Which is the Best Probiotic Supplement for Women?

Camilla Gray Nutritional Therapist Dip CNM - Diploma in Nutritional Therapy from the College of Naturopathic Medicine

Research shows that different probiotic strains (types) do different things, which means they are not one-size-fits-all. Therefore, the best supplement for you depends on your individual needs. Many probiotics are beneficial for both women and men, but several strains are particularly beneficial in supporting women’s health. Whether you are looking to support your gut health or intimate health, this article will pinpoint the best probiotics for you. Learn more by reading What are probiotics?.

In this article, we look at:  

How can probiotics help women?

Best probiotics for women's vaginal health

Best probiotics for women's digestive health

How do I choose the best probiotic supplement?

If you’re short for time, jump to the key take-aways:

Summary

Woman smiling
To stay happy and healthy, don't forget your 'intimate' flora!

How can probiotics help women?

Probiotics are bacteria which exert benefits on the host. You may already know that some probiotics are helpful for gut-related issues, but they can be beneficial for other areas of health too, including vaginal health and skin health (find out more about Probiotics for Acne and Skin Health).

We all have a microbiome in our gut, mouth, skin and lungs, but the beneficial bacteria and microbes which inhabit the urinary tract and vagina are of particular importance to those who have them1. In the vagina and urinary tract, these helpful microbes are thought to exert many of the same beneficial effects as they would in the gut, helping to maintain a healthy balance. Their presence limits the likelihood of bad bacteria and yeasts being able to overgrow, causing conditions such as thrush, urinary tract infections (UTIs) and bacterial vaginosis (BV).

Typically, healthy vaginal and urinary microbiomes are populated largely by Lactobacilli bacteria which discourage the growth of harmful bacteria and yeasts1,2. However, due to the proximity of the vagina to the anus, it is much easier for bad bacteria and yeasts to translocate from the gut in those with vaginas than in those with penises3. It is believed that most infections like thrush, cystitis or UTIs stem from bad microbes in the gut, which can travel through the digestive tract to the anus, across the perineum and over to the urogenital tract.

Learn more about how to take care of your vaginal microbiome by reading our article: All About the Vaginal Flora.

Best probiotics for women's vaginal health

We are often asked: are probiotics good for vaginal health? What is the best women’s probiotic for BV and/or thrush? Let’s explore these questions by looking at some of the evidence which explains how probiotics might help the following vaginal issues:

Bacterial vaginosis

Urinary tract infections

Thrush

Fertility

Clinical trials show that Lactobacillus strains are particularly effective in supporting female intimate health. Certain strains such as Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14® have been shown to reach the vagina alive, and this is where they exert their beneficial effects.

We're often asked "Can you put probiotics into your vagina?" The simple answer to this is "Yes", it's not unsafe to do so; however, with an oral supplement containing strains proven to reach the vagina alive, you don't need to. According to the scientists who conducted one study, "L. rhamnosus GR-1® and L. reuteri RC-14® can translocate to the vaginal environment even if they are taken orally" and "Their administration results in significant changes in the vaginal flora in terms of increased Lactobacilli presence…"4.

This means that there is no need to put these probiotics directly into the vagina.

L. rhamnosus GR-1® and L. reuteri RC-14® can be found in Optibac For Women.

Optibac For Women
Optibac For Women supports vaginal health

Healthcare professionals can learn more about the research behind Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14® on the Probiotics Database.

Bacterial vaginosis

As BV is the most common type of vaginal infection in premenopausal women5, finding a safe and natural approach to treatment/prevention would be a huge ‘win’. One significant study, a randomised, placebo-controlled trial6, showed that the vaginal microflora in women with bacterial vaginosis (BV) was restored to a more favourable, Lactobacilli-dominant environment following two months of taking the probiotics Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14®.

During pregnancy, many often suffer from intimate health infections due to the hormonal changes taking place during this time. It is important for both the health of mother and baby that an expectant mother has a healthy vaginal microbiome, as during a normal vaginal delivery the mother passes on some of her resident microflora to her newborn. This transference of bacteria from mother to baby influences the health of the baby’s microbiome

In 2018 a clinical trial7 showed that the probiotic strain Lactobacillus rhamnosus HN001 (in conjunction with Lactobacillus acidophilus La-14® and lactoferrin) can help reduce symptoms of BV such as itching and discharge.

A clinical trial using Lactobacillus paracasei F-19® demonstrated the ability to improve vaginal pH and odour in those with vaginosis8, maintaining relief even 3 months after the end of treatment when taken orally.

Anyone with a vagina can develop BV, even those undergoing masculinising hormone therapy9, so it's important to always keep an eye on your vaginal health.

Mechanisms of action of Optibac 'For Women'

Urinary tract infections

Urinary tract infections (UTIs) unfortunately affect people of all ages. It seems that in the genitourinary area of those who do not experience infections, Lactobacilli bacteria dominates1. The probiotic strains Lactobacillus rhamnosus GR-1®Lactobacillus reuteri RC-14®10 and Lactobacillus crispatus11 have been reported to support a healthy urinary microbiome in those who experience recurrent UTIs.

Healthcare professionals can learn more by reading Probiotics for UTI – A look at the research on the Probiotic Professionals site.

Thrush

Some find that they may become more prone to thrush at certain points in their menstrual cycle, during pregnancy and when taking the combined oral contraceptive pill or hormonal replacement therapy. When oestrogen levels are high, Candida, the yeast responsible for thrush, thrives12. A probiotic supplement that contains the well-researched Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14® strains may help those prone to thrush, as they may help inhibit the growth of harmful bacteria and yeasts, such as Candida, in the vagina13.

A 2015 study14 looked at 40 women with recurrent vulvovaginal candidiasis (thrush), some were given the probiotic strains Lactobacillus rhamnosus DSM 14870 and Lactobacillus gasseri DSM 14869 alongside conventional treatment. The results showed that probiotics taken alongside conventional treatment increased the efficacy and reduced the risk of the infection coming back compared to conventional treatment alone. 

Healthcare professionals can learn more by reading Which probiotics help with thrush? on the Probiotic Professionals site.

Fertility

Vaginal infections including BV, UTIs and Group B Streptococcus (GBS) have been linked to complications in pregnancy and even reducing the chance of getting pregnant in the first place15. It can be an important consideration for any pre-conceptual regime to incorporate a probiotic that addresses the vaginal microbiome, especially if the infections are reoccurring.

The beauty of these specific probiotics is that not only do they reduce symptoms, but they also appear to act against recurrence. For the 1 in 3 people with vaginas who suffer from BV, 30% who suffer recurring cystitis and 75% who suffer thrush at least once, these strains of probiotics could be a welcome addition to their tool kit to rid themselves of these uncomfortable conditions.

Can probiotics make your vagina smell better?

A few years back there was some buzz around a probiotic supplement that claimed to get your vagina smelling like a peach! However, this turned out to be misleading and was not intended to change the smell of the vagina; as far as we know there aren’t any probiotics that can do that.

It’s true that when you have a vaginal infection, the smell (e.g. in the case of bacterial vaginosis) can be unpleasant and upsetting. Probiotics can indeed help to solve this problem and get you smelling fresh, naturally!

Best probiotics for women's digestive health

The vaginal flora is supported by different probiotic strains to those recommended for gut health. Whilst the question of the best probiotic strains for digestive health conditions is not gender-specific, here we explore a few digestive conditions which are commonly experienced by women.

Bloating

Bloating is an extremely common concern. This may be a constant problem, or the bloating may be cyclical and worsen at certain times of the menstrual cycle (e.g. premenstrual bloating) or around menopause.

Healthcare professionals can learn more by reading Could probiotics help with menopause symptoms? on the Probiotic Professionals site.

There are several factors that can lead to a swollen, uncomfortable abdomen: fluctuating hormone levels, stress, poor diet or disturbed digestion (IBS, food intolerances for example), to name a few. Upset digestion associated with menstruation is very common, including alterations to bowel patterns, constipation, diarrhoea, nausea, abdominal pain and bloating16. Fluctuating levels of female sex hormones, oestrogen and progesterone, and the body’s sensitivity to these fluctuations is thought to contribute to the sensation of bloating that occurs around menstruation17. Certain probiotic strains may help to alleviate this bloating and digestive discomfort, such as Lactobacillus acidophilus NCFM®.

You may like to read the following blog: Bloating – all you need to know to learn more.

Health professionals can read more about Lactobacillus acidophilus NCFM® on the Probiotics Database.

Bloating is a common issue that can cause considerable discomfort

Many women experience a bloated stomach in menopause that might be relieved with a few simple measures to look after their gut health, and the health of the microbiome. However, persistent bloating should never be overlooked and should be investigated by a GP, as bloating can be signs of more serious conditions. 

Constipation

Constipation is more frequently reported in (cisgender) women than men18, often occurring around menstruation, during pregnancy and post-menopause. A probiotic supplement containing Bifidobacterium lactis BB-12® can help support gut health in those with constipation. B. lactis BB-12®, along with fructooligosaccharides (a prebiotic), can help gently encourage regular bowel movements, as supported by one of the largest clinical trials performed on probiotics19.

Health professionals can read more about the research behind this strain on the Probiotics Database: Bifidobacterium lactis BB-12®.

Alterations to normal bowel patterns, including constipation, can also occur as a part of irritable bowel syndrome (IBS). Symptoms of IBS, including abdominal discomfort and disrupted bowel patterns, can be exacerbated around the time of menstruation in those with menstrual cycles and in perimenopausal women20.

To learn more about how to support gut health in IBS, read Which probiotics are for IBS?

For more information about supporting clients with occasional constipation, healthcare professionals can read Probiotics for Constipation on the Probiotic Professionals site.

Pregnancy

Some strains of probiotics such as Lactobacillus rhamnosus HN001, Lactobacillus acidophilus La-14®, and Bifidobacterium lactis HN019, have been researched specifically in pregnancy and found to support common pregnancy-related concerns such as digestive issues, morning sickness, gestational diabetes, and mental wellbeing.

For everything you need to know about using probiotics at this special time, read Probiotics for Pregnancy.

How do I choose the best probiotic supplement?

When selecting a probiotic supplement, choose the one that feels right for you. If you are seeking specific benefits, consider a friendly bacteria supplement with research behind it for this particular purpose. For example, if you are looking for vaginal health support, consider a product that contains well-researched strains including L. paracasei F-19® and the world-renowned L. rhamnosus GR-1® and L. reuteri RC-14® which have shown to help support a healthy vaginal microbiome21.

If you’re confused as what ‘well-researched’ really means, Dr. Kate explains all in this helpful article: Research: is it all equal?.

If you’ve never taken probiotics before and are wondering if they’d suit you, then be reassured that the potential benefits of probiotics are numerous and any side effects are rare, making these supplements a popular choice for daily maintenance of gut and intimate health.

Healthcare professionals can reassure their clients about this topic by reading Probiotics and side effects – an in-depth review on the Probiotic Professionals site.

In Summary

  • Probiotic supplements are not usually gender-specific, but certain strains have been researched specifically for the support of vaginal health and pregnancy-related conditions.
  • The vagina and urinary tract require different friendly bacteria to the gut to maintain a healthy microbiome. Therefore, choose specific probiotic strains that are well researched for their effects in each specific area.
  • Probiotics can help to limit the overgrowth of harmful bacteria and yeasts that contribute to the development of gut and intimate health issues.
  • The best probiotic supplements for intimate health contain probiotic strains such as Lactobacillus paracasei F-19®Lactobacillus rhamnosus GR-1®Lactobacillus reuteri RC-14®Lactobacillus rhamnosus HN001 and Lactobacillus crispatus.
  • The best probiotics to support common female digestive complaints, such as bloating and constipation, include Lactobacillus acidophilus NCFM® and Bifidobacterium lactis BB-12®.

For advice about how to choose other supplements for women’s health, read Kathy’s article: Supplements for women: which do you really need?.

References

  1. Komesu YM et al. Defining the relationship between vaginal and urinary microbiomes. Am J Obstet Gynecol. 2020;222(2). doi:10.1016/j.ajog.2019.08.011.DEFINING
  2. Witkin SS, Linhares IM. Why do lactobacilli dominate the human vaginal microbiota? BJOG An Int J Obstet Gynaecol. 2017;124(4):606-611. doi:10.1111/1471-0528.14390
  3. Magruder M, Sholi AN, Gong C, et al. Gut uropathogen abundance is a risk factor for development of bacteriuria and urinary tract infection. Nat Commun. 2019;10(1). doi:10.1038/s41467-019-13467-w
  4. Morelli L, Zonenenschain D, Del Piano M, Cognein P. Utilization of the intestinal tract as a delivery system for urogenital probiotics. J Clin Gastroenterol. 2004;38(6 Suppl). doi:10.1097/01.mcg.0000128938.32835.98
  5. BASHH. Sexually Transmitted Infections in Primary Care 2013. 2014. https://www.bashhguidelines.org/media/1089/sexually-transmitted-infections-in-primary-care-2013.pdf.
  6. Reid G, Burton J, Hammond JA, Bruce AW. Nucleic acid-based diagnosis of bacterial vaginosis and improved management using probiotic lactobacilli. J Med Food. 2004;7(2):223-228. doi:10.1089/1096620041224166
  7. Russo R, Karadja E, De Seta F. Evidence-based mixture containing Lactobacillus strains and lactoferrin to prevent recurrent bacterial vaginosis: A double blind, placebo controlled, randomised clinical trial. Benef Microbes. 2019;10(1):19-26. doi:10.3920/BM2018.0075 
  8. A. Delia, G. Mordante, G. Rago, M. C. Musaccmio, K Retaglia, V De Leo. (2006). Efficacia dell'utilizzo dtìLactobacillus paracasei subsp. paracasei F19 nella vaginosi e nella prevenzione delle recidive di vaginite somministrato per via orale contemporaneamente ad un Lactobacillus acidofilusptr via vaginale. Minkrva Ginkcoi. 2 (56), 227-3.
  9. Land, E., 2021. Q&A: Gynecologic and vaginal care for trans men - San Francisco AIDS Foundation. [online] San Francisco AIDS Foundation. Available at: <https://www.sfaf.org/collections/beta/qa-gynecologic-and-vaginal-care-for-trans-men/> [Accessed 17 August 2021].
  10. Beerepoot MAJ, Mostert). Women with Recurrent Urinary Tract Infections : Antibiotic Resistance and Non-Antibiotic Prophylaxis. [s.n.]; 2013. https://dare.uva.nl/search?identifier=381af002-2eb8-4956-834f-3aef23760310. Accessed February 15, 2018.
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  12. Dennerstein GJ, Ellis DH. Oestrogen, glycogen and vaginal candidiasis. Aust New Zeal J Obstet Gynaecol. 2001;41(3):326-328. doi:10.1111/j.1479-828X.2001.tb01238.x
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