Probiotics, particularly lactobacilli, play a significant role in maintaining vaginal health. These “friendly” bacteria acidify the vaginal environment, inhibiting the proliferation of pathogenic microorganisms and promoting a balanced vaginal microbiome. However, a decreased abundance of lactobacilli can lead to vaginal dysbiosis and subsequent infections, including bacterial vaginosis (BV). Probiotics can be used solely or together with antibiotics for BV management.
In this article, we will review the best probiotics for treating bacterial vaginosis.
Best probiotic for BV: a shortlist
- Culturelle — premier probiotic for promoting a healthy pH equilibrium in women's health
- Ora — top-rated probiotic for addressing bacterial vaginosis
- Routine — finest probiotic for harmonizing vaginal microbiota
- Ritual — leading probiotic for maintaining vaginal wellness
- Pure Essence Labs – superior probiotic with the maximum CFU concentration
Choosing the right probiotic for bacterial vaginosis
| Ingredient quality | Science-backed probiotic strains |
| Reputable provider | GMP-certified, third-party tested |
| Adequate dosage and price | Price vs. quantity |
| CFU | Adequate probiotic amounts |
| Specific probiotic strains | Specific for bacterial vaginosis |
- Ingredient quality. Ensure the probiotics contain high-quality bacterial strains backed by science. Not all probiotics on the market have strong evidence to support their claims, so it's important to choose products with proven efficacy for the intended health condition.
- Reputable provider. Choose a brand with a good reputation known for producing high-quality supplements. Look for companies that follow good manufacturing practices (GMP) and have third-party testing or certifications to ensure product quality and safety.
- Adequate dosage and price. Consider the dosage of probiotics provided in each serving of the supplement and compare it with the price. Look for supplements that offer a good-price dosage ratio of probiotics at a reasonable price point.
- CFU. Colony Forming Units (CFU) refer to the number of viable bacteria present in each probiotic serving. Higher CFU counts indicate a higher concentration of beneficial bacteria. Ensure that the probiotics you choose have an adequate CFU count, typically in the billions, throughout the shelf life.
- Specific probiotic strains. Look for probiotic strains that specifically target bacterial vaginosis, such as Lactobacillus salivarius and Lactobacillus rhamnosus. These strains have been shown to be effective in suppressing BV-causing pathogens.
Best Probiotic For BV in 2023: an overview
When compiling this list, we reviewed brands offering probiotic products that may benefit individuals with bacterial vaginosis.
Finding a product that suits specific individual needs means you are more likely to receive a positive health effect. While most probiotic supplements are similar in their suggested benefits, the composition of each of them slightly differs. This is important to consider when trying to achieve specific health goals.
Each product is labeled under a specific category highlighting its unique benefits, ingredients, and other features. The list also includes the pros and cons of each product.
1. Culturelle — premier probiotic for promoting a healthy pH equilibrium in women's health
Culturelle Women's 4-in-1 Defense Capsules are specifically formulated to furnish a holistic approach to women's health, potentially rendering vital benefits in a singular capsule for vaginal, urinary, digestive, and immune wellness. This product may foster a wholesome vaginal microflora while maintaining pH equilibrium and shielding the urinary tract from harmful bacteria.
Moreover, it might aid in reinstating the natural harmony of beneficial bacteria within the digestive tract, which is home to 70% of the immune system. Each dosage provides 15 billion CFUs, merging the clinically authenticated probiotic Lactobacillus rhamnosus GG with a blend of 4 lactobacilli frequently observed in the healthy vaginal microbiome of women.
As per the official website, the product's safety and effectiveness are supported by clinical trials, yet it necessitates further investigation in the context of pregnant women.
Culturelle Women’s 4-in-1 Protection Capsules are vegetarian, and the recommended dosage by the provider is 1 capsule daily for optimal results.
The product is priced at $27.49 for a one-time purchase, but a subscription model is available for a discounted price of $24.74.
2. Ora — top-rated probiotic for addressing bacterial vaginosis
Ora Organic's "Lady Bugs" is a unique probiotic and prebiotic blend curated to bolster optimal health in the vaginal and urinary tract. According to the brand, the product integrates 16 billion CFUs of probiotics from 6 scientifically-supported strains, complemented by organic prebiotics.
The selected strains may provide support to maintain healthy vaginal pH levels, mitigate the incidence of urinary tract infections, and aid in the healing of delicate vaginal tissues.
The manufacturer's suggested intake is 2 capsules within a 30-minute window of having a meal, irrespective of the hour.
The ingredients include organic Jerusalem artichoke inulin, Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus crispatus, Lactobacillus reuteri, Lactobacillus fermentum, among others.
Ora Organic underscores its commitment to transparency and stringent quality assurance, subjecting every product batch to testing at independent third-party labs and disclosing the outcomes. The product is vegan-friendly, non-GMO, devoid of gluten, soy, and dairy.
The product is priced at $37.99 for a one-time purchase, with a 20% discount available for subscriptions.
3. Routine — finest probiotic for harmonizing vaginal microbiota
Routine Probiotics for Her represents an all-encompassing prebiotic-probiotic supplement tailored to enhance gut well-being, establish vaginal health equilibrium, fine-tune metabolism, and contribute to improved mood.
As per the brand's claim, every capsule encapsulates 24 billion CFUs and is devised with 5 superior-quality strains: Bifidobacterium lactis HN019, Bifidobacterium lactis Bl-04, Lacticaseibacillus rhamnosus HN001, Bifidobacterium lactis B-420, and Lactobacillus acidophilus La-14.
The supplement also incorporates organic ashwagandha, recognized for its properties in alleviating stress and anxiety.
Routine Probiotics for Her conforms with FDA and Health Canada regulatory standards, and both the production methodologies and products abide by the most stringent pharmaceutical benchmarks.
The recommended dosage on the label is 1 capsule per day, and the ingredients are non-GMO, vegan, gluten-free, dairy-free, and major allergen-free.
The product is priced at $39.95 for a one-time purchase, but a subscription model is available for $29.95, saving an extra $10.00.
4. Ritual — leading probiotic for maintaining vaginal wellness
Ritual's Synbiotic+ is a triple-action supplement engineered to foster a harmonious gut microbiome, delivering prebiotics, probiotics, and a postbiotic. This product showcases two globally recognized, extensively researched strains, yielding 11 billion CFUs for digestive bolstering.
Probiotic supplements such as Ritual Synbiotic+ might have a beneficial impact on comprehensive gut wellness and could potentially provide benefits in dealing with bacterial vaginosis.
The product might also alleviate gastrointestinal discomforts such as bloating, gas, and diarrhea, maintain a balanced gut microbiome, fortify gut barrier functionality, and enhance immune health.
Ritual underscores its dedication to transparency and rigorous quality checks involving third-party testing and an open supply chain. The product is vegan-friendly, gluten-free, free from allergens, and non-GMO.
The recommended dosage by the company is 1 capsule daily. Synbiotic+ is priced at $54.00, with a subscription model offering additional benefits like free shipping and a 30-day money-back guarantee.
5. Pure Essence Labs – superior probiotic with the maximum CFU concentration
Pure Essence Labs PureBiotics Restore is a probiotic supplement encompassing a minimum of 30 billion CFUs, which, based on scientific studies, could be a sufficient quantity for tackling bacterial vaginosis.
The supplement comes in vegan capsules featuring a delayed-release mechanism, safeguarding the probiotics from stomach acid. The suggested intake is 1 capsule per day, taken with water.
Pure Essence Labs underscores its dedication to unadulterated quality, with each product batch undergoing three-stage testing for identity verification, heavy metals, and toxins. The firm ensures full compliance with even the most stringent regulatory standards for every product.
The product is priced at $35.80 for a one-time purchase, with a subscription model available for a 20% discount.
Best probiotics for BV compared
| Provider | Review | Cost (per month) | Daily dose | Probiotic strains | CFU count |
| Culturelle | Culturelle Probiotics Review 2023 | $24.74 | 1 capsule | 5 | 15 billion |
| Ora | Ora Probiotics Review | $30.39 | 2 capsules | 6 | 16 billion |
| Routine | - | $29.95 | 1 capsule | 5 | 24 billion |
| Ritual | Ritual Synbiotic+ Probiotics Review | $54.00 | 1 capsule | 2 | 11 billion |
| Pure Essence Labs | Pure Essence Labs Review | $44.16 | 1 capsule | 12 | 30 billion |
How did we compile our list of the best probiotics for BV in 2023
It is crucial to understand how each product is formulated and what criteria must be considered for it to be a viable option. We looked at several factors when choosing the best probiotic for bacterial vaginosis. This includes the right probiotic strains, customer reviews, the effectiveness of the supplement, and ingredient quality.
- Probiotic strains. We made sure that the provided products contained specific strains of bacteria known to help with bacterial vaginosis. We looked for certain strains of probiotics, such as Lactobacillus rhamnosus and Lactobacillus salivarius, which have shown promise in managing bacterial vaginosis by promoting a healthy vaginal microbiota balance.
- Reviews. We looked at a significant number of online reviews to understand customer sentiment toward brands and their products. Also, learning about customer satisfaction was another crucial factor that we had to consider in order to find the best probiotic supplements for managing bacterial vaginosis.
- Effectiveness. We thoroughly analyzed products that contain scientifically-studied probiotic strains. This involved examining studies that substantiate the effectiveness of probiotic supplements in bacterial vaginosis. By prioritizing probiotics with scientific backing, we aimed to ensure that the chosen formulations offer meaningful benefits.
- Ingredient quality. Ensuring the formulation of probiotic ingredients in adherence to the highest quality standards is crucial for their effectiveness and safety. To meet this criterion, we specifically evaluated probiotics that are manufactured according to the GMP protocol. Additionally, we considered probiotics that undergo third-party testing, which involves independent laboratories verifying the purity, potency, and accuracy of labeling.
What is BV (bacterial vaginosis)?
BV is a condition caused by an overgrowth of some normal vaginal bacteria, leading to an imbalance in the vaginal microflora. It may cause vaginal discharge, vaginal itching, and burning during urination. However, many individuals experience no symptoms.
The condition is linked to the overgrowth of anaerobic bacteria and the decline in hydrogen peroxide-producing lactobacilli, disturbing the balanced vaginal flora. Risk factors include multiple sexual partners, douching, and a lack of lactobacilli bacteria.
Symptoms of bacterial vaginosis
BV is a common vaginal condition characterized by the following symptoms:
- Unusual vaginal discharge with a strong fishy smell, especially noticeable after sexual intercourse.
- A change in the color and consistency of vaginal discharge, which often becomes greyish-white, thin, and watery.
- Vaginal itching and burning sensation during urination, although these are less common.
It's important to note that half of the women with bacterial vaginosis do not exhibit any symptoms. If you suspect you have bacterial vaginosis or experience any of the above symptoms, it's recommended to seek medical advice, as untreated bacterial vaginosis may increase the risk of developing other health complications.
BV treatment
The first-line treatment for bacterial vaginosis involves the use of antibiotics. This usually includes either oral or intravaginal metronidazole and intravaginal clindamycin medications. These treatments have demonstrated similar efficacy and are effective for short-term resolution of the infection.
However, a significant drawback of current treatment options is recurrent bacterial vaginosis, with 50%-80% of women experiencing a recurrence within 6-12 months of completing antibiotic therapy.
Metronidazole
Metronidazole is available as a pill or topical gel. The pill is ingested orally, while the gel is inserted into the vagina. It's important to avoid alcohol while using this medicine and for a full day afterward, as it might cause nausea or stomach pain. It is best to consult a gynecologist to understand when this medicine is appropriate for your condition.
Clindamycin
Clindamycin comes as a cream that is applied to the vagina. It can also be used as a pill or suppository. The cream and suppositories may weaken latex condoms. It's recommended to avoid sexual intercourse during treatment and for at least 3 days after you stop using the medicine. It is also suggested to consult with a gynecologist to find a treatment plan that is catered to your specific needs.
Can you get rid of BV with just probiotics
Probiotics may play a beneficial role in the treatment of BV, although more scientific evidence is needed. Randomized controlled trials have shown that using probiotics alongside antibiotics can increase the cure rate of BV, while probiotics alone may also help treat BV with variable effectiveness.
The therapeutic effect of probiotics can vary with the administration route and dosage. Some strains of probiotics have demonstrated specific benefits, including Lactobacillus rhamnosus, Lactobacillus paracasei, and Lactobacillus crispatus. Despite these potential benefits, medical advice should always be sought for the treatment of BV.
Possible risks and complications of BV
Although BV often does not cause other health problems, if left untreated, it may increase the risk for certain complications. Here are several conditions that can occur if bacterial vaginosis is not treated accordingly on time:
- Sexually transmitted diseases (STDs). Bacterial vaginosis (BV) can heighten the susceptibility to various sexually transmitted diseases, including herpes, chlamydia, gonorrhea, and HIV. Since many STDs can often be asymptomatic or show minimal symptoms, they may spread unchecked and be transmitted unwittingly.
- Pelvic inflammatory disease (PID). PID occurs when bacteria from BV infect the uterus or fallopian tubes. Diseases like chlamydia and gonorrhea are some of the leading causes of PID and infertility. If left untreated, 10-15% of women with chlamydia may develop PID. It can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues, potentially leading to infertility.
- Post-gynecological procedure infections. Women with BV have an increased risk of developing infections following procedures on the female organs, like cesarean sections, abortions, or surgery on the cervix or uterus. STDs can spread to the uterus and fallopian tubes leading to PID, a cause of infertility and ectopic pregnancy.
- Pregnancy complications. For pregnant women, BV can result in premature pregnancy or higher risks of having a low birth weight baby. There's a small chance that it can cause complications such as miscarriage.
How long does it take for probiotics to work for BV?
Probiotics can play an active role in managing BV, and their effectiveness may vary based on dosage and administration route. Intra-vaginal administration of specific lactobacilli strains such as Lactobacillus acidophilus had an effect after 6-12 days, while oral administration of Lactobacillus acidophilus or Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14 had an effect on BV after 2 months of consumption.
Probiotics also have been found to be effective in preventing BV symptom recurrence for 1-3 months after treatment. Given these findings, it's suggested that consistent probiotic use may be necessary during or after BV treatment.
Bacterial vaginosis vs. yeast infection
Bacterial vaginosis and yeast infections are both forms of vaginitis or vaginal inflammation, but they have different causes, symptoms, and treatments. BV is caused by an overgrowth of anaerobic bacteria, usually Gardnerella vaginalis, disrupting the balance of vaginal flora. Typical BV symptoms include a fishy odor that intensifies after sex or during menstruation, discomfort, itching, burning during urination, and thin discharge that can be white, gray, yellow, or greenish.
On the other hand, yeast infections are caused by the overgrowth of Candida fungus. Symptoms of yeast infection include discomfort, itching, burning sensations while urinating or during intercourse, redness and swelling around the vaginal opening or vulva, and thick, white, clumpy discharge similar to cottage cheese. Yeast infections do not typically produce a specific odor.
Treatment for each condition involves different medications, usually antibiotics for BV and antifungal treatments for yeast infections.
Best probiotics for BV in 2023 conclusion
In conclusion, it is important to consider individual needs and preferences when it comes to finding the best probiotic for bacterial vaginosis. The provided list of probiotic products in this article offers various benefits that may alleviate BV symptoms. Everyone's situation is different, so it may require a consultation with your gynecologist to find the probiotic that works best for each individual.
Seeking advice from a healthcare expert can prove valuable in obtaining tailored recommendations and choosing an appropriate probiotic to address your BV symptoms.
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FAQ
Can probiotics cure BV without antibiotics?
Yes. Studies suggest that probiotics may play an active role in treating BV and may be effective in preventing recurrence. Probiotics alone demonstrated significant effectiveness in comparison to placebo. However, the efficacy of probiotics as a standalone treatment compared to antibiotics is still not conclusive, and more research is needed.
Why am I getting BV all the time?
Recurring BV can occur due to imbalances in vaginal bacteria. This imbalance can be triggered by being sexually active, changes in a partner, using certain forms of contraception, or using perfumed hygiene products around the vagina. Specific lifestyle changes, like avoiding smoking or perfumed soaps, might help prevent recurrence.
How can I speed up my BV recovery?
To speed up your BV recovery, you may add probiotics to your diet and strictly adhere to prescribed antibiotic treatment. Avoid alcohol if taking metronidazole. Maintain good hygiene and make sure to dry properly dry your genitals. Wear loose cotton clothing, and don't scratch irritated areas.
What's the longest BV can last?
BV can recur frequently, making it seem persistent. There isn't a universally accepted definition of recurrent BV, but commonly, it's defined as 3 or more clinically or microscopically proven episodes of BV within 12 months. Recurrence rates can be between 50-80% after one year following treatment.
- Sexually transmitted infections. Managing recurrent bacterial vaginosis.
- Cureus. Recurrent Bacterial Vaginosis: A Case Report and Review of Management.
- Diagnostics. Sexually Transmitted Diseases—An Update and Overview of Current Research.
- Reproductive Health Probiotics are a good choice for the treatment of bacterial vaginosis: a meta-analysis of randomized controlled trial.
- Frontiers in Nutrition. Probiotics, a promising therapy to reduce the recurrence of bacterial vaginosis in women? a systematic review and meta-analysis of randomized controlled trials.
Show all references
- Frontiers in Reproductive Health. Bacterial vaginosis: a review of approaches to treatment and prevention.
- StatPearls. Bacterial Vaginosis.
- Nutrients. Efficacy and Safety of MED-01 Probiotics on Vaginal Health: A 12-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial.
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