Probiotics for Vaginal Health: Key Benefits Explained

Key Points

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• Probiotics for vaginal health help maintain the vagina's acidic environment and strengthen immune defenses, which may prevent cervical cancer progression.
• Lactobacillus species are crucial in promoting vaginal health, serving as the main guardians of the vaginal ecosystem.
• Current research indicates the potential of probiotics in managing HPV, bacterial vaginosis, and menopause-related genitourinary issues.
• Probiotics could enhance relief from menopausal symptoms such as vaginal dryness and painful intercourse.
• Vaginal microbial transplantation (VMT) is an emerging approach to improve vaginal health, akin to the success of fecal microbiota transplantation for digestive disorders.
• Probiotics show promise in enhancing treatment and reducing the recurrence of bacterial vaginosis, offering a holistic treatment approach.
• Probiotics might play a significant role in combating cervical cancer by secreting substances that inhibit the growth of cancer cells and boosting immune defenses.
• Lactobacillus is key in maintaining the balance of the vaginal microenvironment, and its disruption can lead to increased growth of harmful bacteria and potentially advance cervical cancer development.
• Incorporating probiotics alongside traditional cancer treatments like radiotherapy could enhance the treatment's anti-tumor effect and improve patient survival rates.
• The role of probiotics in the menstrual cycle and hormone regulation is noted, with Lactobacillus thriving on glycogen produced due to hormonal influences, protecting against harmful pathogens.
• Significant imbalances in the vaginal microecological balance can lead to diseases, with certain bacteria linked to increased risk of cervical lesions, especially in the presence of HPV.

Probiotics: A Key to Vaginal Health and Beyond

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Probiotics, especially the Lactobacillus species, play a pivotal role in promoting vaginal health.

These beneficial bacteria are the main guardians of the vaginal ecosystem, adhering to its lining and outcompeting harmful pathogens.

They produce substances like bacteriocin and hydrogen peroxide, which not only curb the growth of invaders but also help maintain the vagina's naturally acidic environment.

This activity is crucial for vaginal health, as it strengthens immune defenses and may even help prevent the progression of cervical cancer.

Current research shines a light on the potential of probiotics in managing conditions like HPV, bacterial vaginosis, and menopause-related genitourinary issues.

This article reflects the collective findings on the importance of probiotics for women's health, paving the way for further exploration into their benefits.

Harnessing Probiotics for Optimal Vaginal Health

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The secret to vaginal health lies in a delicate balance within its ecosystem, largely upheld by probiotics.

These microscopic champions, primarily Lactobacillus, make up a staggering 95% of the vagina's normal flora, working tirelessly to maintain harmony A Trusted Source Ilhan, Z. E., Łaniewski, P., Thomas, N., Roe, D. J., Chase, D. M., Herbst-Kralovetz, M. M. (2019). Deciphering the complex interplay between microbiota, HPV, inflammation and cancer through cervicovaginal metabolic profiling. EBioMedicine 44, 675–690. doi: 10.1016/j.ebiom.2019.04.028 PubMed AbstractCrossRef Full TextGoogle Scholar.

They form different community state types (CSTs) with CST I, II, III, and V predominantly consisting of L.crispatus, L.gasseri, L.iners, and L.jensenii, respectively, while CST IV indicates a decline in these helpful bacteria A Trusted Source Langner, C. A., Ortiz, A. M., Flynn, J. K., Kendall, H., Lagenaur, L. A., Brenchley, J. M. (2021). The vaginal microbiome of nonhuman primates can be only transiently altered to become lactobacillus dominant without reducing inflammation. Microbiol. Spectr. 9 (3), e0107421. doi: 10.1128/Spectrum.01074-21 PubMed AbstractCrossRef Full TextGoogle Scholar.

Lactobacillus bacteria are the stars of vaginal health, producing lactic acid and hydrogen peroxide.

This dynamic duo acidifies the vaginal environment to a pH less than 4.5, creating a hostile atmosphere for harmful viruses and bacteria A Trusted Source Anderson, D. J., Marathe, J., Pudney, J. (2014). The structure of the human vaginal stratum corneum and its role in immune defense. Am. J. Reprod. Immunol. 71 (6), 618–623. doi: 10.1111/aji.12230 PubMed AbstractCrossRef Full TextGoogle Scholar A Trusted Source Das, S., Bhattacharjee, M. J., Mukherjee, A. K., Khan, M. R. (2022). Recent advances in understanding of multifaceted changes in the vaginal microenvironment: implications in vaginal health and therapeutics. Crit. Rev. Microbiol. 21, 1–27. doi: 10.1080/1040841x.2022.2049696 CrossRef Full TextGoogle Scholar.

Moreover, these probiotics stimulate our bodies to produce protective antimicrobial peptides and anti-inflammatory cytokines A Trusted Source Niu, X. X., Li, T., Zhang, X., Wang, S. X., Liu, Z. H. (2017). Lactobacillus crispatus modulates vaginal epithelial cell innate response to candida albicans. Chin. Med. J. (Engl) 130 (3), 273–279. doi: 10.4103/0366-6999.198927 PubMed AbstractCrossRef Full TextGoogle Scholar.

A woman's menstrual cycle, influenced by hormones like estrogen and progesterone, also plays a role.

These hormones prompt the production of glycogen, which feeds Lactobacillus, allowing them to thrive and block harmful pathogens from latching onto vaginal epithelial cells through a process called competitive rejection A Trusted Source Han, Y., Ren, Q. L. (2021). Does probiotics work for bacterial vaginosis and vulvovaginal candidiasis. Curr. Opin. Pharmacol. 61, 83–90. doi: 10.1016/j.coph.2021.09.004 PubMed AbstractCrossRef Full TextGoogle Scholar.

Vaginal microecological balance is a dynamic, self-regulating process, but significant imbalances can lead to diseases.

The presence of certain bacteria, such as Gardnerella, is linked to an increased risk of cervical lesions, especially in the presence of HPV, a known precursor to cervical cancer A Trusted Source Mitra, A., MacIntyre, D. A., Ntritsos, G., Smith, A., Tsilidis, K. K., Marchesi, J. R., et al. (2020). The vaginal microbiota associates with the regression of untreated cervical intraepithelial neoplasia 2 lesions. Nat. Commun. 11 (1), 1999. doi: 10.1038/s41467-020-15856-y PubMed AbstractCrossRef Full TextGoogle Scholar.

Additionally, as women transition into menopause, a drop in estrogen leads to a decrease in glycogen and Lactobacillus, making the vagina more susceptible to infections A Trusted Source Athanasiou, S., Pitsouni, E., Antonopoulou, S., Zacharakis, D., Salvatore, S., Falagas, M. E., et al. (2016). The effect of microablative fractional CO2 laser on vaginal flora of postmenopausal women. Climacteric 19 (5), 512–518. doi: 10.1080/13697137.2016.1212006 PubMed AbstractCrossRef Full TextGoogle Scholar.

Probiotic Supplements for Women: Enhance your vaginal health with our specially formulated probiotic supplements, designed to maintain a healthy vaginal flora and boost your immune defenses.

Probiotics, beneficial microorganisms found in both the gut and reproductive tract, have shown promise in treating various digestive diseases and maybe just as beneficial for vaginal health Łaniewski et al., 2020 A Trusted Source Piccioni, A., Franza, L., Vaccaro, V., Saviano, A., Zanza, C., Candelli, M., et al. (2021). Microbiota and probiotics: The role of limosilactobacillus reuteri in diverticulitis. Medicina (Kaunas) 57 (8), 802. doi: 10.3390/medicina57080802 PubMed AbstractCrossRef Full TextGoogle Scholar A Trusted Source Łaniewski, P., Ilhan, Z. E., Herbst-Kralovetz, M. M. (2020). The microbiome and gynaecological cancer development, prevention and therapy. Nat. Rev. Urol 17 (4), 232–250. doi: 10.1038/s41585-020-0286-z PubMed AbstractCrossRef Full TextGoogle Scholar .

This review emphasizes the crucial role of probiotics, particularly Lactobacillus, in maintaining or restoring the vaginal microecological balance, underscoring their potential in women's health.

By understanding and leveraging the power of probiotics, we can appreciate their vital role in not just digestive health but also in safeguarding the delicate balance of the vaginal ecosystem, a cornerstone of women's overall health.

Boosting Vaginal Health with Probiotics: A Shield Against Cervical Cancer

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Probiotics and vaginal health are intricately connected in the fight against cervical cancer, a leading cause of death among women A Trusted Source Jahanshahi, M., Maleki Dana, P., Badehnoosh, B., Asemi, Z., Hallajzadeh, J., Mansournia, M. A., et al. (2020). Anti-tumor activities of probiotics in cervical cancer. J. Ovarian Res. 13 (1), 68. doi: 10.1186/s13048-020-00668-x PubMed AbstractCrossRef Full TextGoogle Scholar A Trusted Source Kovachev, S. M. (2020). Cervical cancer and vaginal microbiota changes. Arch. Microbiol. 202 (2), 323–327. doi: 10.1007/s00203-019-01747-4 PubMed AbstractCrossRef Full TextGoogle Scholar.

The balance of the vaginal microenvironment, which includes beneficial Lactobacillus, can be disrupted by HPV infection.

This disruption can lead to increased growth of harmful bacteria and potentially advance cervical cancer development A Trusted Source Curty, G., de Carvalho, P. S., Soares, M. A. (2019). The role of the cervicovaginal microbiome on the genesis and as a biomarker of premalignant cervical intraepithelial neoplasia and invasive cervical cancer. Int. J. Mol. Sci. 21 (1), 222. doi: 10.3390/ijms21010222 CrossRef Full TextGoogle Scholar.

Groundbreaking studies have shown that the diversity of vaginal bacteria is greater in women with HPV, indicating a different microbial composition A Trusted Source Gao, W., Weng, J., Gao, Y., Chen, X. (2013). Comparison of the vaginal microbiota diversity of women with and without human papillomavirus infection: a cross-sectional study. BMC Infect. Dis. 13, 271. doi: 10.1186/1471-2334-13-271 PubMed AbstractCrossRef Full TextGoogle Scholar.

Excitingly, research by DI Pierro et al.(2021) revealed that oral intake of Lactobacillus curlicus could improve the vaginal flora and aid in clearing HPV A Trusted Source DI Pierro, F., Criscuolo, A. A., Dei Giudici, A., Senatori, R., Sesti, F., Ciotti, M., et al. (2021). Oral administration of lactobacillus crispatus M247 to papillomavirus-infected women: results of a preliminary, uncontrolled, open trial. Minerva Obstet Gynecol 73 (5), 621–631. doi: 10.23736/s2724-606x.21.04752-7 PubMed AbstractCrossRef Full TextGoogle Scholar.

Lactobacillus not only activates the immune response but also secretes anti-tumor metabolites, which could impede the growth of cancer cells A Trusted Source Champer, M., Wong, A. M., Champer, J., Brito, I. L., Messer, P. W., Hou, J. Y., et al. (2018). The role of the vaginal microbiome in gynaecological cancer. Bjog 125 (3), 309–315. doi: 10.1111/1471-0528.14631PubMed AbstractCrossRef Full TextGoogle Scholar A Trusted Source Pourmollaei, S., Barzegari, A., Farshbaf-Khalili, A., Nouri, M., Fattahi, A., Shahnazi, M., et al. (2020). Anticancer effect of bacteria on cervical cancer: Molecular aspects and therapeutic implications. Life Sci. 246, 117413. doi: 10.1016/j.lfs.2020.117413PubMed AbstractCrossRef Full TextGoogle Scholar.

Embracing probiotics may be a key strategy in reducing the progression of cervical cancer, highlighting the potent link between these microorganisms and women's health.

Probiotics: A Potential Ally in the Fight Against Cervical Cancer

Recent scientific insights reveal a promising connection between probiotics, such as Lactobacillus, and vaginal health, particularly in combating cervical cancer A Trusted Source Li, Y., Yu, T., Yan, H., Li, D., Yu, T., Yuan, T., et al. (2020). Vaginal microbiota and HPV infection: Novel mechanistic insights and therapeutic strategies. Infect. Drug Resist. 13, 1213–1220. doi: 10.2147/idr.s210615PubMed AbstractCrossRef Full TextGoogle Scholar A Trusted Source Kandati, K., Belagal, P., Nannepaga, J. S., Viswanath, B. (2022). Role of probiotics in the management of cervical cancer: An update. Clin. Nutr. ESPEN 48, 5–16. doi: 10.1016/j.clnesp.2022.02.017PubMed AbstractCrossRef Full TextGoogle Scholar.

These friendly bacteria do more than just acidify and stabilize the vaginal environment; they engage in a microscopic battle against cancer cells.

Lactobacilli assert their presence in the vaginal lining, creating a shield that blocks harmful pathogens.

They go on the offensive, secreting substances like peptidoglycan and exopolysaccharides that inhibit the growth of cancer cells.

Probiotics also bolster the body’s immune defenses, encouraging the production of cytokines and hindering the proliferation of monocytes.

The anti-cancer effects extend to immune cell activation, where Lactobacillus casei and Lactobacillus rhamnosus are found to spur the maturation of NK cells and dendritic cells, crucial players in the body's defense system A Trusted Source Wang, H., Ma, Y., Li, R., Chen, X., Wan, L., Zhao, W. (2019). Associations of cervicovaginal lactobacilli with high-risk human papillomavirus infection, cervical intraepithelial neoplasia, and cancer: A systematic review and meta-analysis. J. Infect. Dis. 220 (8), 1243–1254. doi: 10.1093/infdis/jiz325 PubMed AbstractCrossRef Full TextGoogle Scholar.

They also influence the proliferation and differentiation of critical immune cells, amplifying the body's ability to recognize and destroy cancerous cells.

Furthermore, an increase in Lactobacillus spp. correlates with a decrease in high-risk HPV infections and the severity of cervical abnormalities A Trusted Source Wang, H., Ma, Y., Li, R., Chen, X., Wan, L., Zhao, W. (2019). Associations of cervicovaginal lactobacilli with high-risk human papillomavirus infection, cervical intraepithelial neoplasia, and cancer: A systematic review and meta-analysis. J. Infect. Dis. 220 (8), 1243–1254. doi: 10.1093/infdis/jiz325 PubMed AbstractCrossRef Full TextGoogle Scholar.

With their cytotoxic effects on cancer cells, probiotics stand out as a non-chemotherapeutic option for maintaining normal vaginal flora and potentially treating cervical cancer, highlighting their significant role in cancer treatment strategies A Trusted Source Xie, Y., Feng, Y., Li, W., Zhan, F., Huang, G., Hu, H., et al. (2020). Revealing the disturbed vaginal micobiota caused by cervical cancer using high-throughput sequencing technology. Front. Cell Infect. Microbiol. 10. doi: 10.3389/fcimb.2020.538336 CrossRef Full TextGoogle Scholar.

As we continue to explore these microscopic warriors, Table 1 encapsulates the various studies spotlighting the impact of probiotics on cervical cancer cells, marking a new frontier in cancer therapy.

Probiotics	Sources	Cell Line	Results	Ref.
Lactobacillus plantarum 5BL	Vaginal secretions	HeLa	Lactobacillus can inhibit the activity of HeLa cells.	Nami et al., 2014
Lactobacillus gasseri and Lactobacillus crispatus	Commercial probiotics	HeLa	Supernatant of Lactobacillus is cytotoxic to cervical cancer cells.	Motavasei et al., 2013
Lactobacillus gasseri	Vaginal secretions	HeLa	L. gasseri inhibits HeLa cell proliferation and shows anti-inflammatory by reducing TNF-α.	Sunug et al., 2017
Bifidobacterium adolescentis	Fecal samples	SiHa	Bifidobacterium can inhibit the expression of E6 and E7 oncogenes in SiHa cells.	Cha et al., 2012
Lactobacillus rhamnosus and Lactobacillus crispatus	Commercial probiotics	HeLa	Supernatants of these two Lactobacilli were cytotoxic to HeLa cells.	Nour et al., 2016
Lactobacillus crispatus, L. jensenii, and L. gasseri	Commercial probiotics	Caski	Supernatant of Lactobacillus inhibits cervical cancer cells by regulating HPV oncogenes and cell cycle related genes.	Wang et al., 2018
Lactobacillus casei and Lactobacillus paracasei	Human breast milk	HeLa	Supernatant of Lactobacillus inhibits HeLa cells by regulating the expression of apoptotic genes.	Riaz Rajoka et al., 2018
Lactobacillus DM8909	Laboratory milk culture	HeLa and U14	Lactobacillus can inhibit HeLa and U14 cell migration by upregulating E-cadherin expression.	Li et al., 2017
Lactobacillus crispatus and Lactobacillus rhamnosus	Commercial probiotics	HeLa	Probiotic supernatant can inhibit the proliferation of HeLa cells by down regulating HPV oncogene.	Motavasei et al., 2016

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Probiotics: Mitigating Side Effects in Cervical Cancer Treatment

Probiotics are emerging as supportive care in cervical cancer treatments, particularly in reducing radiotherapy-induced diarrhea (RID), a prevalent side effect that adds to patients' burdens A Trusted Source Jahanshahi, M., Maleki Dana, P., Badehnoosh, B., Asemi, Z., Hallajzadeh, J., Mansournia, M. A., et al. (2020). Anti-tumor activities of probiotics in cervical cancer. J. Ovarian Res. 13 (1), 68. doi: 10.1186/s13048-020-00668-x PubMed AbstractCrossRef Full TextGoogle Scholar.

These beneficial bacteria are traditionally known for their positive impact on digestive health and are now showing promise in alleviating inflammation-related side effects of cancer therapies.

Studies suggest that incorporating probiotics alongside radiotherapy can enhance the treatment's anti-tumor effect and even improve patient survival rates A Trusted Source Okawa, T., Niibe, H., Arai, T., Sekiba, K., Noda, K., Takeuchi, S., et al. (1993). Effect of LC9018 combined with radiation therapy on carcinoma of the uterine cervix. a phase III, multicenter, randomized, controlled study. Cancer 72 (6), 1949–1954. doi: 10.1002/1097-0142(19930915)72:6<1949::aid-cncr2820720626>3.0.co;2-w PubMed AbstractCrossRef Full TextGoogle Scholar.

A meta-analysis revealed a significant reduction in the incidence of RID when probiotics were used, indicating a potential for a more tolerable treatment experience A Trusted Source Qiu, G., Yu, Y., Wang, Y., Wang, X. (2019). The significance of probiotics in preventing radiotherapy-induced diarrhea in patients with cervical cancer: A systematic review and meta-analysis. Int. J. Surg. 65, 61–69. doi: 10.1016/j.ijsu.2019.03.015 PubMed AbstractCrossRef Full TextGoogle Scholar.

Additionally, innovative approaches like cisplatin and probiotic pessaries are being explored for their safety and efficacy in local cancer treatments A Trusted Source Negi, D., Singh, A., Joshi, N., Mishra, N. (2020). Cisplatin and probiotic biomass loaded pessaries for the management of cervical cancer. Anticancer Agents Med. Chem. 20 (5), 589–598. doi: 10.2174/1871520619666191211110640 PubMed AbstractCrossRef Full TextGoogle Scholar.

While promising, more research, including clinical trials, is needed to fully understand how probiotics can best support cervical cancer treatments.

As summarized in Table 2, the exploration into probiotics offers a hopeful avenue for lessening gastrointestinal side effects for those undergoing cervical cancer therapy.

Probiotics	Methods	Findings	Ref.
Lactobacillus acidophilus plus Bifidobacterium bifidum	Patients who received cisplatin and pelvic radiotherapy were divided into a probiotic group and a placebo group.	Probiotics reduced the incidence of RID and improved stool consistency.	Chitapanarux et al., 2010
Lactobacillus acidophilus LA-5 plus Bifidobacterium animalis subsp lactis BB-12	Patients were randomized to a probiotics group (containing 75 billion live freeze-dried bacteria) or a placebo group.	Probiotics reduced the incidence of diarrhea and grade 2 abdominal pain.	Lin et al., 2019
VSL#3	Patients were assigned to either the high-potency probiotic preparation VSL#3 or placebo	Probiotic treatment reduces grade 3-4 diarrhea and reduces the number of bowel movements.	Delia et al., 2007
Lactobacillus acidophilus LA-5 plus Bifidobacterium lactis BB-12	Patients were randomized between a placebo and either of two regimens of double strain Bifidobacteria probiotics.	Probiotics reduce radiation-induced grade 2-3-4 diarrhea.	Demers et al., 2014
Lactobacillus casei DN-114 001	Patients were randomly assigned to a probiotic drink or placebo.	Probiotic intervention had a significant effect on stool consistency.	Giralt et al., 2008

While the HPV preventive vaccine guards against high-risk infections, it doesn't enhance cervical cancer treatment.

Thus, researchers like Werner et al.(2012) are exploring therapeutic vaccines, particularly targeting HPV E6 and E7 oncoproteins, known for their role in advancing cervical cancer A Trusted Source Werner, J., Decarlo, C. A., Escott, N., Zehbe, I., Ulanova, M. (2012). Expression of integrins and toll-like receptors in cervical cancer: effect of infectious agents. Innate Immun. 18 (1), 55–69. doi: 10.1177/1753425910392934 PubMed AbstractCrossRef Full TextGoogle Scholar .

Innovating Vaginal Health: Probiotics as a Therapeutic Avenue for HPV

These vaccines, including protein and peptide vaccines, DNA vaccines, and bacterial vector vaccines, are currently under development, with bacterial-based vaccines gaining traction A Trusted Source Taghinezhad, S. S., Keyvani, H., Bermúdez-Humarán, L. G., Donders, G. G. G., Fu, X., Mohseni, A. H. (2021). Twenty years of research on HPV vaccines based on genetically modified lactic acid bacteria: an overview on the gut-vagina axis. Cell Mol. Life Sci. 78 (4), 1191–1206. doi: 10.1007/s00018-020-03652-2 PubMed AbstractCrossRef Full TextGoogle Scholar.

Among these, transgenic Lactobacillus shows promise due to its safety profile and ability to induce both humoral and cellular immunity, potentially attacking the HPV virus A Trusted Source Das, S., Bhattacharjee, M. J., Mukherjee, A. K., Khan, M. R. (2022). Recent advances in understanding of multifaceted changes in the vaginal microenvironment: implications in vaginal health and therapeutics. Crit. Rev. Microbiol. 21, 1–27. doi: 10.1080/1040841x.2022.2049696 CrossRef Full TextGoogle Scholar.

For instance, Komatsu et al.(2018) developed an innovative Lactobacillus casei therapeutic vaccine expressing the HPV E7 protein, which has been linked to an effective E7-specific mucosal immune response A Trusted Source Komatsu, A., Igimi, S., Kawana, K. (2018). Optimization of human papillomavirus (HPV) type 16 E7-expressing lactobacillus-based vaccine for induction of mucosal E7-specific IFNγ-producing cells. Vaccine 36 (24), 3423–3426. doi: 10.1016/j.vaccine.2018.05.009 PubMed AbstractCrossRef Full TextGoogle Scholar .

Similarly, studies by Lee et al. have demonstrated that oral administration of Lactobacillus casei expressing HPV16 E6 protein can trigger the production of specific antibodies.

Park et al.(2019) explored an oral treatment, BLS-M07, using Lactobacillus casei to carry the HPV 16 E7 antigen, showing increased serum HPV16E7 specific antibodies in CIN3 patients A Trusted Source Park, Y. C., Ouh, Y. T., Sung, M. H., Park, H. G., Kim, T. J., Cho, C. H., et al. (2019). A phase 1/2a, dose-escalation, safety and preliminary efficacy study of oral therapeutic vaccine in subjects with cervical intraepithelial neoplasia 3. J. Gynecol Oncol. 30 (6), e88. doi: 10.3802/jgo.2019.30.e88 PubMed AbstractCrossRef Full TextGoogle Scholar .

Although still in the clinical trial phase without current clinical applications, these studies reinforce the feasibility of engineering bacteria, particularly Lactobacillus, to develop HPV therapeutic vaccines, pointing to a future focused on utilizing these bacteria for vaginal health and beyond.

Probiotics: Enhancing Treatment and Reducing Recurrence of Bacterial Vaginosis

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The struggle against bacterial vaginosis (BV), a condition marked by flora imbalance and the rise of harmful anaerobic bacteria like Gardnerella, is seeing a ray of hope with probiotics A Trusted Source Bagnall, P., Rizzolo, D. (2017). Bacterial vaginosis: A practical review. Jaapa 30 (12), 15–21. doi: 10.1097/01.JAA.0000526770.60197.fa PubMed AbstractCrossRef Full TextGoogle Scholar.

Traditional antibiotic treatments, such as metronidazole, often lead to high recurrence rates and unwanted side effects A Trusted Source Muzny, C. A., Łaniewski, P., Schwebke, J. R., Herbst-Kralovetz, M. M. (2020). Host-vaginal microbiota interactions in the pathogenesis of bacterial vaginosis. Curr. Opin. Infect. Dis. 33 (1), 59–65. doi: 10.1097/qco.0000000000000620 PubMed AbstractCrossRef Full TextGoogle Scholar.

Probiotics offer a promising complement, improving vaginal flora by increasing beneficial bacteria and reducing harmful ones, thereby stabilizing the vaginal environment A Trusted Source Ling, Z., Liu, X., Chen, W., Luo, Y., Yuan, L., Xia, Y., et al. (2013). The restoration of the vaginal microbiota after treatment for bacterial vaginosis with metronidazole or probiotics. Microb. Ecol. 65 (3), 773–780. doi: 10.1007/s00248-012-0154-3 PubMed AbstractCrossRef Full TextGoogle Scholar.

Evidence from a meta-analysis of 30 studies showed that probiotics significantly lowered the recurrence of vaginitis and improved cure rates A Trusted Source Jeng, H. S., Yan, T. R., Chen, J. Y. (2020). Treating vaginitis with probiotics in non-pregnant females: A systematic review and meta-analysis. Exp. Ther. Med. 20 (4), 3749–3765. doi: 10.3892/etm.2020.9090 PubMed AbstractCrossRef Full TextGoogle Scholar.

Lactobacillus plantarum Lp62, in particular, has demonstrated notable success in inhibiting the growth of Gardnerella A Trusted Source Selis, N. N., Oliveira, H. B. M., Souza, C. L. S., Almeida, J. B., Andrade, Y., Silva, L. S. C., et al. (2021). Lactobacillus plantarum Lp62 exerts probiotic effects against gardnerella vaginalis ATCC 49154 in bacterial vaginosis. Lett. Appl. Microbiol. 73 (5), 579–589. doi: 10.1111/lam.13547 PubMed AbstractCrossRef Full TextGoogle Scholar.

Furthermore, an 18-study meta-analysis with a 3-month follow-up found that combining antibiotics with probiotics markedly reduced BV recurrence compared to antibiotics alone A Trusted Source Liu, H. F., Yi, N. (2022). A systematic review and meta-analysis on the efficacy of probiotics for bacterial vaginosis. Eur. Rev. Med. Pharmacol. Sci. 26 (1), 90–98. doi: 10.26355/eurrev_202201_27752 PubMed AbstractCrossRef Full TextGoogle Scholar .

Products for Bacterial Vaginosis Management: Combat bacterial vaginosis effectively with our probiotic-based products, designed to restore and maintain a healthy vaginal microbiome.

Given the link between chronic inflammation and cancer, probiotics also emerge as a key player in anti-inflammatory treatments.

This synergistic approach of pairing probiotics with antibiotics is paving the way for more effective BV treatments.

Table 3 encapsulates the recent clinical research on the use of probiotics in treating BV, indicating a shift towards a more holistic treatment paradigm.

Probiotics	Methods	Results	Ref.
Lactobacillus acidophilus GLA-14 and Lactobacillus rhamnosus HN001	Patients received metronidazole (500 mg, bid) for 7 days and were randomly assigned to concurrently receive probiotics plus lactoferrin or placebo (n=48).	Probiotic mixture combined with lactoferrin improved symptoms (vaginal discharge and itch), Nugent scores, and recurrence rates.	Russo et al., 2019
Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14	Patients received oral metronidazole for 7 days, and probiotics and placebo for 30 days (n=125).	Combined use of probiotics and antibiotics improves BV cure rates.	Anukam et al., 2006
Lactobacillus crispatus LMG S-29995, Lactobacillus crispatus and Lactobacillus acidophilus	After completing metronidazole treatment, patients received probiotics and placebo, respectively (n=166).	Oral probiotics reduce the time of recurrence and prolong the rate of BV disease clearance.	Recine et al., 2020
Lactobacillus rhamnosus BMX 54	After completing metronidazole treatment, patients received placebo and vaginal tablets containing probiotics, respectively (n=250).	Patients treated with probiotics had reduced BV recurrence rate and vaginal pH.	Recine et al., 2016
Lactobacillus crispatus Lbv 88, Lactobacillus gasseri Lbv 150N, Lactobacillus jensenii Lbv 116 and Lactobacillus rhamnosus Lbv96	After completing metronidazole treatment, patients received placebo and yogurt with probiotics, respectively (n=36).	Yogurt with probiotics increases BV recovery rates and improves vaginal microbes.	Laue et al., 2018
L. brevis CD2, L. salivarius subsp. salicinius (FV2), and L. plantarum (FV9)	Patients were randomized to receive probiotic vaginal tablets and vaginal pH tablets (n=64).	Probiotics improve BV cure rates and reduce vaginal cytokines IL-1β and IL-6.	Hemalatha et al., 2012
Lactobacillus rhamnosus GR-1 and L. reuteri RC-14	Patients were treated with probiotics for 6 months and metronidazole for 10 days (n=65).	Supplementation with probiotics did not improve BV cure rates, but improved vaginal flora composition.	Hummelen et al., 2010
L. brevis (CD2), L. salivarius subsp. salicinus (FV2), and L. plantarum (FV9)	Patients received probiotic-containing vaginal tablets or placebo for 7 days (n=39).	Lactobacillus probiotics can increase the cure rate of BV and improve the vaginal environment.	Mastromarino et al., 2009

Probiotics and Estrogen: A Synergistic Approach for Menopausal Vaginal Health

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Genitourinary Syndrome of Menopause (GSM), previously termed vulvovaginal atrophy or atrophic vaginitis,

affects over half of postmenopausal women with symptoms like vaginal dryness, discomfort during intercourse, and urinary issues A Trusted Source Donders, G. G. G., Ruban, K., Bellen, G., Grinceviciene, S. (2019). Pharmacotherapy for the treatment of vaginal atrophy. Expert Opin. Pharmacother. 20 (7), 821–835. doi: 10.1080/14656566.2019.1574752PubMed AbstractCrossRef Full TextGoogle Scholar A Trusted Source Yoo, S. H., Kim, K. R., Park, N. J. (2022). Transitional cell metaplasia of the uterine cervix: A histopathological and immunohistochemical analysis suggesting a possible role of androgenic conversion during urothelial-like differentiation in peri/postmenopausal women. Ann. Diagn. Pathol. 56, 151839. doi: 10.1016/j.anndiagpath.2021.151839PubMed AbstractCrossRef Full TextGoogle Scholar.

The hormonal shifts of menopause, particularly reduced estrogen, contribute to these challenges and even make cervical cells more susceptible to malignancy due to changes in vaginal flora, including a decline in Lactobacillus.

Traditional GSM therapies have included estrogen-based treatments, but recent findings advocate for the adjunctive use of probiotics.

A study by Petricevic et al.(2008) revealed that oral probiotics (Lactobacillus rhamnosus Gr-1 and Lactobacillus reuteri RC-14) could significantly improve GSM symptoms in postmenopausal women.

Ribeiro et al.(2018) reported that combining estrogen therapy with probiotics notably enhanced relief from symptoms, particularly vaginal dryness and painful intercourse A Trusted Source Ribeiro, A. E., Monteiro, N. E. S., Moraes, A. V. G., Costa-Paiva, L. H., Pedro, A. O. (2018). Can the use of probiotics in association with isoflavone improve the symptoms of genitourinary syndrome of menopause? results from a randomized controlled trial. Menopause 26 (6), 643–652. doi: 10.1097/gme.0000000000001279 PubMed AbstractCrossRef Full TextGoogle Scholar.

Moreover, Lim et al.(2021) discovered that probiotics could address climacteric symptoms and bolster intestinal barrier integrity in ovariectomized rats A Trusted Source Lim, E. Y., Song, E. J., Kim, J. G., Jung, S. Y., Lee, S. Y., Shin, H. S., et al. (2021). Lactobacillus intestinalis YT2 restores the gut microbiota and improves menopausal symptoms in ovariectomized rats. Benef Microbes 12 (5), 503–516. doi: 10.3920/bm2020.0217 PubMed AbstractCrossRef Full TextGoogle Scholar .

Menopausal Relief Supplements: Ease the symptoms of menopause with our probiotic-based supplements, offering natural relief from discomforts like vaginal dryness and hormonal imbalances.

These insights suggest that beyond local estrogen application, oral or vaginal probiotics could effectively ease menopausal symptoms, offering a new avenue to enhance the quality of life for postmenopausal women.

Embracing Probiotics for Vaginal Health: The Promise of Vaginal Microbial Transplantation

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Recent studies are spotlighting the potential of vaginal microbial transplantation (VMT) as a novel approach to improving vaginal health,

inspired by the success of fecal microbiota transplantation (FMT) in treating digestive disorders A Trusted Source Korpela, K., Helve, O., Kolho, K. L., Saisto, T., Skogberg, K., Dikareva, E., et al. (2020). Maternal fecal microbiota transplantation in cesarean-born infants rapidly restores normal gut microbial development: A proof-of-Concept study. Cell 183 (2), 324–334.e325. doi: 10.1016/j.cell.2020.08.047 PubMed AbstractCrossRef Full TextGoogle Scholar A Trusted Source Wang, J., Li, Z., Ma, X., Du, L., Jia, Z., Cui, X., et al. (2021). Translocation of vaginal microbiota is involved in impairment and protection of uterine health. Nat. Commun. 12 (1), 4191. doi: 10.1038/s41467-021-24516-8 PubMed AbstractCrossRef Full TextGoogle Scholar.

A pivotal study by Chen et al.(2021) revealed that VMT could markedly alleviate bacterial-induced inflammation and rebalance the vaginal microbiota A Trusted Source Chen, T., Xia, C., Hu, H., Wang, H., Tan, B., Tian, P., et al. (2021). Dysbiosis of the rat vagina is efficiently rescued by vaginal microbiota transplantation or probiotic combination. Int. J. Antimicrob. Agents 57 (3), 106277. doi: 10.1016/j.ijantimicag.2021.106277 PubMed AbstractCrossRef Full TextGoogle Scholar .

Lev-Sagie et al.(2019) led the way with a groundbreaking use of VMT, taking healthy donors' vaginal microbes as a treatment for patients with bacterial vaginosis (BV) A Trusted Source Lev-Sagie, A., Goldman-Wohl, D., Cohen, Y., Dori-Bachash, M., Leshem, A., Mor, U., et al. (2019). Vaginal microbiome transplantation in women with intractable bacterial vaginosis. Nat. Med. 25 (10), 1500–1504. doi: 10.1038/s41591-019-0600-6 PubMed AbstractCrossRef Full TextGoogle Scholar .

Follow-ups demonstrated not only improved vaginal fluid appearance but also a Lactobacilli-rich vaginal microbiota in recipients.

Similarly, Huang et al.(2021) observed that introducing the fecal microbiota of mice with healthy ovaries to those without significantly mitigated vaginal epithelial atrophy A Trusted Source Huang, J., Shan, W., Li, F., Wang, Z., Cheng, J., Lu, F., et al. (2021). Fecal microbiota transplantation mitigates vaginal atrophy in ovariectomized mice. Aging (Albany NY) 13 (5), 7589–7607. doi: 10.18632/aging.202627 PubMed AbstractCrossRef Full TextGoogle Scholar .

However, not all related studies align with these promising outcomes.

Wilson et al.(2021) conducted a randomized controlled trial on infants born via cesarean section, finding that oral administration of maternal vaginal microbes did not significantly change the infants' gut microbiota compared to a placebo A Trusted Source Wilson, B. C., Butler É, M., Grigg, C. P., Derraik, J. G. B., Chiavaroli, V., Walker, N., et al. (2021). Oral administration of maternal vaginal microbes at birth to restore gut microbiome development in infants born by caesarean section: A pilot randomised placebo-controlled trial. EBioMedicine 69, 103443. doi: 10.1016/j.ebiom.2021.103443 PubMed AbstractCrossRef Full TextGoogle Scholar .

These contrasting results underscore the need for further research into the applications of VMT.

While its efficacy and value remain under study, the integration of probiotics into treatment regimens holds potential for enhancing vaginal health and warrants continued scientific exploration.

Discussion and Conclusion

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• The integration of probiotics into treatment regimens is still under study, but it holds potential for enhancing vaginal health and deserves further scientific exploration.
• Probiotics, especially strains of Lactobacillus, are crucial for promoting vaginal health, acting as the main guardians of the vaginal ecosystem.
• The potential of probiotics in managing conditions like HPV, bacterial vaginosis, and menopause-related genitourinary issues is highlighted, pointing to a future where these bacteria are utilized beyond just vaginal health.
• Probiotics are emerging as a promising complement to traditional treatments for bacterial vaginosis, potentially stabilizing the vaginal environment and reducing recurrence rates.
• In the context of cervical cancer, probiotics may play a significant role by inhibiting the growth of cancer cells and boosting the body's immune defenses.
• The review emphasizes the vital role of probiotics in women's health, underscoring their potential in maintaining or restoring vaginal microecological balance.
• There is a promising connection between probiotics and the fight against cervical cancer, suggesting that these microorganisms could be allies in reducing the progression of the disease.
• The article mentions innovative approaches to cervical cancer treatments that include probiotics, indicating a hopeful avenue for lessening side effects for those undergoing therapy.
• Vaginal microbial transplantation (VMT) is presented as a novel approach to improving vaginal health, with a need for further research into its applications.

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