Laurie Cullen, ND
Laurie Cullen, ND, associate professor of clinical medicine and chair of the department of clinical sciences, Bastyr University, Kenmore, Washington, and core clinical faculty member, Bastyr Center for Natural Health, Seattle.
You know how helpful probiotics are for your digestive health…but did you know that these beneficial bacteria also promote vaginal health?
Folk medicine has long recommended eating yogurt as a natural remedy for vaginal infections, and now studies are finding evidence that folk wisdom was on the right track. For instance, a recent study in Journal of Family Practice showed that the probiotics in yogurt and in certain vaginal suppositories may reduce the recurrence of bacterial vaginosis (BV), the most common type of vaginal infection among women of childbearing age.
Although we don’t yet have a large body of peer-reviewed research proving that probiotics prevent various types of recurrent vaginal infections, it just makes sense to use beneficial bacteria to battle harmful bacteria, said Laurie Cullen, ND, an associate professor of clinical medicine at Bastyr University, whose practice focuses on women’s health.
“The vaginal ecosystem is very sensitive,” Dr. Cullen explained. “The beneficial Lactobacilli strains of bacteria that live in the vagina keep the pH around 4.2. Certain factors can raise the vaginal pH, leading to an overgrowth of various bacteria and causing BV. Situations that lower the vaginal pH can lead to an overgrowth of fungal organisms, such as Candida albicans, and cause a yeast infection.”
Among the many factors that can affect vaginal pH are the use of antibiotics, oral steroid medications, spermicidal contraceptives or birth control pills…sexual intercourse, menstruation, tampon use, pregnancy or menopause… diabetes or obesity…cancer or cancer treatment…and conditions that compromise the immune system.
The following prevention strategies are appropriate for just about any woman who wants to keep her vagina as healthy as possible…and they’re particularly helpful for those who have a history of vaginal infections.
Note: Whatever type of probiotic you use—be it in the form of yogurt, an oral supplement or a topical vaginal product—avoid brands that contain only the species of Lactobacillus called acidophilus. “Acidophilus, which comes from cow’s milk, is really good at populating a cow’s vagina with cow-beneficial probiotics, but on its own it doesn’t do much to help repopulate the human vagina with the various Lactobacilli species normally found there,” Dr. Cullen explained. She recommends probiotics that contain a number of different Lactobacillus species in addition to acidophilus, such as Lactobacillus GG, rhamnosus, reuteri, plantarum and/or salvarius.
Dr. Cullen suggested trying one, two or all three of the types of products below for two to six months to see if they help your vagina stay infection-free. If so, you can continue to use them indefinitely.
Cultured yogurt. Eat at least one serving daily. For women who like dairy yogurt, Dr. Cullen recommended the plain-flavored, American-style Stonyfield brand. For people who prefer a cultured soymilk yogurt alternative, she suggested the Silk brand’s Fruity & Creamy line. Why does she like these brands? “Because we can verify the cultures, meaning that we can grow in a lab the bacteria that they say are in their product,” she explained.
Oral probiotics. For her patients, Dr. Cullen most often prescribes over-the-counter oral supplements such as Fem-Dophilus…FemEcology…or Pro-Flora Women’s Probiotic by Integrative Therapeutics. Usually these are taken daily, following the guidelines on the product label.
Vaginal moisturizers. Sex affects the vaginal pH because men’s semen has a pH of about 7.1 to 8.0. Spermicidal contraceptives also alter the pH of the vagina. A vaginal moisturizer helps keep the vaginal pH in balance, which is why it’s a good idea to use one before and immediately after having sex. Also use it daily whenever you are taking antibiotics. Dr. Cullen’s preferred brands include RepHresh Vaginal Gel…and Luvena Prebiotic Vaginal Moisturizer and Lubricant.
If you develop any symptoms of a vaginal infection, such as itching, discharge, odor and/or pain, it’s important to see a doctor who can diagnose the cause. “Women who try self-treatment without first getting a diagnosis may end up making the problem worse,” Dr. Cullen cautioned. Treatment depends on the type of infection your doctor ends up diagnosing. The most common types are…
Yeast vaginitis. For her patients with vaginal yeast infections, Dr. Cullen relies on vaginal suppositories of boric acid (also called borax). Although such suppositories are available without a prescription, before using them, you should make sure that your doctor confirms the yeast diagnosis. If you are prone to recurrent yeast infections and your doctor is satisfied that you can recognize the symptoms, however, he/she may give you the go-ahead to self-treat. In such cases, Dr. Cullen often prescribes a five-to-seven-day course of Yeast Arrest Suppositories, which contain several homeopathic anti-yeast ingredients in addition to boric acid.
After the boric acid treatment is done, Dr. Cullen said, it’s a good idea to help restore vaginal health by inserting a probiotic product directly into the vagina once daily for one to two weeks. For this, Dr. Cullen recommends capsules of Fem-Dophilus, FemEcology or Pro-Flora Women’s Probiotic—yes, the same oral probiotic supplements mentioned in the prevention section above also can be used as vaginal suppositories, she said.
Bacterial vaginosis. For her patients with BV, Dr. Cullen typically recommends using Fem-Dophilus, Fem-Ecology or Pro-Flora Women’s Probiotic both orally and vaginally—one oral and one vaginal capsule per day. Sometimes this strategy provides enough immune support to allow a woman’s body to fight off the infection. However, if this approach doesn’t work within three or four days, it may be necessary to use antibiotics to get rid of BV.