Are Vaginal Probiotics Needed?
Probiotics have been one of the most fashionable trends in the field of health in the last decade – in fact, they have always been present in various fermented products – and quickly became a regular part of the diet and supplementation schemes of many people. While probiotics are commonly associated with gut health , they are also heavily marketed to people with vaginas . This makes sense because the two areas are more related than you might think (more on that later).
If you have a vagina, then you are already well aware of all the products that constantly tell us that we need to keep it fresh and healthy, and probiotics are on the list. But do we really need them, and if so, when? Can they do more harm than good ? Are they a waste of money or a valuable way to prevent yeast infections? As it turned out, everything is not so simple.
What are probiotics?
In short, probiotics are “good” bacteria that either look like bacteria that already exist in your body, or are similar to them. Like our gut, our vagina is crawling with billions of bacteria – usually some good and some bad, according to Mary Jane Minkin, MD , clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale University School of Medicine and practitioner of obstetrics. -GIN.
“Usually, the good guys are in balance with the bad guys, so in general you don’t have people with vaginitis, ” she explains. “When the bad guys take control, you run out of symptoms.” (If you need a rundown of vaginal health, vaginitis is an inflammation of the vagina , and common types include yeast infections, bacterial vaginosis (BV), and trichomoniasis.)
But as Minkin notes, people still panic when they find out that they, like everyone else, have bacteria in their vagina, so it makes sense to turn to products that promise to get rid of them, even if they don’t have a problem with first of all. What’s more, there is very little research-based evidence that probiotics actually help prevent and / or treat vaginitis. This is the topic of a recent Harvard Women’s Health Watch article in which Caroline Mitchell, M.D., assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, says vaginal probiotics “are probably a waste of money.”
But before we throw probiotics along with douching water (kidding: don’t douche ), let’s take a closer look at probiotics, what they do, and who they might benefit from.
Probiotics and the vagina
The theory behind probiotics helping your vagina is pretty simple: As Minkin explains, the vagina ideally contains a balance of good and bad bacteria, so when we add a few more good guys it should prevent things like yeast infections and BV. right ? Unfortunately, everything is much more complicated, and, as Minkin says, “There are many hocus pocus in the world of vaginitis and vaginal flora.”
What’s more, when harmful bacteria end up dominating the vagina, people tend to think it’s their fault – as if they are wiping the wrong way, which, as Minkin notes, is probably the most common misconception. In a similar vein, if a vaginal test returns indicating high levels of harmful bacteria, “we don’t even know what kind of bad guys they are,” she adds. However, we do know that vaginitis is caused by an imbalance of anaerobic organisms in the vagina, as opposed to the aerobic flora of the lactobacilli you want there.
“It’s hard to tie this to one specific organism,” says Minkin. “It is usually the growth of anaerobic organisms that causes you symptoms such as foul odor or irritating discharge.” So the idea behind using probiotics to prevent and / or treat vaginitis is to see if we can improve the good bacteria in the vagina by injecting more lactobacilli.
But this is even more confusing. “In the vagina, yeast and lactobacilli coexist quite successfully, while in the laboratory, lactobacilli can kill yeast,” says Mitchell in a Harvard article. In other words, real life circumstances do not match what is happening in the laboratory, which further complicates the situation. Again, the problem – as both Minkin and Mitchell point out – is that not enough research has been done on vaginal probiotic treatments to definitively know if they actually work or not.
The Vaginal-Intestine Connection
Some of the small existing literature on vaginal probiotics is based on research on oral probiotics (as opposed to vaginal suppositories). Here we are going to return to the relationship between the vagina and the intestine: according to Minkin, the bacterial flora of the vagina is the bacterial flora of the intestines.
“It doesn’t mean poor hygiene or anything like that,” she explains. “This is how bacteria usually grows there. It has nothing to do with how you wipe or anything like that. It’s just that if you look at the location of the vagina and anus, they really are next to each other. “
So the question is whether taking probiotics can help migrate into the vagina and re-colonize there after passing through the intestines, Minkin says. Once again, she emphasizes that there is not much data on this topic, so we are not sure if this works.
Risks and benefits of probiotics
The good news is that Minkin says the risk of taking oral probiotics is “negligible,” so even if they don’t actively prevent or treat vaginitis, they probably won’t harm you. And they may actually be useful for some people – we just don’t have definitive statements based on the research that says this yet.
While Minkin doesn’t force probiotics on her patients, she says she sometimes suggests trying them for those with recurrent yeast infections. At this point, when all other treatment options have been exhausted, trying probiotics is worth a try.
However, she does not recommend that the average person with a healthy vagina take probiotics as a way to regulate the bacterial flora of the vagina. “If you’re okay, don’t worry,” says Minkin.
Bacterial Zen and the Art of Vaginal Care
As we said earlier, people with vaginas are constantly told that they are disgusting, smelly, unhealthy or dirty, so some resort to sticking all kinds of things on there, either to relieve symptoms or as a preventive measure. But Minkin says most of these foods and methods, including adding garlic, tea tree oil, or jade egg, are not a good idea. And if you still douche, stop it. According to Minkin, it destroys most of the vaginal flora, including beneficial bacteria.
However, she has had patients with recurrent yeast infections who reported that inserting a yogurt-soaked tampon helped with vaginitis symptoms. While this is not what she recommends and has any research to confirm, this is something she has faced for decades as a practicing obstetrician-gynecologist. It is worth noting, however, that the Harvard article states that such yoghurt should not be used.
Another important thing you can do is stay away from products that can irritate your vagina or vulva, such as some laundry detergents, body soap, and scented panty liners. “For me, the most sensitive tissue in the body is the vulva and vagina, so the less irritant you throw into that area, the better,” says Minkin.
In fact, many people who think they have a yeast infection are actually just dealing with irritation, she said. Some may have the usual symptoms like itching and burning, but Minkin says that only one third of people who think they have a yeast infection actually have it, one third will have BV and one third there will be an irritation reaction to soap. , detergent or other products. Now that drugs to treat yeast infections like Monistat have been available over the counter for decades, Minkin says many people try to treat what they think of yeast infections themselves, and then get frustrated when they don’t go away, or assume. that they are recurrent fungal infections.
Because of this, Minkin says that anyone who thinks they have a recurrent yeast infection should talk to their doctor about it and have a vaginal culture done to find out what’s causing the irritation. Additionally, it could be the underlying cause of recurring yeast infections. The first possibility is blood sugar: Minkin says diabetics can often get yeast infections, so if your doctor runs a blood test, you can tell if this is the problem. HIV can also cause persistent yeast infections, so testing for this is a good idea (with or without recurrent yeast infections, in fact) to rule it out.