Do probiotics really improve vaginal health?

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

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

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

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

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

The study in question was a randomized, double-blind, placebo-controlled study, enabling great objectivity and helping to remove the risk of prejudice. Researchers included 74 participants. The participants were all referred for IVF and had unfavorable vaginal microbiome.

Researchers divided the participants into two groups: one received a placebo, and the other had vaginal probiotic capsules containing Lactobacillus. The researchers reevaluated the participants’ vaginal microbiomas after completing their treatment and after having 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, consultant gynecologist and obstetrician at the Cadogan Clinic, who was not involved in this study, noted that Medical News Today that “[t]here there was no significant difference between the two groups – the lactobacilli group [and the] placebo group. ”

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

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

She explained to MNT:

“The study indicates that the ‘rush to probiotics’ must be carefully tempered. We have found that the use of a specific probiotic contains Lactobacillus rhamnosus and Lactobacillus gasseri has not improved an (asymptomatic) unfavorable vaginal microbiota in infertile women. “

When sharing the study’s findings, its authors noted some limitations. First, the vaginal probiotic capsules do not have all the strains of Lactobacilli which can 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 deny the importance of vaginal health. However, it raises questions about how to best address vaginal health, especially when working on optimal vaginal microbiome before infertility treatments.

Dr. Jepson further noted some areas for potential further research:

“Suggestions for new research could be to investigate different Lactobacilli strains or to investigate vaginal microbiota transplantation of women with normal vaginal microbiota. Furthermore, it will 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 a spontaneous improvement is seen during the next 1–3 months, as this study indicates.

Results may further influence future IVF recommendations. Dr. Jepson explained that “[w]e saw a spontaneous improvement in the patients with an unfavorable vaginal microbiota, mainly with a low profile, over 1-3 months. This suggests that an idea for patients with an unfavorable vaginal microbiota may be to postpone IVF treatment to spontaneous improvement.