How To Find the Best Probiotic for You

Probiotics are live microorganisms—mainly bacteria and yeast—that affect bacteria and other microorganisms living in your digestive tract, exerting certain health benefits.

The human gut is home to many microorganisms, such as bacteria, viruses, and fungi. These microorganisms, known as the gut microbiota, can affect your health. Probiotics work in the gut, where they can influence these microorganisms and, in turn, affect overall health.

Some research suggests that the positive effects of probiotics on bacteria balance could benefit certain aspects of gynecologic care, such as protection against vaginal infections and relief from painful periods.

Benefits of Probiotics for Women

Probiotics have been widely used to support gut health, but they're now gaining attention for their potential benefits in women's health, particularly in gynecologic conditions.

Can Help Treat Bacterial Vaginosis

A microbiome is a community of microorganisms, like bacteria, that live in various body parts, such as the gut, skin, and urogenital tract. The vaginal microbiome is mostly made of the bacterial strain Lactobacillus. These bacteria produce lactic acid, making the vagina slightly acidic, which creates a hostile environment for bad bacteria and other harmful organisms.

Bacterial vaginosis (BV) is a common type of vaginal infection. Symptoms include increased vaginal discharge, a fishy smell, and itching and burning in the vulva. In people with BV, the vaginal microbiome has shifted away from one that's mostly made up of Lactobacillus to a more diverse mix of bacteria. Research shows that probiotics are a safe way to restore the natural balance of bacteria in the female reproductive tract.

Several studies compared how well probiotics combined with antibiotics worked against BV versus using antibiotics alone or with a placebo. The results showed that a combination of probiotics and antibiotics was more effective at curing BV than antibiotics alone. Probiotics alone worked just as well as antibiotics, and both were better than a placebo.

May Protect Against Yeast Infection

Candida is a type of fungus that naturally lives in the vagina. When Candida grows excessively, it causes a common yeast infection called vulvovaginal candidiasis (VVC). Early research suggests that Lactobacillus might help prevent and treat VVC, but most of this research is from animal and lab studies. More human studies are needed to confirm these results.

Can Treat Vulvovaginal Atrophy

Vulvovaginal atrophy (VVA) is common during peri- and post-menopause. It involves thinning of the vaginal lining, reduced elasticity, shrinkage of the labia, and a higher vaginal pH.

Research suggests that treatment combining estriol, an estrogen hormone, with probiotic Lactobacilli can help manage VVA. Estriol supports the vaginal lining, while Lactobacilli help restore balance by blocking harmful bacteria and boosting the vagina's natural immune defense.

Potential Aid in Period Pain

Primary dysmenorrhea, or a painful period, is a common issue for females of reproductive age, often affecting work, school, and overall quality of life. While non-steroidal anti-inflammatory drugs (NSAIDs) and hormone pills are standard treatments, they come with risks.

Probiotics have been suggested as an alternative. In one small study, participants who took a probiotic supplement had less need for NSAIDs and reported better mental health than those who took a placebo. However, more research with a larger group is needed to confirm these results.

Food Sources of Probiotics

Although most probiotics research focuses on supplements, a few fermented foods contain probiotics. Fermented foods are made of live microorganisms that turn carbohydrates (sugars) into acid or alcohol. Examples include yogurt, cheese, and kimchi. However, not all fermented foods are considered probiotics.

Yogurt, a fermented milk product, is a probiotic food because it contains well-studied bacteria like Lactobacillus bulgaricus and Streptococcus thermophilus, which survive through the shelf life and in the gut. Kefir, a fermented milk drink, is also a probiotic food.

Research suggests that consuming fermented foods, particularly yogurt and kefir, is associated with improved health. These fermented dairy products can aid in lactose digestion. Regular consumption is linked to a reduced risk of breast and colorectal cancer and type 2 diabetes, as well as better weight management and improved heart, bone, and digestive health.

Other fermented foods like cheese, kimchi, kombucha, pickles, and sourdough bread have live microorganisms but don't usually contain proven probiotics. They may still offer health benefits; it just hasn't been proven in clinical studies.

How To Choose a Probiotic Supplement

Probiotics are identified by their specific strain, which includes the genus, species, subspecies (if any), and a unique code. Probiotic supplements vary widely in strains and dosing, so there’s no one-size-fits-all approach.

While some probiotics are specifically designed for women, it’s essential to research and choose a quality probiotic that aligns with your specific health needs for the best results. There is no one best probiotic strain or brand. Different strains have different effects. For example, Lactobacillus paracasei B 21060 is recommended for diarrhea in adults, while Bifidobacterium bifidum KCTC 12199BP is used for adult constipation.

For vaginal healthy specifically, the strain Lactobacillus rhamnosus HN001 has been shown to possibly be effective against bacteria causing vaginal infections like BV. Other strains like Lactobacillus reuteri, Lactobacillus paracasei, and Lactobacillus crispatus have also shown promise for treating vaginal infections and protecting genital health.

Probiotics are measured in colony-forming units (CFU), indicating the number of live cells. Supplements typically have one to 10 billion CFU per dose, with some going as high as 50 billion or more. However, more CFU doesn’t always mean better results. It’s important to look for a supplement labeled with the CFU count at the end of its shelf life, not just at the time of manufacture, because the microorganisms die off over time.

Once you’ve identified the right strain, consider the form of the supplement (capsule, liquid, or powder) and choose what fits your budget and routine. Check the label for dosage, whether it should be taken with food, and if it needs refrigeration. There’s no best time of day to take a probiotic supplement; just follow the instructions on the product label for the best results.

Also, be aware of non-medical ingredients that might be added to a probiotic supplement, such as gelatin, corn starch, lactose, or wheat, especially if you have allergies or dietary restrictions.

Like other supplements, probiotics aren't strictly regulated by the U.S. Food and Drug Administration (FDA) in the same way as medications. Whenever possible, choose supplements from companies certified by third-party organizations like U.S. Pharmacopeia or NSF International, which enforce high standards for quality and safety.

For the best advice on choosing a probiotic, consult a healthcare provider who knows about them.

Side Effects and Other Considerations

Many probiotic strains come from species that have been safely used in foods for a long time or from microbes that naturally live in healthy digestive systems. Common probiotic strains such as Lactobacillus and Bifidobacterium species are typically safe in people without preexisting health conditions. Probiotic side effects are usually mild and include temporary gastrointestinal issues like gas.

However, probiotics can be harmful to people who are very sick or have weakened immune systems. In these cases, probiotics have been linked to serious infections. If you have a weakened immune system, have short gut syndrome, or are of older age, consult your healthcare provider before taking any supplements.

The World Gastroenterology Organisation (WGO) recommends only using probiotics that have been clinically shown to work for your specific condition.

A Quick Review

Probiotics are live microorganisms that can support your health when taken in the right amounts. While probiotics are often associated with digestive health, research shows they can also benefit gynecological health.

Yogurt and kefir are great food sources of probiotics, and many supplements are available too. However, it's important to choose the right probiotic for your specific health needs, ideally one that's third-party certified. If you’re considering adding a probiotic supplement to your routine, consult a healthcare professional who is knowledgeable about probiotics.