Best Probiotics for Bacterial Vaginosis

What are Probiotics? 

Probiotics are microorganisms that provide health benefits to humans when consumed in adequate amounts. These beneficial bacteria are commonly known as “friendly” or “good” bacteria since they help to maintain a healthy balance of bacteria in various parts of the body, including the digestive system and urinary tract

What is Bacterial Vaginosis (BV)?

Bacterial vaginosis (BV) is a common vaginal infection caused by an overgrowth of certain types of bacteria in the vagina. Normally, the vagina is home to a mix of “good” and “bad” bacteria. However, in women with BV, the natural balance of bacteria is disrupted, and the “bad” bacteria outnumber the “good” bacteria. This can lead to symptoms such as vaginal discharge, itching, and a strong, unpleasant odour.

Although bacterial vaginosis is not a sexually transmitted infection (STI), it favours the development of STIs including HIV. 

The bad organisms that result in bacterial vaginosis are.   

• Gardnerella vaginalis
• Atopobium vaginae
• Prevotella spp.
• Mobiluncus spp.
• Mycoplasma hominis
• Ureaplasma urealyticum

What are the symptoms of Bacterial Vaginosis? 

The most common symptoms 

• Thin, grey, or white vaginal discharge

• Strong, unpleasant “fishy” odour, especially after sex
• Itching or burning in the vaginal area
• Vaginal irritation or inflammation
• Pain or discomfort during sex

Asymptomatic, yet Dangerous

In some women,  BV may be asymptomatic. And yet, such asymptomatic infection can still increase the risk of developing other infections, including sexually transmitted infections (STIs).

Difficult to Differentiate Clinically

Since those symptoms may present in other types of vaginal infections, it is advisable to consult with a  healthcare provider to perform a pelvic exam, swab the vaginal area, and examine the discharge under a microscope to confirm or exclude this condition. 

What are the favourable conditions to develop bacterial vaginosis? 

Although the exact cause of bacterial vaginosis (BV) is not fully understood, there are several factors that can increase the likelihood of developing the condition. 

• Sexual activity: Having sex, particularly with multiple partners, can disrupt the natural balance of bacteria and pH in the vagina and increase the risk of BV.
• Vaginal hygiene: Overwashing or using harsh soaps and detergents in the genital area can upset the natural balance of bacteria and lead to BV. Douching can also disrupt the vaginal flora and increase the risk of infection. Likewise, poor vaginal hygiene can also cause BV.
• Antibiotics: Although not very common, taking antibiotics for other infections can kill off both harmful and beneficial bacteria, allowing BV to develop.
• Menstrual cycle: Some women are more prone to BV during their menstrual cycle as a result of hormonal changes as well as the vaginal flora throughout the cycle. 
• Smoking: Surprisingly, smoking can disrupt the natural balance of bacteria in the vagina and make women more susceptible to developing BV.
• Immunodeficiency: Women with weakened immune systems due to conditions like HIV, diabetes, or cancer are more likely to develop BV. 

Note: *** It’s noteworthy that not all women who have these risk factors will develop BV, and vice vasa, women who don’t have any risk factors may still get the infection.

How do probiotics work in bacterial vaginosis? 

Restoration of Good Bacteria

Research suggests that certain strains of probiotics, such as Lactobacillus acidophilus and Lactobacillus rhamnosus, can help to restore the natural balance of bacteria in the vagina and prevent the overgrowth of harmful bacteria that can lead to BV. 

Lower the vaginal pH and make it hostile to Harmful Bacteria

Probiotics can help to lower the pH level in the vagina, creating an environment that is less hospitable to harmful bacteria. This can help to reduce the risk of developing BV or to reduce the severity and duration of symptoms.

What are the routes for administering probiotics in BV?

Probiotics can be consumed orally, such as in the form of supplements. part of daily diet as fermented foods (i.e. yoghurt), or they can be applied topically to the vaginal area in the form of suppositories, capsules, or creams. 

Although it is not advisable to use as a sole treatment for BV, some studies have suggested that the use of probiotics in combination with standard treatments for BV may be more effective than standard treatments alone.

My choice for best probiotics for bacterial vaginosis

Optibac Probiotics for Women

Optibac comes first in most of my recommendations because this is the product I have the most experience with and most of the patients find this shows the most benefits with the least side effects.

It contains the most researched probiotic strains in women’s health L. reuteri and L. rhamnosus which have been shown to improve symptoms and reduce recurrence.

Symprove Daily Essential Gut Health Supplement

Symprove is one of the most popular probiotics in US and UK.

This is suitable for those who want to use probiotics for both vaginal health and general benefits, as it has other Lactobacillus species as well.

The fluid formula is quite rare to find in the market and it is thought to have helped prevent digestion of bacteria in the stomach and more probiotics reach the system.

Dr. Formulated Probiotics Once Daily Women’s

This is suitable for those who prefer to have a shotgun approach.

This contains 50 billion CFU with different Lactobacillus and Bifidobacterium strains.

Most of the patients reported significant improvement in symptoms however a few have told me that they developed indigestion, rash, and bloating symptoms.