The Vagina Bible: The Vulva and the Vagina: Separating the Myth from the Medicine by Jennifer Gunter
Author:Jennifer Gunter [Gunter, Jennifer]
Language: eng
Format: azw3
Publisher: Citadel Press
Published: 2019-08-26T16:00:00+00:00
Probiotics for vulvovaginal conditions
The three gynecologic indications for which probiotics are promoted are recurrent bacterial vaginosis, recurrent yeast infections, and recurrent bladder infections. Deficient or low levels of lactobacilli are associated with bacterial vaginosis and may have a role in yeast infections and urinary tract infections, so the hypothesis is sound. If the bowel could be populated with healthy bacteria, might some find its way into the vagina?
There have been a few studies, and when probiotics are analyzed rigorously there is no proof they benefit any of these three conditions. The data is lower quality, and none of the studies addressed whether or not the probiotics increased vaginal lactobacilli.
Other reasons why the data on probiotics has been discouraging include studying the wrong strains (the strains that we believe to be most important for vaginal health are difficult to grow outside the vagina) and that women may need strains individualized for their own flora or specific medical condition. It is also possible that the tested brands were mislabeled, and so there is no way to know what was actually tested.
Anecdotally, I have seen no benefit. I admit it is not a study, but fifteen years ago I recommended probiotics enthusiastically, and over the years it seems that they have not helped many women. Many women are frustrated that they have been taking these expensive products, sometimes for years, and yet they are still symptomatic.
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