Probiotics: Women’s Health & Vaginal balance
Can an Oral Probiotic Help Your Vaginal Health? Let’s Talk About It.
It’s not the kind of topic that comes up over coffee with friends—but maybe it should. Vaginal health is something many women quietly struggle with, and one of the most common issues is bacterial vaginosis (BV). In fact, it's estimated that 15-30% of women in the U.K. will experience BV at some point, and globally the numbers are similar. That’s millions of women dealing with discomfort, odor, and the frustration of recurring symptoms—even after treatment.
If that sounds familiar, you’re not alone. And if you’re curious about how your gut health might be connected to your vaginal health, you’re asking a really smart question.
As an osteopath with specialist training in women’s health and a keen interest in the microbiome, I see firsthand how interconnected our bodies are. The idea that an oral probiotic—something you swallow—could help your vaginal microbiome might sound a bit surprising at first. But stay with me.
So, What’s Going on with BV?
BV is essentially a microbial imbalance. Normally, the vagina is home to beneficial bacteria like Lactobacillus, which keep things in balance by producing lactic acid and keeping the pH slightly acidic. When that balance is thrown off (due to stress, antibiotics, hormonal changes, or even over-cleansing), less-friendly bacteria can take over.
This often results in that tell-tale “fishy” or “sour” odor, discharge, or irritation. While antibiotics can help in the short term, recurrence rates are high—up to 80% within nine months.
From my perspective as a Women’s Health osteopath, it seems only a short term fix to give oral antibiotics leading to subsequent damage to the gut microbiome (both beneficial and bad bacteria are affected by broad spectrum antibiotics) and perhaps we are missing a key player for helping the right vaginal bacterium to thrive.
Where Do Oral Probiotics Come In?
Here’s the interesting bit: research now shows that taking certain probiotics by mouth can actually support vaginal health. This happens via what’s called the gut-vagina axis—a communication pathway between your digestive system and reproductive tract.
Strains like Lactobacillus rhamnosus, L. crispatus, and L. jensenii have been shown to help restore and maintain a healthy vaginal microbiome when taken orally. One study even found that women who took L. rhamnosus daily saw a significant increase in vaginal lactobacilli and a reduction in harmful bacteria—with effects lasting a month after stopping the supplement.
In another study, women with asymptomatic BV saw positive changes in their vaginal flora from a multi-strain oral probiotic, suggesting this could be a powerful tool for prevention—not just treatment.
The gut-vaginal axis refers to the two-way relationship between the gut microbiome and the vaginal microbiome. It's part of a broader concept that acknowledges how microbial ecosystems in different parts of the body are interconnected and can influence each other.
🧬 How Does the Gut-Vaginal Axis Work?
1. Shared Microbial Influence
The gut and vagina both host their own communities of bacteria, but many beneficial species (especially Lactobacillus) are found in both.
Microbes or their metabolites (like short-chain fatty acids or signaling molecules) can travel via the bloodstream or lymphatic system, potentially affecting vaginal health.
2. Immune System Crosstalk
The gut plays a central role in immune regulation. A healthy gut microbiome helps train and modulate immune responses, which can reduce inflammation and support a balanced vaginal microbiota.
Disruption of gut bacteria (e.g. from antibiotics or poor diet) may lead to immune dysfunction, increasing the risk of vaginal infections like BV or yeast overgrowth.
3. Hormonal Interactions
Estrogen influences vaginal microbiota by encouraging the growth of Lactobacilli. The gut is involved in estrogen metabolism (via the estrobolome), so gut dysbiosis may indirectly affect estrogen levels—and by extension, vaginal microbial health.
4. Microbial Migration
Though less direct, translocation of microbes from the gut to the vaginal area (especially due to proximity in the female anatomy) can also influence vaginal flora—this is why gut health can impact conditions like recurrent UTIs and BV.
Why It Matters
Understanding the gut-vaginal axis helps explain why oral probiotics can be effective in supporting vaginal health. By improving gut microbial balance, you may indirectly create a healthier environment for the vaginal microbiome to thrive.
What to Look For in a Probiotic
If you’re considering adding a probiotic to your daily routine, here are a few tips:
Strain matters: Look for well-studied strains like L. rhamnosus GR-1, L. reuteri RC-14, or L. crispatus. These have shown the most benefit for vaginal health.
Dose counts: Aim for products with at least 1 billion CFUs (colony-forming units) per dose.
Consistency is key: Probiotics aren’t a quick fix—they work best when taken daily over time.
Quality over marketing: Ignore bold claims about "feminine odor control" and look for supplements backed by clinical research.
There are many products on the market that are easily added to your shopping basket, I use ‘Optibac Every Day Extra’ which is delivered with my weekly grocery shop !
Final Thoughts
Personally, I’ve always been amazed how vaginal flora changes during pregnancy, particularly in the latest stage of gestation. This is when it is preparing to provide baby with its building blocks for healthy gut microbiome - during a vaginal delivery babies get a good mouthful which is a huge contributor to their gut microbiome.
If you’ve been battling recurrent BV or just want to support your vaginal health naturally, an oral probiotic might be a gentle and effective part of your toolkit. It’s not about replacing medical treatment, but about supporting your body’s natural balance.
Of course, every woman’s body is different. If you’re unsure where to start, speak with a healthcare provider who understands the gut-vagina connection and can help guide you to the right strains for you.
Got questions? I’m always happy to chat more about this fascinating and important topic.
Sources:
Kenyon C., Colebunders R., Crucitti T. (2013). "The global epidemiology of bacterial vaginosis: a systematic review." American Journal of Obstetrics & Gynecology. Available at: [https://pubmed.ncbi.nlm.nih.gov/23102758/](https://pubmed.ncbi.nlm.nih.gov/23102758/)
Public Health England (via The Pharmaceutical Journal). "Bacterial vaginosis: diagnosis and management." Available at: [https://pharmaceutical-journal.com/article/ld/bacterial-vaginosis-diagnosis-and-management](https://pharmaceutical-journal.com/article/ld/bacterial-vaginosis-diagnosis-and-management)
Bradshaw C.S. et al. (2006). "High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence." The Journal of Infectious Diseases. Available at: [https://pubmed.ncbi.nlm.nih.gov/16544262/](https://pubmed.ncbi.nlm.nih.gov/16544262/)
De Alberti D. et al. (2015). "Impact of oral administration of ‘Lactobacillus rhamnosus’ on vaginal microbiota in healthy women." Scientific Reports. Available at: [https://www.nature.com/articles/s41598-021-81931-z](https://www.nature.com/articles/s41598-021-81931-z)
Parolin C. et al. (2024). "Daily oral intake of multi-strain probiotics and effects on vaginal microbiota in women with asymptomatic BV." Nutrients, 16(20), 3469. Available at: [https://www.mdpi.com/2072-6643/16/20/3469](https://www.mdpi.com/2072-6643/16/20/3469)
Reid G. et al. (2001). "Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora." FEMS Immunology & Medical Microbiology. Available at: [https://pubmed.ncbi.nlm.nih.gov/11751396/](https://pubmed.ncbi.nlm.nih.gov/11751396/)
Jernberg C. et al. (2007). "Long-term ecological impacts of antibiotic administration on the human intestinal microbiota." ISME Journal. Available at: [https://www.nature.com/articles/ismej200710](https://www.nature.com/articles/ismej200710)
Dethlefsen L. et al. (2008). "The pervasive effects of an antibiotic on the human gut microbiota, as revealed by deep 16S rRNA sequencing." PLoS Biology. Available at: [https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.0060280](https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.0060280)
Koedooder R. et al. (2019). "The vaginal microbiome as a major determinant for the outcome of in vitro fertilization: a prospective study." Human Reproduction. Available at: [https://academic.oup.com/humrep/article/34/6/1042/5498024](https://academic.oup.com/humrep/article/34/6/1042/5498024)
Brotman R.M. (2011). "Vaginal microbiome and sexually transmitted infections: an epidemiologic perspective." Journal of Clinical Investigation. Available at: [https://www.jci.org/articles/view/57193](https://www.jci.org/articles/view/57193)