Do Probiotics Really Improve Vaginal Health?

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A new study casts doubt on whether probiotics can improve vaginal health. Credit: Liliia Lysenko/Getty Images.
  • Vaginal health, including vaginal flora, is vital to well-being and fertility.
  • The success rate of fertility treatments like IVF can be affected by many factors, including the makeup of the vaginal microbiome prior to treatment.
  • Recent results suggest that probiotics administered vaginally 10 days prior to fertility treatment may not improve unfavorable vaginal microbiomes.

The importance of probiotics and maintaining the “good” bacteria in the body is essential in many areas of health. The microorganisms that inhabit the vagina can affect pregnancy and other health outcomes.

However, improving the vaginal microbiome may not be as simple as taking probiotics. Experts shared recent study results at the 38th Annual Meeting of the European Society for Human Reproduction and Embryology (ESHRE).

They found that treatment with vaginal probiotic capsules did not improve vaginal flora any more than placebo in women with unfavorable vaginal microbiomes.

That National Institute for Environmental Health Sciences notes that “[t]The microbiome is the collection of all microbes such as bacteria, fungi, viruses and their genes that live naturally on and within our bodies.”

The human microbiome plays a crucial role in many areas of health. The vaginal microbiome refers to all microorganisms in the vagina. That Structure of the vaginal microbiome may affect the risk of gynecological cancers.

It can also affect the risk of sexually transmitted infections. Finally, it can also affect conception and pregnancy. The microorganism lactobacilli typically contributes to a healthy vaginal microbiome and protects the body.

Physicians need to consider vaginal health and how to improve it, including for those seeking infertility treatments such as in vitro fertilization (IVF).

A healthy vaginal microbiome can increase the chances of a healthy pregnancy. However, how best to improve the vaginal microbiome can be more complicated than just using vaginal probiotics.

The study in question was a randomized, double-blind, placebo-controlled study, allowing for great objectivity and helping to remove the risk of bias. The researchers included 74 participants. The participants had all been referred for IVF and had unfavorable vaginal microbiomes.

The researchers divided the participants into two groups: one received a placebo and the other vaginal probiotic capsules included lactobacilli. The researchers re-evaluated the participants’ vaginal microbiomes after they completed their treatment and after they had their next menstrual cycle.

The study authors found no significant differences between the control and intervention groups. However, more than a third (34.2%) of all participants experienced improvements in vaginal microbiome quality over 1-3 months, regardless of whether they received a probiotic or a placebo.

Yasser Diab, a consultant gynecologist-obstetrician at the Cadogan Clinic, who was not involved in this study, commented Medical news today the “[t]Here there was no significant difference between the two groups – the lactobacilli group [and the] placebo group.”

“The intervention did not include all lactobacilli strains involved in influencing fertility outcomes. More detailed studies are needed to establish therapeutic strategies to improve fertility treatment outcomes through interventions that address the vaginal microbiome,” he emphasized.

Study author Dr. Ida Enberg Jepson commented that she and her colleagues were surprised by the results and that certain probiotic treatments may not be as effective as they had hoped.

She declared for MNT:

“The study suggests that the ‘probiotic rush’ should be moderated cautiously. We found that the use of a specific probiotic is included Lactobacillus rhamnosus and Lactobacillus gasseri did not improve an (asymptomatic) unfavorable vaginal microbiota in infertile women.”

In sharing the results of the study, the authors noted some limitations. First of all, the vaginal probiotic capsules did not contain all strains of lactobacilli that may affect fertility outcomes. They also noted that their broad categorization of low, medium, and high vaginal microbiome profiles may have masked subtle changes.

The study does not negate the importance of vaginal health. However, it raises questions about how best to address vaginal health, particularly when working toward optimal vaginal microbiomes prior to infertility treatments.

dr Jepson also mentioned some areas for potential further research:

“Suggestions for new research could be exploring different strains of Lactobacilli or investigating transplantation of vaginal microbiota from women with normal vaginal microbiota. In addition, it would be interesting to investigate whether it is possible to achieve a higher pregnancy rate if we postpone IVF treatment in patients with an unfavorable vaginal microbiota until spontaneous improvement is seen over the next 1-3 months, like this study suggests.”

Results may further influence future pre-IVF recommendations. dr Jepson explained: “[w]We saw spontaneous improvement in patients with unfavorable vaginal microbiota, mainly low profile, over 1-3 months. This suggests that an idea for patients with an unfavorable vaginal microbiota might be to postpone IVF treatment until spontaneous improvement.”

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