When it comes to probiotics, everything starts with your microbiome. This is the healthy ecosystem of bacteria and organisms that lives in a specific part of your body such as your gut, or vagina. 

Professor Georgina Holt, from the Microbiome Research Centre in Sydney explains that women and men do have differences in microbiomes, but there is not a lot of research looking at these differences. “More exploration is needed,” she says. 

 Your race, where you live and what you eat play a part. For example, many Asians are lactose intolerant – but that is partly because Asians don’t tend to eat much dairy foods anyway. If an Asian person moves to a Western country and starts eating more dairy products, they often become less lactose-intolerant, over time. Their gut adjusts the balance in the microbiome to digest dairy foods more effectively.

“Ethnicity, geography and diet play a huge part in microbes, so what’s healthy for one person living in one place isn’t necessarily healthy for someone else. There’s a lot of variation and we’re still trying to understand it,” explains Prof Holt. 

With so many factors affecting your microbiome, can probiotic manufacturers claim a probiotic is helpful just for women? According to Professor Gregor Reid, from the University of Western Ontario in Canada, it depends on the type of probiotic and why you are taking them. 

Professor Reid has been studying probiotics since the early 80s, especially the benefits of lactobacilli on vaginal health. The foundations of his work are some studies that showed women who never had a Urinary Tract Infection or UTI, had more lactobacilli in their vagina, compared to women who often got UTI. He found women who often had UTI had certain pathogens in their vagina, called coliforms. These coliforms moved up into the bladder and caused infections.

Professor Reid and his team developed two probiotic strains called Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. The probiotic strains reduced UTIs by increasing the body’s defenses. They produced molecules that weakened or killed the coliform pathogens, and also stopped them from being able to climb up into the bladder to cause a UTI.

Reduced levels of lactobacillus are also linked to bacterial vaginosis, a condition where the vagina is colonised by too many bacteria. Bacterial vaginosis produces a discharge and a fishy smell. Thrush infections are also caused by an overgrowth of yeast which naturally lives in the vagina. At normal levels, it helps keep the vagina healthy, But if it overgrows, you get thrush. “This is why certain probiotic strains are administered – because they have anti-yeast activity,” explains Professor Reid. 

Professor Reid is wary of claims by probiotic manufacturers. He says “Some manufacturers claim their probiotics can relieve digestive symptoms and improve vaginal health, but there’s no evidence to support this. Our studies show Lactobacillus types are not all the same. For example, the Lactobacillus Rhamnosus GG that is used for gut health is not suitable for urogenital effects.”

The Australian Department of Health’s Therapeutic Goods Administration analysed 26 studies into the use of probiotics for vaginal health and decided that there was no evidence they were harmful – but also no evidence to show they were helpful either.

In Singapore, the situation is similar. Health supplements do not require approval and are not evaluated by the Health Sciences Authority (HSA) before they can be sold locally. But if a product is found to contain banned or dangerous substances, it can be removed from sale. 

Plus, supplement advertisements here cannot make claims that a supplement can treat or prevent diseases. This balanced approach is similar to other developed countries such as the USA and Australia.

Professor Reid explains, “Consuming an oral probiotic can help because bugs that go through the mouth can also go around the body. They can move out of the intestinal tract to other parts of the body.”

If you go online, you’ll find plenty of advice about applying probiotics directly to the vagina. Bloggers often suggest you put plain yoghurt on a tampon and insert it into the vagina to cure a yeast infection. But it does not work. Yoghurt does contain lactobacilli but it’s not the same type that populates a healthy vagina.

Various studies show no negative effects when pregnant women take probiotics – but there’s mixed evidence about possible benefits. 

One study in New Zealand looked at whether taking probiotics during pregnancy could prevent skin conditions in babies, including eczema and allergies like atopic dermatitis. They gave Lactobacillus Rhamnosus HN001 to nearly 500 mothers from 35 weeks pregnant until six months after giving birth, and during breastfeeding. The researchers tracked the children as they grew up and found 50 per cent less eczema, by age two. Allergies were also reduced.

Another study at the University of California found that taking probiotics can improve the symptoms of pregnancy-related nausea, vomiting, and constipation, which affects 85 per cent of pregnancies. But they only tested 32 women, who took the probiotics twice a day. As the researchers noted, “Although the findings are intriguing, we caution that due to the small sample size, further studies will be needed to confirm the effects of the probiotics.”

The bottom line is that Lactobacillus rhamnosus GR-1 and Lactobacillus Reuterie RC-14 do have evidence to show they can help with vaginal health. But other types – and other uses – still need to be studied.

Credit: Bauer syndication 

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