Role of Antibiotics and Probiotics in Treating Bacterial Vaginosis

Bacterial Vaginosis (BV) is the most common form of vaginal infection, affecting one in three women of reproductive age. This condition is characterized by an overgrowth of primarily anaerobic, as well as pathogenic, organisms (e.g. the Mobiluncus species, Mycoplasma hominis, the Prevotella species, Gardnerella vaginalis) in the vagina, resulting in a disrupted vaginal pH.

BV is commonly treated with antibiotics and/or probiotics, with the latter being available in various forms such as tablets, capsules, and even tampons and suppositories.

Effects of Antibiotics on the Vaginal Flora

Bacterial vaginosis and yeast infections are commonly treated with antibiotics and antifungal medications. However, these types of treatment may have some harmful effects as well, as they can kill both the bad and good bacteria. Lack of good bacteria in the vagina may increase risk of urinary tract infections (UTI) and vaginal candidiasis, which would result from the regrowth of fungi and harmful bacteria. In addition, antibiotics may also kill off beneficial bacteria in the gut, which may impair the immune and digestive system.

Eating Probiotics for BV

Probiotics are important in women’s health for numerous reasons: they support a healthier urinary tract and vagina, as well as better digestion. Probiotics promote an acidic environment in the vagina which in turn encourages favorable balance.

Consuming probiotics regularly and eating alkaline foods can significantly increase your chances of having normal vaginal balance. These foods are some of the best choices for probiotics foods:

  • Yogurt containing live, active strains
  • Kefir (fermented milk)
  • Fermented foods (e.g. kimchi, tempeh, pickles, sauerkraut)
  • Miso soup

In addition, probiotics may also improve gastrointestinal function, improve cholesterol levels, and exhibit anti-glycation and insulin-sensitizing effects.

Taking Probiotics for BV

Instead of consuming probiotics, you may also take supplements and other probiotic products. Multiple clinical trials suggest that probiotic supplements are highly effective in treating bacterial vaginosis and in preventing the recurrence of the infection.

A study published in international journal BJOG stated that taking 1-2 Gynoflor vaginal tablets daily can improve cure rates after 6 days, as compared to a placebo. The said product contains about 10 million colony-forming units of the strain Lactobacillus acidophilus and 0.3mg of estriol per tablet.

The study concluded that the probiotic supplement restored the healthy balance of the vaginal flora in affected women by a significant degree. After using the product, a greater number of live lactobacilli were observed.
For oral probiotics, capsules containing the strains Lactobacillus fermentum RC-14 and Lactobacillus rhamnosus GR-1 are believed to be most effective for BV.

If you plan to take probiotics, the recommended dosage is between 1-10 billion CFUs daily.

Probiotics Safety Precautions

Probiotics are generally safe for oral use, provided that the individual is not immuno-compromised. If you have an immune-impaired condition or are taking an immune-suppressant medication, avoid probiotics in any form. The cultures of friendly bacterium are not appropriate for immune-impaired individuals as these could be a source of infection.

When taking Lactobacillus, you may experience mild intestinal gas, but this is temporary only and shall subside shortly. If you are lactose intolerant, avoid milk-based probiotics.

If you’re suffering from short bowel syndrome or using a catheter, avoid probiotics as well. Unless otherwise directed by a health professional, avoid probiotics if you’re pregnant or lactating.