Can probiotics help prevent recurrent bacterial vaginosis?

According to the Women’s Health Bureau, BV doesn’t always cause symptoms. But when that happens, you might notice the following:

White, milky, or gray discharge Strong fishy odor Stinging when you pee Itching or irritation around the vagina

So, can taking probiotics prevent BV from recurring or just reduce symptoms? “The only FDA-approved BV treatment is available in oral or topical form. Antibiotics,” Dr. Camera Phillips, a New York-based obstetrician-gynecologist and Organon Health Partner, told Well+Good. But as far as probiotics go, Dr. Phillips recommends skipping unapproved treatments. Read below to learn more about BV and why probiotics may not be your best choice.

How does vaginal imbalance occur in the first place?

Like your gut, your vagina has its own microbiome, filled with bacteria (mainly beneficial strains like lactobacilli) that help keep your vagina healthy. However, these good insects can sometimes be overrun by unfriendly insects like Gardnerella. According to the National Women’s Health Network, the growth of these bad bacteria can disrupt the vagina’s normal pH (which is usually quite acidic), leading to BV.

Where do the bacteria that cause infections come from? Often, they enter the vagus nerve through sex (especially unprotected sex or sex with multiple partners) or through irrigation, says Dr. Phillips. But then again, BV can eventually affect anyone with a vagina.

Could probiotics help at all?

If you’re experiencing vaginal imbalances or symptoms of BV, you may be wondering if probiotics (the “good bacteria”) can help eliminate the bad bacteria. But the answer is not as simple as we think. This means that probiotics may have some effect. However, there is currently not enough evidence to say unequivocally “yes” or to provide specific treatment guidelines for the use of probiotics. Here’s what science says so far:

Oral probiotics like Lactobacillus rhamnose may have a role in supporting antibiotic treatment of BV, according to an analysis published in the journal Reproductive Health. However, this means that probiotics may be useful as an antibiotic supplement, rather than a drug replacement. Additionally, a randomized controlled trial published in the New England Journal of Medicine found that taking Lactobacillus vaginally after treatment can reduce the risk of BV recurrence (which often occurs ). However, the study authors say more research is needed.

Therefore, you should not rely on probiotics to manage BV at this time. At a minimum, you should not rely on probiotics before seeing your health care provider, receiving an accurate diagnosis, and having an informed discussion about approved treatment options (aka antibiotics). “I’ve seen many patients try to self-medicate at home, which often results in women delaying getting diagnosed and ending up in my office if symptoms persist.” says Dr. Phillips.

Other prevention and treatment options for BV

If you have a BV infection that is causing your symptoms, your health care provider will likely recommend treating the infection with an antibiotic, such as Cleocin (clindamycin) or Metrosa (metronidazole). Both can be prescribed orally, topically, or vaginally. According to the National Library of Medicine, these drugs have a 90% chance of curing a BV infection within a month.

In some cases, your health care provider may prescribe a second course of antibiotics if the first course is not effective or if your BV returns. However, recurrent BV can still be a stubborn problem. “It can be frustrating and embarrassing for patients. Apart from the emotional impact, untreated infections can lead to serious complications,” says Dr. Phillips.

At that point, says Dr. Phillips, it’s worth talking with your provider to develop strategies to reduce your risk of infection as much as possible. You may decide together that probiotic supplements should be part of your plan.

But perhaps lifestyle-based risk factors also need to be addressed, she added. To lower BV, the Women’s Health Bureau recommends the following tips.

Avoid vaginal douching. The natural bacterial balance of the vagina is disrupted. Practice safe sex: Use condoms or dental dams, limit the number of partners, and clean sex toys after each use. Be careful when wiping. Be sure to wipe from front to back to keep germs from your anus away from your vagina. Wear cotton underwear: Cotton wicks excess moisture, reducing the risk of bacterial growth.

When should you see a health care provider?

If you notice symptoms of BV, it’s important to call or schedule a visit with your health care provider as soon as possible. “To get an accurate diagnosis of BV and other vaginal health concerns, you should see your health care provider. That’s why we recommend seeing your doctor if you notice any unusual changes in your vagina. I highly recommend it,” said Dr. Phillips. Say. Once you understand what’s going on, you can work with your provider to create a plan that best suits your body’s needs.