We're regularly told that probiotics are the answer to our gut health woes. The idea of consuming special "good" bacteria to supposedly aid digestion, boost our immune systems and possibly even enhance our moods is well established in the wellness world by now. But a strand of probiotics that's less spoken about (at least up to now) are those for vaginas.
Health brands now manufacture probiotics that purport to boost our vaginal health. There's OptiBac "For women", Canesten's "Canesflor probiotics for vaginal use" and RepHresh's "Pro-B Probiotic Feminine Supplement", to name just a few, which promise to replenish good bacteria and maintain a healthy balance of vaginal flora with the aim of preventing "bad" bacteria and yeasts from thriving. (The natural balance of bacteria in the vagina can be thrown out of whack by using scented feminine hygiene products.)
"Certain strains of commercially available probiotic bacteria, such as Lactobacillus reuteri RC-14® and Lactobacillus rhamnosus GR-1®, have been shown to be natural residents of a healthy vaginal microbiome," Kerry Beeson, a nutritional therapist and customer care team leader at OptiBac Probiotics, told us. "Research suggests that even when taken orally they are able to colonise in the vagina and discourage the growth of the types of pathogenic (bad) bacteria and yeasts that cause infections."
Such products cost between £10-£50 (depending on the pack size) – but are they actually necessary?
Not according to NHS gynaecologist Dr Anita Mitra, otherwise known as The Gynae Geek, who completed a PhD about the vaginal microbiome and frequently speaks about the topic on the international scientific circuit. "There is currently no evidence that every woman needs to be taking a probiotic for their vagina. I personally do not take a vaginal probiotic as a routine," she told Refinery29.
I wouldn't recommend all women to take them if they don't have any problems.
Dr Anita Mitra, gynaecologist aka The Gynae Geek
Dr Mitra does say, however, that supplements like OptiBac "For women" are "quite good for certain women only," specifically those with recurrent thrush and recurrent urinary tract infections. "Probiotics aren't currently part of any UK guidelines for the management of any kind of gynaecological disorders, but it's a very active area of research, and I predict that they'll become part of them in the future," Dr Mitra added.
While she's not currently aware of any risks associated with taking vagina probiotics, Dr Mitra conceded that "their use is relatively new. This is another reason why I wouldn't recommend all women to take them if they don't have any problems." She is also "[worried about women feeling they need to self-diagnose and use the increasing number of over-the-counter products that are available."
The Royal College of Obstetricians and Gynaecologists (RCOG) is also clear that not every woman should hop on this wellness bandwagon. "Some studies have suggested [vagina probiotics] can be helpful with conditions like bacterial vaginosis, through maintaining or restoring the vaginal microecology, but more robust research is needed to confirm such benefits," Dr Vanessa MacKay, consultant gynaecologist and spokesperson for RCOG, told Refinery29. Importantly, she added, "there are risks around allergic reaction and there are specific instances where the use of probiotics is actively discouraged including in people with compromised immune systems or those who have a serious health condition."
Instead, RCOG advises women who think they may have bacterial vaginosis or are experiencing symptoms, such as unusual vaginal discharge, to speak to a healthcare professional before rushing to buy an over-the-counter probiotic for their vagina. "A GP or healthcare professional in a sexual health service can prescribe antibiotics or creams for women who have bacterial vaginosis which are effective treatments. Women can also help to relieve symptoms by using water and plain soap to wash the genital area and have showers instead of baths."
There are particular risks associated with the versions of these supplements that are meant to be taken vaginally, said obstetrician and gynaecologist Dr Fiona Mattatall. "If using vaginally, there is the risk of introducing other bacteria with insertion – for instance, because of dirty hands or if the tablet wasn’t clean at insertion – as well as the risk of small cuts in the vagina if it's not inserted correctly and the risk of increased vaginal discharge and change in odour."
Dr Mattatall also told us she's concerned that the studies cited in adverts for vagina probiotics are often small scale and of dubious quality, and that women with a healthy vagina "assume they need to take [vagina probiotics] because of marketing."
Dr Mitra assures us there are many other – easier and cheaper – ways to ensure good vaginal health than by taking a probiotic. "Wipe front to back, urinate after sex, don't smoke, wear cotton underwear, and please avoid feminine hygiene products like vaginal washes, wipes, etc. If you have discharge or irritation, see your doctor. I've told loads of women to stop using [these products] and their symptoms clear up, but I've never had anyone who told me they actually helped. They just wash away all the good bacteria, but don't really help to get rid of any of the bad bacteria or yeasts."