Vaginal probiotics: which one should you choose to protect your intimate flora?

What exactly is the vaginal microbiome?

The vaginal microbiome is the collective term for all the microorganisms that live in the vagina. In simple terms, it’s as important to intimate health as the gut microbiota is to intestinal health!

Its function is two-fold: to defend the vaginal mucosa from pathogens by protecting it with a biofilm, and to maintain its pH within an ideal range (between 3.5 and 4.5) (1).

A guarantee of good vaginal health, this important ecosystem is, however, sometimes subject to imbalances, referred to as dysbiosis. This is usually caused by hormonal or environmental factors such as certain medications, stress, fatigue or inappropriate intimate hygiene (2).

In allowing particular bacterial strains to ‘get the upper hand’, vaginal dysbiosis paves the way for the development of gynaecological or urinary tract problems (3). When such problems become recurrent, they can cause significant genital discomfort and adversely affect a woman’s sex life.

The healthy microorganisms that populate the vaginal flora

200: that’s the approximate number of different species of bacteria so far identified in the vagina (4). But a closer look shows that a healthy vaginal microbiota displays far less diversity.

Here, it’s lactic bacteria (lactobacilli) which form the overwhelming bulk of its composition - almost 90%. This defensive battalion is what’s referred to as Döderlein flora.

While every profile is unique, most women will have between one and four dominant strains from among the following: Lactobacillus jensenii, Lactobacillus gasseri, Lactobacillus crispatus and Lactobacillus iners (5).

Other beneficial lactic colonisers include L. acidophilus, L. casei, L. Plantarum, L. rhamnosus and L. salivarius, which are also found in other regions of the body (such as the mouth and digestive tract) (6).

It’s worth noting that vaginal flora composition depends heavily on estrogen secretions (7). It can therefore vary significantly across the menstrual cycle, and during pregnancy and the menopause.

Which vaginal probiotic should you choose?

The purpose of a vaginal probiotic is to ‘re-seed’ the physiological flora with friendly microorganisms in order to restore a harmonious environment.

For optimal efficacy, you therefore need to focus on the above-mentioned lactobacilli. Other species of lactic bacteria such as bifidobacteria (used in yogurt fermentation) are also able to anchor themselves to the vaginal wall, and deserve a place in your microbiotic regimen (8).

While choosing the right bacteria is crucial, it’s equally important that they successfully implant themselves in the mucosa. To facilitate this tricky process, we recommend opting for a formulation that contains prebiotics, substances that nourish and support the growth of healthy bacteria (9).

Finally, there are two ways in which vaginal probiotics can be administered: the vaginal route (pessaries) or the traditional oral route (capsules, tablets …). The first is more direct, the second less restrictive. It’s all down to personal choice.

Combining 5 recognized strains of lactic bacteria (Lactobacillus rhamnosus, Bifidobacterium lactis, Lactobacillus salivarius, Lactobacillus acidophilus and Lactobacillus casei), the oral microbiotic Vaginal Health provides, in a single formulation, the ‘good bacteria’ of the vaginal microbiome, at a high dose of 5 billion microorganisms per capsule (10). It also contains fructo-oligosaccharides, non-digestible plant sugars, to support the bacteria’s growth (11).

Good habits to adopt to help take care of your intimate flora

There are also a number of everyday steps you can take to help maintain ahealthy balance in your vaginal flora:

• avoid vaginal douches, as they disrupt the vaginal microbiome and impair natural vaginal self-cleansing (12) ;
• once a day (no more, no less), wash your genitals with a gentle, or superfatted, soap. Never use antiseptic soaps, as they will adversely affect your levels of good bacteria, and don’t wash with water only as it affects the skin’s hydrolipidic film (13) ;
• try not to smoke. Nicotine tends to lower estrogen levels which are essential for the growth of lactobacilli (14) ;
• eat less sugar. While the link between diet and vaginal dysbiosis has yet to be clearly established, a high-sugar diet can promote the growth of yeasts (such as Candida albicans) (15) ;
• don’t self-medicate with antibiotics. Though sometimes necessary for treating a bacterial infection, certain antibiotics can modify or adversely affect the vaginal flora (16). If you regularly suffer from urogenital problems such as vaginitis or yeast infections, your doctor can prescribe preventive treatments;
• to prevent excessive moisture and allow your genital area to ‘breathe’, try to sleep without underwear (or at least, wear loose-fitting underwear) (17).