Approximately 75 percent of women experience at least 1 vaginal infection caused by fungi, according to a November 2017 Cochrane Database of Systematic Reviews analysis. A type of yeast called Candida albicans most commonly causes this infection, known as vulvovaginal candidiasis or VVC.
Unfortunately, VVC recurs in at least 40 to 45 percent of women within a year, as noted in the Cochrane review. Oral or vaginal probiotics can potentially aid in the treatment of VVC and prevention of a recurrent infection.
Probiotics and Vaginal Infections
Just as an array of microorganisms normally inhabit your skin and colon, the same is true of your vagina. In a healthy vaginal environment during your reproductive years, species of Lactobacillus bacteria predominate. The numbers of these bacteria decrease after menopause, especially among women not on hormone replacement therapy.
A healthy level of Lactobacillus bacteria protects against vaginal infections via several mechanisms, including keeping the area appropriately acidic. VVC typically occurs when in imbalance develops in the organisms present in the vagina, allowing an overgrowth of Candida yeast.
Use of probiotics containing 1 or more species of Lactobacillus bacteria — and possibly other types of bacteria — can be potentially useful for the treatment and prevention of VVC by helping restore a healthful balance among the microorganisms in the vagina.
The November 2017 Cochrane review article evaluated the combined results from 6 studies involving more than 650 women with VVC who were not pregnant. The authors reported that use an oral or vaginal probiotic in conjuction with an antifungal medication led to a higher cure rate 2 weeks and 1 month after treatment, compared to treatment with an antifungal medicine alone.
High-quality research involving VVC treatment with a probiotic alone is limited. However, a small pilot study reported in October 2012 in the Journal of Clinical Gastroenterology noted successful treatment of VVC after 4 weeks of treatment with vaginal suppositories containing Lactobacillus fermentum and Lactobacillus acidophilus among 26 of the 30 women studied. Additional research is needed to determine whether probiotics alone can be safely and effectively used a the sole therapy for VVC.
Prevention of VVC Recurrence
The November 2017 Cochrane review article found that women who used a probiotic in combination with an antifungal medicine had a lower risk of a VVC recurrence 1 month after treatment, compared to women who used antifungal treatment alone. This finding was based on results from 3 studies involving 388 women.
A separate study evaluated use of oral probiotics twice daily for 10 days after successful antifungal treatment for a vaginal yeast infection among 59 women of childbearing age who were not pregnant. The researchers found that women who took the probiotics had a significantly lower VVC relapse rate at 6 months, compared to women who did not take probiotics.
Other Considerations and Precautions
The Centers for Disease Control and Prevention and the Infectious Diseases Society of America recommend an over-the-counter vaginal antifungal medicine or an oral prescription antifungal for the treatment of VVC.
As of May 2018, neither organization recommends probiotics for the treatment or prevention of vaginal yeast infections. Talk with your healthcare provider if you are interested in using a probiotic for these purposes. She can help guide your decision-making process and offer recommendations about the best probiotic products, if safe and appropriate for you.
Yogurt inserted into your vagina is not recommended for the treatment of vaginal yeast infections. Among other reasons, the bacteria typically present in yogurt with active cultures are usually not the strains most active against the yeast responsible for VVC.
The many species of Lactobacillus bacteria are not equally active against Candida yeast. Furthermore, the concentration of probiotic bacteria in yogurt is generally far below the amounts in probiotic capsules or vaginal suppositories.
Although you might think you have a yeast infection, it is best to see your healthcare provider to get an accurate diagnosis before starting over-the-counter treatment because self-diagnosis is frequently inaccurate, as reported in a 2000 article published in the journal Family Practice.
Seeing your healthcare provider prior to treatment is particularly important if you are pregnant, or have diabetes, a weakened immune system or recurrent vaginal symptoms. Call your healthcare provider right away if you experience vaginal symptoms accompanied by fever, chills, or lower abdominal or pelvic pain.