Bacterial Vaginosis (BV) is the most common infection in women of childbearing age, affecting approximately 1 in 3 women, and yet surprisingly many women have never even heard of it.

female body
Bacterial Vaginosis affects up to one in three women

BV is characterised by an overgrowth of predominantly anaerobic, and pathogenic, organisms (such as Gardnerella vaginalis, the Prevotella species, Mycoplasma hominis and the Mobiluncus species) in the vagina, leading to a reduction in healthy lactobacilli populations. Reduced numbers of lactobacilli can lead to an increase in vaginal pH from a healthy acidic pH of less than 4.5, to a less healthy pH that can be as high as 7.0.

In effect BV is dysbiosis in the vagina and uro-genital tract. In the same way that the flora of the GI tract can lose its healthy balance, so too can the flora in this ‘intimate’ area.

Women are often unaware that they have BV as in 50% of cases it is asymptomatic, however if left untreated it can lead to other complications such as reduced fertility, and reduced birth-weights (when pregnancy does occur). If symptoms are present these usually include: a thin, white homogenous discharge and an unpleasant, ’fishy’ odour.

So, what causes the condition?

Doctors are not always sure what causes BV, but certain lifestyle factors increase its likelihood. Women that have more than one sexual partner expose themselves to greater numbers of potential pathogens, and increase their chances of developing BV in that way. Also, women that douche frequently or use soaps or shower gels in the intimate area, run the risk of alkalising the area too much, which allows pathogenic strains of bacteria to flourish.


Washing with soap can alter the pH of the vagina and affect the delicate flora

However for the large majority of sufferers there is no obvious, external ‘cause’ for the dysbiosis, and in these cases we need to consider the link between the gut flora and the vaginal flora.

Due to the close anatomical proximity of the vagina to the anus, it is easy for bacteria from the GI tract to ‘trans-locate’ (ie migrate) from one area to the other. Any pathogenic strains of bacteria that are present in the gut, can therefore infect the vaginal tract and imbalance the delicate balance of flora there.

In order to reintroduce beneficial strains of bacteria into the vagina, it is not so simple as to just use any strain of probiotic however. The strains need to be able to survive transit through the entire length of the digestive tract, and they also need to be able to successfully migrate to, and then colonise the vagina. Strains of probiotic bacteria that colonise well in the digestive tract, do not necessarily show good adherence to vaginal epithelium.

Which probiotic strains help to eliminate and prevent BV?

There have been many different clinical trials over the years, looking at the efficacy of probiotics in the treatment of BV. It is understood that the Lactobacillus genus is the predominant genus of bacteria found in a healthy vagina, so most trials have centred around one or other Lactobacillus species.

Incidentally, Joanna has just written a piece about a new 'probiotic' to make women's intimate areas smell like peach! We are not convinced, and are not sure there is yet any research into it - but the blog post might be an interesting read.

In a rather small but well-designed double-blinded randomized, controlled trial1 34 women with BV received either a vaginal probiotic tablet (containing at least 109 viable lactobacilli, in particular Lactobacillus brevis CD2, Lactobacillus salivarius FV2, and Lactobacillus plantarum FV9) or a placebo for 7 days. The 2-week cure rates were 61% (11 out of 18) in the active treatment group as compared with 19% (three out of 16) in the placebo group (p = 0.017).

In another randomised, double-blind, placebo controlled study2 125 women were divided in to two groups. One group received a 7 day course of antibiotics, and the second group received both the antibiotics coupled with a probiotic formulation, containing the strains Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14®. The probiotic supplementation was continued for a further 3 weeks after the end of the antibiotic therapy. Treatment success rates increased from just 40% (as seen with antibiotic therapy alone) to 88% (on the combination therapy)!

BV clinical trial
Efficacy rate more than doubled in the group taking probiotics alongside their antibiotics

These two strains, were originally isolated from a healthy vaginal tract; demonstrating that they are an integral part of the vaginal microbiota.

Not only do L. rhamnosus GR-1® and L. reuteri RC-14® reach the ‘intimate’ area and adhere to the epithelium, they have also been shown to effectively colonise the area, as demonstrated by their presence in vaginal swabs taken up to 3 weeks after probiotic supplementation ceased.

For further reading, see OptiBac Probiotics 'For women'.

Update May 2017: Another great new clinical trial also shows promise for these strains in those with BV. Click on this link to read more about this clinical trial!

Recommendations:

I often see women in my clinic, complaining of unusual vaginal discharge and irritation. The symptoms are both uncomfortable and slightly embarrassing for them, and often they have suffered in silence for quite some time. If they have been to their GP, most likely they will have been prescribed a course of antibiotics. This may have bought temporary relief, however this is often short-lived as over time the antibiotics actually make the situation of dysbiosis worse.

Following a low sugar diet can be helpful, to reduce the likelihood of glucose being excreted in the urine (which can promote the overgrowth of pathogenic species of bacteria in the genito-urinary tract). However, probiotic supplementation alongside these dietary changes, is always the corner stone of any natural protocol to restore the health of the vaginal flora.

If you would like to read more about probiotics for female health, check out the following links:

FAQ: Which probiotics are best for women?

'For women' - scientific research

Lactobacillus rhamnosus GR-1 can help protect women and children against heavy metals

References: 1) Mastromarino et al, 2009. 2) Anukam et al, 2006. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14

Comments

  • Thanks for this information. I have a vaginal bacteria infection now and the smell is on and off. I'm going to try this probiotic.

  • Response from OptiBac Probiotics

    Hi Lisa,

    Thanks for your comments.
    I hope that you find a benefit - do come back and share your personal experience!

    Best wishes,

    Kerry

  • I couldn't recommend these enough! I was first put on to them by a health shop as I would get recurrent cystitis and BV. I have been using them for over a year now and have found that I have not had a case of cystitis or BV once, even in the cold winter months when it would be more prevalent.

    Highly recommend!

  • Response from OptiBac Probiotics

    Dear Sam,

    Wow!
    We are just delighted that you have found such a positive benefit from using live cultures to support your genito-urinary health.
    That's fantastic news - thank you so much for sharing your experience with us.

    Warm wishes,

    Kerry
    Customer Care and Nutritional Advisor

  • I felt like I had tried everything, including acidophilus probiotics, for my BV... a friend who takes Optibac recommended the For Women to me and, 3 months in, I am SO happy to have found it! The BV cleared up after a few weeks, but I'm still taking one a day in case it returns. Thank you Optibac, what an incredible product, and such a relief.

  • Response from OptiBac Probiotics

    Dear Chloe,

    That's such great news!
    Thank you so much for sharing this with us, and I hope that you continue to see benefits.

    Best wishes,

    Kerry
    Customer Care and Nutritional Advisor

  • Hello,

    I used to suffer from chronic BV and have just had a reoccurrence for the first time in 8 months. I am back to using this product as I found it helpful in the past. I wonder if you have thoughts about using a pill internally to boost the good flora?

    Many thanks!

  • Hi,
    I am using optibac for women and I also used optibac every day.
    I love them !
    I had a vaginal bacteria infection but now I fell much better!
    Do you do also vaginal probiotics for local use?

  • Response from OptiBac Probiotics

    Hello Amy and Francesca,

    Thank you both for taking the time to share your thoughts and feedback with us.
    So pleased you've found positive benefits from using probiotics for intimate health.

    In terms of probiotics as pessaries: although ‘For women’ was briefly trialled as a topical product, as a food supplement company, we are unable to recommend that any of our products are used as pessaries. As the product has been shown to colonise the intimate area very effectively when administered orally, topical application should not be necessary.

    In other parts of the world where the same strains as For women are marketed, perhaps in the US, it may be that the regulations are different and therefore this product and others like it can be recommended intra-vaginally in these countries. In the UK, however, we can only recommend that you take the capsules orally.

    With kind regards,

    Kerry
    Customer Care and Nutritional Advisor

  • Hi
    I recently purchased the optical probiotics for women to treat my recurring bv and I was wondering, can I take the probiotics along with a course of metronidazole??

  • Response from OptiBac Probiotics

    Dear Joanne,

    Thank you for your enquiry.

    For women can be taken alongside antibiotic treatment; however, you would need to take this product around 1-2 hours away from the antibiotic doses. I would advise taking it with food or a snack but preferably breakfast if possible.

    I hope this helps with your enquiry.

    Kind regards,
    Naomi
    Assistant Customer Care & Nutritional Advisor

  • Hi
    Would Optibac For Women be a good option to try for a 10 (nearly 11) year old girl with recurring urine infections? I note there is a specific Optibac for children but I'm not sure how beneficial it would be for this particular problem. Any advice much appreciated.

  • Response from OptiBac Probiotics

    Hello Col,

    Thanks for your comments.
    I can advise you that 'For women' is suitable for use in girls from the age of four years.

    Kind regards,

    Kerry

  • This product is truly a god send. I have suffered b.v for 9.5 yrs. It has affected my relationships, my self esteem and generally my mental and physical health. Please continue with the good work!
    Many Thanks

  • Response from OptiBac Probiotics

    Dear Claire,

    That's amazing!
    Thank you so much for sharing your personal experience - we really appreciate it, and we're delighted that you've found such a positive benefit. What brilliant news.
    It's also really helpful for other ladies who might be suffering, to learn more about how others have got on using probiotics.
    Thanks again, and I hope that you continue to experience great results.

    Best wishes,

    Kerry
    Nutritional advisor

  • Hi
    I use your optical everyday which has helped enormously with reducing bloating , but I also suffer from BV and would like to take the women's optical products. Can I take both supplements or would that be too much lactobacillus ?
    Regards
    Michelle

  • Response from OptiBac Probiotics

    Hi there Michelle,

    It's fine to take any combination of our products according to your individual needs. See our FAQs:
    Can I take two OptiBac Probiotics supplements at the same time?
    https://www.optibacprobiotics.co.uk/faq/can-i-take-two-optibac-probiotics-supplements-at-the-same-time
    Is it possible to overdose on probiotics?
    https://www.optibacprobiotics.co.uk/faq/is-it-possible-to-overdose-on-probiotics

    I hope that this answers your question.

    Best wishes,

    Kerry
    Nutritional Advisor



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