clinically studied ingredients: It’s always advised to choose probiotics with clinically studied strains and in the combination and dose that matches the clinical trials, as different strains can have different effects. These will have outcomes that are backed by clinical research.^[3]

Of course, it’s also important to consider your lifestyle when selecting a probiotic. Which form of probiotic best aligns with your preferences? For some, an oral supplement may be easier to incorporate into your daily life than a vaginal suppository. For others, simply introducing a probiotic rich yogurt into your breakfast routine is the easiest choice. The best probiotic is one that you’ll consistently take. 

Probiotics can be a great way to support a healthy vaginal microbiome. When taken correctly, they can not only improve your vaginal health but can also improve your overall health.