Your vagina is kind of like The Incredible Hulk—not necessarily in the muscular and green kind of way (I hope?), but in a “you won’t like her when she’s angry” kind of way.

Unfortunately, lots and lots of things can make her angry (she still doesn’t know you refuse the lube, btw). The good thing is, it’s not too hard to stay in her good graces. Here’s how to keep her from hulking out.

Contents

1. Don’t forget to use condoms with new partners.

.

This should be a no-brainer, but condoms are the only effective way to protect against sexually transmitted diseases (STIs), says Gokhan Anil, M.D., an ob-gyn in the Mayo Clinic Health System.

One thing you may not have known, however: They can also help keep your vagina’s pH level steady during sex, so all the good bacteria that’s in there can stay healthy, according to a 2013 study in the journal PLoS One.

That’s super important since those little bacteria help prevent yeast infections, UTIs, and bacterial vaginosis. You know, just in case you needed another reason to wrap things up.

2. Don’t blow off your gyno.

Although new guidelines advise against annual pelvic exams if you’re symptom-free and not pregnant (every three years for normal Pap tests), a visit to your doctor isn’t just about poking around your lady parts, says Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University. “I think an annual exam is important for talking about health problems,” she adds.

Before you automatically switch to the three-year rule, talk it over with your doctor. Some risk factors (along with your personal and family histories) can make it so you need pelvic exams and Pap tests more frequently.

It’s also okay to want an annual exam, even if you don’t need one. You can use that time to chat about birth control, fertility, and STI checks.

3. Use lube, for god’s sake.

It’s a major buzzkill when you hit the sheets, but it seems like your vagina didn’t get the memo. But it’s totally normal—vaginal dryness can impact you if you take certain medications like antihistamines, antidepressants, or hormonal birth control, says Minkin. It can also crop up after pregnancy or shortly before menopause.

When this happens, make sure you’re communicating with your partner so they don’t forge ahead before you’re properly lubricated, which is obviously painful and can cause abrasions. Or just use lube to speed up the process and make sex even hotter, says Minkin.

4. Wear cotton undies (or go commando).

.

When it comes to your underwear selection, your vagina has a preference: cotton. That’s why most undies come with a strip of cotton in the crotch.

It’s all about that breathability—cotton lets air in and absorbs moisture, says Anil.

Minkin, goes a step further, suggesting going commando when you’re just hanging around the house to let things air out. One tip: Don’t go to the gym sans undies, because you want that extra layer between you and germy gym equipment.

5. Definitely don’t douche—or stop ASAP.

That whole “your vagina is a self-cleaning oven” spiel isn’t just a funny phrase—your vagina actually does clean itself. “The vagina already has healthy bacteria that maintain its harmony,” says Anil. “Introducing new chemicals to that can disrupt that harmony.”

Another thing: A 2013 study published in the journal Obstetrics & Gynecology found that that using intravaginal hygiene products can put you at increased risk of infections, pelvic inflammatory disease, and STDs. Just don’t do it.

6. Try to be a little more careful during cycling class.

An unexpected place you might be putting your vaginal health at risk is the cycling studio. If you’re a frequent rider, you could be at risk for genital numbness, pain, and tingling (not in a good way) while cycling.

In fact, a study of female cyclists in the Journal of Sexual Medicine found that a majority experienced these symptoms. If you love to hit up cycling studios, try wearing padded shorts and following these form modifications to keep your vagina pain-free during your workout.

7. Don’t overuse antibiotics.

.

“Unnecessary antibiotic use can significantly reduce vaginal health,” says Anil. That’s because antibiotics don’t discriminate—they kill off both good and bacteria, which can then change the flora (i.e., the colony of healthy bacteria) in your vagina, causing yeast and other infections to grow.

Obviously, if you have to take an antibiotic to fight infection, you shouldn’t pass up the prescription—just make sure it’s totally necessary before you start that course, says Anil.

8. Treat sex like wiping—always go from front to back.

Definitely don’t go from anal to vaginal sex without changing the condom or properly cleaning off first, says Minkin. Going from backdoor to front exposes your vagina to a host of bacteria and can up your risk of infections, she adds.

9. Skip the scented soaps for ~down there~.

Scented body wash may be awesome, but it doesn’t belong anywhere near your genitals, says Minkin.

That’s because, unlike your skin, your vagina doesn’t have an extra protective layer—which means soap and other chemicals can be really drying to that sensitive skin, says Anil.

You really only need to rinse with warm water to keep things clean down there. But if you just don’t feel right about going soap-free, stick with a plain, gentle, unscented soap, adds Minkin.

10. Do your kegel exercises.

FYI: Kegel exercises aren’t just another pointless thing your mom reminds you to do. Doing kegels helps strengthen your pelvic floor muscles, says Anil, which then helps reduce strain on your pelvic organs, and improves bladder and bowel function. Oh, and they can make your orgasms stronger, too.

Anil recommends doing three sets of 10 kegels each day, holding each kegel for five seconds. That’s just three minutes of kegel work—totally doable.

Amber Brenza Amber Brenza is the health editor at Women’s Health, and she oversees the website’s health and weight loss verticals.

Explore Methods

share this

We shared nutrition hacks for better sex. (Because bloated sex is rarely the best sex.) Now we’re exploring foods that are beneficial for your vagina because we want you—and Lady V—happy and healthy.

  • Cranberry juice. Loaded with acid compounds that fight off bad bacteria, cranberry juice can help you prevent and relieve urinary tract infections. But go for a natural, no-sugar-added brand to get the benefits.
  • Yogurt. It has the same good bacteria your vadge needs to maintain its healthy pH levels. Look for yogurt with live and active cultures/probiotics. (BTW, other sources of probiotics work too, including pickles, kimchi, miso, kefir, sauerkraut, and kombucha tea.)
  • Sweet potatoes. Their vitamin A contributes to healthy vaginal and uterine walls and helps us produce the hormones we need to stay vibrant and energized.
  • Garlic. It’s known to be antimicrobial and they say eating it raw can help fight yeast infections.
  • Soy. The phytoestrogens in soy help keep your vagina lubricated, but don’t go for the overly processed stuff like soy burgers or nuggets. Stick with edamame, tofu, tempeh, and miso.
  • Avocados, apples, flaxseeds, and water. They are all super-healthy for many reasons, but for those who don’t like soy, remember that these four can also help you stay naturally lubricated down there.
  • Almonds and pumpkin seeds. They’re high in zinc, which can normalize your menstrual cycle and regulate hormones. Zinc can also boost your immune system and your mood.
  • Hot chilies. They contain capsaicin, which improves blood circulation and stimulates nerve endings. That’s good for arousal.
  • Guava, kiwi, oranges, and green peppers. They are full of vitamin C, which helps with stamina and keeps your sex drive going by removing the free radicals that disrupt normal sexual health.
  • Dark chocolate. The high-flavonoid kind is a great source of antioxidants and women who eat at least a square a day report increased desire and better overall sexual function. Bon Appétit adds, “Chocolate is also rich in magnesium (which soothes nerves), methylxanthines (boosts libido) and phenylalanine, an amino acid that produces dopamine (the feel-good chemical).”
  • Fresh fruit and veg in general. Want fewer menstrual cramps? Better skin? Easier orgasms? Eat a diet that supplies you with a variety of vitamins and minerals. The health benefits are good for your whole body, from your pinky toes to your punani to your beautiful brain.

If you add just a few of these to your meals, your vagina is gonna thank you. And since birth control also contributes to your healthy lifestyle (and peace of mind), go ahead and stock up on that too.

See you in the produce aisle,
Bedsider

P.S. What if you could easily compare every single method of birth control in one side-by-side matrix? Oh, yeah. You can!

In This Section

  • Vaginitis
  • How do I get checked and treated for vaginitis?
  • How do I prevent vaginitis?
  • What is a yeast infection?
  • What is bacterial vaginosis?

Healthy vaginas come with bacteria in them. But changes in the balance of the different kinds of bacteria in your vagina can lead to bacterial vaginosis (BV).

X in a circle

Think you may have vaginitis?

Find a Health Center A right arrow in a circle

What causes Bacterial Vaginosis?

Bacterial vaginosis — usually called BV — is a bacterial infection. It happens when the different kinds of healthy bacteria in your vagina get out of balance and grow too much. BV is often caused by gardnerella vaginalis, the most common type of bacteria in your vagina.

Anything that changes the chemistry of your vagina’s pH balance can mess with bacteria levels and lead to infection — like douching or using vaginal deodorants and other irritating products. Learn more about keeping your vagina healthy.

Bacterial vaginosis isn’t a sexually transmitted infection. But having sex with a new partner, or multiple partners, may increase your risk for BV. And sex sometimes leads to BV if your partner’s natural genital chemistry changes the balance in your vagina and causes bacteria to grow.

What are bacterial vaginosis symptoms?

BV doesn’t always have symptoms, so many people don’t even know they have it. Sometimes symptoms come and go, or they’re so mild that you don’t notice them.

The main symptom of BV is lots of thin vaginal discharge that has a strong fishy smell. The discharge may be white, dull gray, greenish, and/or foamy. The fishy smell is often more noticeable after vaginal sex.

You may have a little itching or burning when you pee, but many people don’t have noticeable irritation or discomfort.

How do I treat BV?

BV is usually easily cured with antibiotics — either pills that you swallow, or a gel or cream that you put in your vagina. There are a few different antibiotics for bacterial vaginosis treatment, but the most common ones are metronidazole and clindamycin.

Make sure you use all of the medicine the way your doctor says, even if your symptoms go away sooner. And don’t have sex until you finish your treatment and your infection clears up.

If you have BV that keeps coming back, probiotics may help. But ask your doctor before trying any supplements. Your nurse, doctor, or local Planned Parenthood health center can help you figure out the best treatment if you struggle with chronic BV.

Was this page helpful?

  • Yes
  • No

Help us improve – how could this information be more helpful?

How did this information help you?

You’re the best! Thanks for your feedback. Thanks for your feedback.

Probiotics for Vaginal Health: Do They Work?

Vaginal imbalances can result in:

  • bacterial vaginosis (BV)
  • yeast infections
  • trichomoniasis

Having a vaginal imbalance may also increase your chances of a urinary tract infection (UTI). However, it’s important to note that UTIs are not always caused by the same pathogens that cause vaginal infections.

Read on to learn more about these issues:

Bacterial vaginosis (BV)

The most common vaginal imbalance issue is bacterial vaginosis (BV). Women with BV have high numbers of many different species of bacteria in their vaginas. Healthy women have lower numbers of fewer species of bacteria in their vaginas.

These additional bacteria cause the pH of the vaginal to elevate above 4.5. This reduces the number of lactobacilli present in the vagina. Besides an elevated vaginal pH, women with BV often experience:

  • a fishy odor
  • burning during urination
  • a milky or gray vaginal discharge
  • itching

Doctors say they aren’t completely certain what causes BV, but some factors appear to put some women at a higher risk. These include:

  • having more than one sexual partner or a new sexual partner
  • douching, or rinsing your vagina with soap and water (the vagina cleanses itself and douching can disrupt its natural balance)
  • a natural lack of lactobacilli bacteria (some women don’t have high levels of good bacteria present in their vaginas, which can lead to BV)

Treatment of BV most often includes use of antibiotic medication. These are given orally or as a gel that’s inserted into the vagina. Some doctors may also recommend a probiotic in addition to — but not in lieu of — antibiotics.

Yeast infection

Yeast infection is another type of vaginal imbalance issue. Most cases of yeast vaginitis are caused by a fungus called candida albicans. Other types of fungus may also cause this condition.

Usually, growth of fungus is kept in check by good bacteria. But an imbalance of vaginal bacteria, especially having too little lactobacillus, can cause fungus to grow out of control inside the vagina.

A yeast infection can range from mild to moderate. Symptoms include:

  • irritation
  • a thick white or watery discharge
  • intense itching in the vagina and vulva
  • a burning sensation during sex or urination
  • pain and soreness
  • vaginal rash

The overgrowth of yeast that results in a yeast infection may be caused by:

  • antibiotics, which can cause kill off the good bacteria in your vagina
  • pregnancy
  • uncontrolled diabetes
  • an impaired immune system
  • taking oral contraceptives or other type of hormone therapy that increases estrogen levels

Most yeast infections can be treated with a short course of antifungal medication. These are available as:

  • topical creams
  • topical ointments
  • oral tablets
  • vaginal suppositories

In other cases, your doctor may recommend a single dose of oral antifungal medication, or a combination of medications.

Trichomoniasis

Trichomoniasis is a very common sexually transmitted infection (STI). According to the Centers for Disease Control and Prevention (CDC), 3.7 million Americans are infected with trichomoniasis at any given time.

Symptoms of trichomoniasis include:

  • itching, burning, redness or soreness
  • discomfort when urinating
  • change in vaginal discharge: either a thin amount or noticeably more; it may be clear, white, yellow, or greenish with an unusual fishy smell.

Antibiotics (metronidazole (Flagyl) or tinidazole (Tindamax) are the recommended treatment for trichomoniasis. Probiotics would not be used as a treatment or even a preventative method. However, it’s worth noting that having vaginal imbalance such as BV can increase your chances of getting an STI like trichomoniasis.

Urinary tract infection (UTI)

Although your urethra is close to your vagina, urinary tract infections (UTIs) are not always caused by the same pathogens that cause vaginal infections. That said, having healthy vagina flora may help prevent harmful bacterial from entering your urinary tract.

UTIs occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. While the urinary system is designed to keep foreign bacteria out, they sometimes enter and cause an infection.

Most UTIs affect only the bladder and urethra. A UTI becomes more serious when it spreads to your kidneys, where it can cause a life-threatening infection.

A UTI does not always cause symptoms that are easy to recognize. Some more common symptoms include:

  • the need to urinate more frequently
  • a burning sensation during urination
  • passing small amounts of urine
  • passing urine that appears cloudy, bright red, pink, or cola colored
  • passing strong-smelling urine
  • pelvic pain, especially around the center of the pelvis and the area of the pubic bone

UTIs are more common in women. This is because women have shorter urethras than men, making it easier for bacteria to enter. Other risk factors for developing a UTI include:

  • sexual activity
  • having a new sexual partner
  • certain types of birth control, such as diaphragms and spermicides
  • menopause
  • physical issues within the urinary system
  • blockages in the urinary system
  • a suppressed immune system
  • use of a catheter
  • a recent urinary exam or surgery

With most UTIs, doctors will recommend use of antibiotics.

The type of antibiotic your doctor prescribes depends upon several factors, including:

  • the type of bacteria found in your urine
  • your health status
  • how long you’ve been dealing with your infection

For severe UTIs, you may need treatment with intravenous antibiotics in a hospital setting.

What is bacterial vaginosis?

BV often clears up without treatment, but women with signs and symptoms should seek treatment to avoid complications.

Treatment may not be needed if there are no symptoms. Sometimes BV can appear and disappear for no apparent reason.

If there is an abnormal vaginal discharge, it is important to see a doctor as soon as possible. A doctor can diagnose BV and rule out other infections, such as gonorrhea or trich.

Untreated BV can also lead to complications, especially during pregnancy.

Some doctors recommend giving BV treatment to all women who will be undergoing a hysterectomy or termination, before the procedure, regardless of symptoms.

Male partners do not usually need treatment, but they can spread BV between female sex partners.

Antibiotic medication

Antibiotics are effective in up to 90 percent of cases, but BV often comes back again within a few weeks.

Metronidazole is the most common antibiotic for BV.

Share on PinterestOral antibiotics are normally effective against BV.

It is available in the following forms:

  • Tablets: Taken orally, twice daily for 7 days. It is seen as the most effective treatment, and the preferred treatment if the woman is breastfeeding or pregnant.
  • A single tablet: Taken orally as a one-time dose. BV is more likely to return with this treatment, compared with the 7-day tablet course.
  • Gel: Applied to the vagina once daily, for 5 days.

Metronidazole reacts with alcohol. The combination can make the patient feel very ill. Individuals taking metronidazole should not consume alcohol for at least 48 hours afterward.

Clindamycin is an alternative antibiotic. It may be used if metronidazole is not effective, or if the infection recurs.

When taking clindamycin, barrier contraception methods, such as latex condoms, diaphragms, and caps may be less effective.

Tinidazole is another antibiotic that is sometimes used to treat BV if metronidazole does not work or if BV recurs. It is taken by mouth as a single dose. Alcohol must be avoided when taking this medication.

If the following happens, further tests will be needed:

  • symptoms persist
  • symptoms go away but come back
  • the patient is pregnant

If symptoms resolve after completing a course of antibiotics, the woman will not have to be tested for BV again.

Recurring symptoms

Around 30 percent of women whose symptoms disappear with treatment will have a recurrence within 3 months, and 50 percent will have a recurrence within 6 months.

This may be treated with a 7-day course of oral or vaginal metronidazole or clindamycin. If the previous treatment was by mouth, vaginal treatment might work better the second time, and if the first treatment was vaginal, the follow-up treatment should be by mouth.

If more than three episodes occur within 12 months, the doctor may prescribe a vaginal metronidazole gel to use twice a week for 3 to 6 months.

8 Rules for a Healthy Vagina

If your vagina has a strong or unpleasant odor, see your doctor; a douche will only cover up the smell without curing the problem that’s causing it. Avoid using harsh soaps or cleansers on the vulva or inside the vagina, as these also can affect a healthy pH balance.

Maintain a Healthy Diet for Vaginal Health

You may not realize it, but following a balanced, nutritious diet and drinking plenty of fluids are both key to vaginal and reproductive health. In fact, certain foods may be effective in treating vaginal health problems.

Yogurt can potentially help prevent yeast infections and aid in their treatment. “Yogurt is rich in probiotics, especially plain Greek yogurt, so if a woman is prone to yeast infections, taking a probiotic that is rich in Lactobacilli, or eating plain Greek yogurt every day can be helpful,” notes Millheiser.

If you’re prone to urinary tract infections, research published in July 2012 in the journal Archives of Internal Medicine suggested it may be helpful to take a cranberry supplement daily.

Practice Safe Sex to Keep Harmful Germs Away

Using condoms — either the male or female kind — during sex helps to protect against sexually transmitted infections (STIs), such as HIV, genital herpes, syphilis, gonorrhea, genital warts, and chlamydia. Some of these, like HIV and genital herpes, have no cure. And others, like the human papillomavirus (HPV) that causes genital warts, are known to cause cancer.

You should change condoms when switching from oral or anal sex to vaginal sex, to prevent the introduction of harmful bacteria into the vagina. You should also avoid sharing sex toys with your partner, notes Millheiser, as you can spread STIs that way — especially HPV.

See Your Gynecologist — or Primary Care Doctor — for Preventive Care

Having regular gynecological exams is crucial to maintaining your vaginal health. The American Congress of Obstetricians and Gynecologists recommends women have their first screening gynecologic exam at age 21. It is also recommended that women undergo Pap smears starting at age 21 to screen for changes in vaginal cells that might indicate the presence of cancer. Gynecologists and many primary care physicians are trained to diagnose diseases and disorders that can harm the vagina or your reproductive system as a whole.

Treat Infections When They Arise

Three types of vaginal infections are common: yeast infection, bacterial vaginosis, and trichomoniasis. If you’re prone to yeast infections and you recognize the symptoms, it’s “okay to self-treat with an over-the-counter” medication, says Millheiser. “But if the symptoms don’t go away, then you need to be seen as soon as possible.”

While yeast is a fungal infection, bacterial vaginosis is caused by bacterial overgrowth in the vagina. Trichomoniasis is an infection caused by a parasite and is sexually transmitted. Treating these infections is crucial because not treating them can lead to unpleasant, painful, and serious reproductive health problems. Millheiser notes that if you already have a vaginal infection and are then exposed to HIV, you’re more prone to becoming infected.

It’s worth noting that women who have poorly controlled diabetes or are infected with HIV can often experience recurrent yeast infections. “If you’re experiencing many yeast infections during the course of a year, you should be evaluated by your doctor to make sure that there’s nothing more worrisome going on,” says Millheiser.

Use Enough Lubricant, but Not Petroleum Jelly

Lubrication is an important part of intercourse. Without it, the skin of the labia and vagina can become irritated and chafed. While vaginal lubrication usually occurs naturally during female arousal, some women do not produce enough natural lubricant. In this case, they should use an artificial lubricant to reduce friction and to enhance pleasure.

If you’re trying to get pregnant, certain lubricants can interfere with the sperm and make it difficult to conceive, notes Millheiser. In this instance, she recommends using a pH-balanced product called Pre-Seed. If you’re not trying to get pregnant, water-based, silicone-based, and oil-based lubricants are fine, depending on what your needs are. “If you need a little bit of lubricant, then water-based is great. If you’re experiencing more dryness, consider using silicone-based or oil-based,” says Millhesier.

If you’re using condoms for protection, do not use an oil-based lubricant — they can cause the latex in condoms to break down. Millheiser also cautions, “Never put petroleum jelly or baby oil inside of your vagina. It causes inflammation and can set you up for infection.”

Choose Clothing Carefully to Stay Dry

Your vagina should stay clean and dry — and what you wear can affect that. Certain types of fabrics and tight-fitting clothing create warm, moist conditions in which yeast thrive. Wear breathable cotton underwear and avoid thongs. If you’re prone to yeast infections, change out of wet swimsuits and sweaty workout clothes as quickly as possible.

Dr. Millheiser’s advice: “If you experience a lot of discharge and dampness during the day, take two pairs of underwear with you every day when you go to work or school, and change your underwear during the day. It’ll help you feel more comfortable and will help prevent infection.”

Follow Good Hygiene

Common sense can go a long way in protecting the health of your vagina. After a bowel movement, wipe from front to back to avoid bacterial contamination of the vagina and to lower the risk of bladder infection. Change sanitary pads and tampons regularly during your period. Dr. Millheiser notes that it’s fine to wear panty liners to absorb normal vaginal discharge as long as you change them frequently, though she adds that women who wear them all the time may experience some vulvar irritation.

Want a healthy vagina? This organ requires very little care, so less is more, says Beri Ridgeway, MD.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

She encourages women to do the following:

  1. Go for whole body health. Eat right, control your weight and exercise. Not only is this good for your whole body; it’s good for your sexual organs too. Conversely, chronic conditions can put women at risk. For example, poorly controlled diabetes increases a woman’s likelihood of contracting yeast infections and urinary tract infections (UTIs).
  2. Get regular screenings. Stay current with health screenings, and see your gynecologist for routine care. Remember that screening intervals for pap smears change based upon your age and Pap smear findings. For young women, HPV vaccination is especially important for reducing cervical cancer risk.
  3. Use condoms. It’s so important to protect yourself from sexually transmitted diseases and unwanted pregnancies. Insist on using condoms with any new sexual partner.
  4. Just use water. The vagina is a self-cleaning organ. Using harsh chemicals, prepackaged wipes or douching can disrupt its normal process. If you must, a gentle soap is OK for the external genitalia. Most products marketed to help women feel or smell cleaner are not backed by any scientific evidence and can lead to other problems. If you have particularly sensitive skin, also watch for soaps and shampoos you use in the shower. Even laundry detergents, dryer sheets, and some lubricants can cause irritation.
  5. Don’t prep for your gynecologist. Showering is all we expect and desire.
  6. Consider natural lubricants. Coconut oil or olive oil may be better lubricants and vaginal moisturizers than manufactured products; they’re an option for women who aren’t using condoms.
  7. Never ignore post-menopausal bleeding. If you ever experience bleeding after menopause, see your doctor for an evaluation.
  8. Prolapse and incontinence are usually not dangerous. These conditions only need treatment if they bother you; no need to treat them just because the gynecologist noted them during an exam. However, if you have trouble emptying your bladder or bowels or have pain or bleeding, it’s time to seek care.
  9. Vaginal estrogen is safe for most women. Vaginal estrogen can help prevent or reverse changes that occur with age, such as painful sex (due to thinning vaginal walls and less elasticity) and increased risk for UTIs (due to pH changes as the vagina becomes less acidic).

7 Ways to Keep Your Vagina Young

Just as your face starts sagging, so your lady parts will inevitably age over time. One critical difference: There are a million products to help keep your face looking supple, but your vagina is kind of left to fend for itself. “Gynecologists don’t tell women these things are going to happen, and then women come in shocked that their vagina and vulva have completely changed over the course of a couple years,” says Karen Boyle, M.D., an expert in female sexual health and vaginal rejuvenation.

Beginning as early as your 20s, you may lose fat in your outer labia and mons pubis (the mound of fatty tissue above your lips). “Those areas can start to sag—it’s volume loss, just like you’d have in your breasts or face as you age,” says Boyle. That’s often followed by changes inside your vagina (hello, stretching!), and as you approach menopause, the lining of your vagina starts to thin, blood flow decreases, and your pelvic floor muscles weaken, says cosmetic gynecologist Marco Pelosi, III, M.D.

RELATED: How Your Vagina Changes in Your 30s, 40s, and Beyond

And a sagging hoo-ha can be a confidence killer in the bedroom. A recent study in Psychology of Women Quarterlyfound that women who were dissatisfied with the appearance of their genitals had lower sexual self-esteem and satisfaction. “Not only do things look different, but things feel different,” says Boyle.

That may explain why vaginal rejuvenation is becoming increasingly popular—the number of procedures performed in the U.S. jumped 64 percent from 2011 to 2012, according to the American Society for Aesthetic Plastic Surgery. But you don’t have to seek plastic surgery to keep your lady parts looking and feeling young. Instead, try these simple strategies.

RELATED: 13 Down-There Grooming Questions Answered

1. Avoid the Yo-Yo

If you gain and lose, you can expect your vulva to flop. “The more swings in the size of an area, the more stretching,” says Pelosi. Equally important is maintaining a healthy weight. If you’re super skinny, your private parts can start to look as gaunt as your face as soon as aging sets in. “We see women who are 35 years old, but look much older because they have no fat in their face,” says Boyle. “Similarly, the labia majora can take on a saggy appearance—and once you lose that fat, you’re not going to gain it back.”

RELATED: The One Thing That Finally Helped Me Stop Overeating After Decades of Yo-Yo Dieting

2. Kick up Your Kegels

You’ve probably read about the merits of Kegels a million times: tighter vagina! Better sex!—but there’s a good chance you’re still doing them wrong. “Women don’t do enough of them, and they don’t hold them for long enough,” says Pelosi. The routine he suggests: Contract your pelvic floor muscle five seconds, relax, and repeat 100 times, three times a day. Sound daunting? You can make Kegels fun by squeezing a few reps in during sex. You can imagine pinching your partner’s penis with those muscles, which helps you target the right spot (and gives your guy an extra, pleasurable sensation), Boyle says.

RELATED: 4 Ways Yoga Can Make Your Sex Life Better

3. Ditch Your Office Chair

For a little extra workout—for your vaginal muscles, that is—trade your desk chair for a Swiss ball for 15 minutes a day. This forces the muscles of your pelvic floor to contract, without doing a single squeeze, says Pelosi. “It feels like nothing is happening, but it’s a very efficient way to keep the pelvic floor toned,” he says.

4. Stay Sexually Active

The whole “use or lose it” idea applies to your vag, ladies. “If you’re not getting stimulation and increased blood flow to that area, the tissue and muscle can change,” says Boyle. Blood flow is critical for lubrication (and orgasm)—which you naturally start to lose as you age. Plus, if you and your guy aren’t worried about pregnancy, his semen may have an anti-aging effect, thanks to the hormones, fatty acids, and anti-inflammatory compounds, say Spanish scientists.

RELATED: This Is How Often Most Couples Have Sex, According to Science

5. Re-Think Long Bike Rides

Training for a triathlon? Know this: The constant friction of crotch-to-seat contact can pull and stretch your labia, especially if you have naturally pronounced outer lips, says Christine Hamori, M.D., director of Cosmetic Surgery + Skin Spa in Duxbury, Massachusetts.

6. Stick to Mild Cleansers

Scrubbing the living daylights out of your labia is not only unnecessary—a gentle cleansing will do, really!—but harsh soaps can leave you dry and irritated below the belt. “The labial tissue is so sensitive,” says Boyle. “You see women with very dry facial skin because they overuse products that suck water out of the cells. That can happen down there too.”

RELATED: How Your Vagina Changes in Your 30s, 40s, and Beyond

7. Switch Things up in the Sack

Take the reins and climb on top: “Being on bottom can sometimes cause stretching,” says Boyle. Why? Because your partner—not you—is usually controlling the pace and intensity of the thrusting, which means he may accidentally push past what’s physically comfortable for you. By contrast, when you’re on top, you’re in control—and “it’s much easier to contract those muscles when you’re on top,” says Boyle.

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

This article originally appeared on Shape.com

Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora

Abstract

Forty-two healthy women were randomized to receive one of three encapsulated Lactobacillus rhamnosus GR-1 plus Lactobacillus fermentum RC-14 probiotic dosage regimens or L. rhamnosus GG by mouth each day for 28 days. However, the vaginal flora, assessed by Nugent scoring, was only normal in 40% of the cases, and 14 patients had asymptomatic bacterial vaginosis. Treatment with L. rhamnosus GR-1/L. fermentum RC-14 once and twice daily correlated with a healthy vaginal flora in up to 90% of patients, and 7/11 patients with bacterial vaginosis converted to normal or intermediate scores within 1 month. Ingestion of L. rhamnosus GG failed to have an effect. This study confirms the potential efficacy of orally administered lactobacilli as a non-chemotherapeutic means to restore and maintain a normal urogenital flora, and shows that over 108 viable organisms per day is the required dose.

1 Introduction

Recent studies have emphasized the importance of a healthy, lactobacilli dominated flora not only to prevent sexually transmitted diseases and preterm labour , but also to maintain the quality of life of women . In an attempt to develop a non-chemotherapeutic means to restore and maintain a healthy urogenital tract, probiotic therapy using lactobacilli has been considered, and there is evidence to indicate that certain strains can be effective when inserted directly into the vagina or when ascending from the rectum after oral ingestion . Two strains, Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14, appear to be particularly adept at the latter . Repeated intake of probiotics could be important not only in women prone to urogenital infections, but also for healthy women as their vaginal flora is often depleted of lactobacilli thereby increasing the risk of infection .

The present study was designed to determine the dose required for probiotic lactobacilli to impact the vaginal flora, and to compare a commercial product with strains GR-1 and RC-14. A Gram stain system, proven to be effective in assessing the normality or ‘health’ of the vaginal flora without the need for culture , was used. L. rhamnosus GG was selected as a control arm of the study, because its ingestion fails to affect the vaginal flora .

2 Methods

2.1 Lactobacillus strains

Strains L. rhamnosus GR-1 and L. fermentum RC-14 were grown in MRS broth (Sigma, Detroit, MI, USA), tested for purity, and freeze dried in equal amounts into gelatin capsules in dosage forms of 8×108 and 6×109 viable organisms. Commercially available capsules containing 1010 viable L. rhamnosus GG were purchased. All capsules were placed in vials and stored in a household refrigerator until use. Viable counts were carried out at regular intervals to determine shelf life, and no significant loss of viability was found during the duration of the study.

2.2 Subjects and randomization

The subjects, primarily Caucasian, were recruited through family practices in London, ON, Canada. Each subject voluntarily signed an informed consent using a format approved by the Ethics Review Board of the University of Western Ontario. The inclusion criteria were for healthy women, 17 years and over (actual range was 17–50 with mean of 31±8), who were currently free from urogenital infections (urinary tract infection (UTI), bacterial vaginosis (BV), or yeast vaginitis) and were not on long term, low dose antibiotics for UTI. The exclusion criteria were patients with abnormal renal function (serum creatinine >110 µmol l−1, upper limit 90 µmol l−1) or pyelonephritis, women who were pregnant, women who were lactose intolerant or receiving prednisone, immunosuppressive drugs, antimicrobial therapy or were using nonoxynol-9 as a spermicide agent. No subject received antibiotics during the study.

The capsules were dispensed in a randomized manner into vials containing one capsule per day of 1010 of GG (Group 4), 8×108 (Group 1) and 6×109 (Group 3) of GR-1/RC-14, and two per day of the 8×108=1.6×109 (Group 2) GR-1/RC-14 dose. Treatment was given for 28 days. The technician evaluating the Nugent scores was blinded as to the treatments given, as were the researchers and patients, except for those subjects given twice daily therapy.

2.3 Sample processing

Deep vaginal swabs were collected within 2 days prior to study, then on days 7, 14, 21, 28, 35, and 41. The swabs were placed onto glass slides and examined using the Nugent scale (0–3 normal; 4–6 intermediate; 7–10 BV) .

3 Results

Compliance was excellent and all 42 subjects completed the study, although four did not provide a final vaginal swab. None of the patients reported symptomatic yeast vaginitis, UTI or BV or adverse side effects during the 6 week test period. While all the subjects reported feeling normal with respect to the urogenital tract upon entry into the study, only 17/42 (40%) actually showed a normal Nugent score. Indeed, asymptomatic BV was diagnosed by Nugent scoring in 4/10 women in Group 1, 3/12 in Group 2, 4/11 in Group 3 and 3/9 in the GG control Group 4 (Tables 1–4). BV scores reverted to normal or intermediate at day 28 in 7/11 (64%) subjects given one of three forms of GR-1/RC-14 therapy. At 2 week follow-up, 2/9 (22.2%) patients in the GG control Group 4 had a BV score, compared to 4/29 (13.8%) in the GR-1/RC-14 treated group (P=0.613 Fisher’s Exact test).

Table 1

Nugent scoring outcomes of patients in Group 1 given once daily 8×108L. rhamnosus GR-1 and L. fermentum RC-14

Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
104 YV BV BV BV BV BV BV N/A
110 YV/UTI Normal Normal Normal Normal Normal Normal Normal
111 YV Int. Int. Int. Int. Normal Normal Int.
113 UTI Int. Normal Int. Int. Int. BV Int.
116 UTI Normal Normal Normal Normal Normal Normal Normal
117 UTI/YV/BV Normal Normal Int. Normal Normal Normal Normal
118 YV BV Normal Normal Normal Normal Normal Normal
120 YV BV Int. Int. Int. Int. Int. BV
125 YV/UTI Normal Normal Normal Normal Normal Normal Normal
133 None BV BV BV BV BV BV BV
Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
104 YV BV BV BV BV BV BV N/A
110 YV/UTI Normal Normal Normal Normal Normal Normal Normal
111 YV Int. Int. Int. Int. Normal Normal Int.
113 UTI Int. Normal Int. Int. Int. BV Int.
116 UTI Normal Normal Normal Normal Normal Normal Normal
117 UTI/YV/BV Normal Normal Int. Normal Normal Normal Normal
118 YV BV Normal Normal Normal Normal Normal Normal
120 YV BV Int. Int. Int. Int. Int. BV
125 YV/UTI Normal Normal Normal Normal Normal Normal Normal
133 None BV BV BV BV BV BV BV

None, no past history of urogenital infection; BV, asymptomatic bacterial vaginosis and scores within the BV Nugent range of 7–10; YV, yeast vaginitis; UTI, urinary tract infection; Normal, scores within the normal Nugent range of 0–3; Int., scores within the intermediate Nugent range of 4–6; N/A, not available.

Table 1

Nugent scoring outcomes of patients in Group 1 given once daily 8×108L. rhamnosus GR-1 and L. fermentum RC-14

Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
104 YV BV BV BV BV BV BV N/A
110 YV/UTI Normal Normal Normal Normal Normal Normal Normal
111 YV Int. Int. Int. Int. Normal Normal Int.
113 UTI Int. Normal Int. Int. Int. BV Int.
116 UTI Normal Normal Normal Normal Normal Normal Normal
117 UTI/YV/BV Normal Normal Int. Normal Normal Normal Normal
118 YV BV Normal Normal Normal Normal Normal Normal
120 YV BV Int. Int. Int. Int. Int. BV
125 YV/UTI Normal Normal Normal Normal Normal Normal Normal
133 None BV BV BV BV BV BV BV
Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
104 YV BV BV BV BV BV BV N/A
110 YV/UTI Normal Normal Normal Normal Normal Normal Normal
111 YV Int. Int. Int. Int. Normal Normal Int.
113 UTI Int. Normal Int. Int. Int. BV Int.
116 UTI Normal Normal Normal Normal Normal Normal Normal
117 UTI/YV/BV Normal Normal Int. Normal Normal Normal Normal
118 YV BV Normal Normal Normal Normal Normal Normal
120 YV BV Int. Int. Int. Int. Int. BV
125 YV/UTI Normal Normal Normal Normal Normal Normal Normal
133 None BV BV BV BV BV BV BV

None, no past history of urogenital infection; BV, asymptomatic bacterial vaginosis and scores within the BV Nugent range of 7–10; YV, yeast vaginitis; UTI, urinary tract infection; Normal, scores within the normal Nugent range of 0–3; Int., scores within the intermediate Nugent range of 4–6; N/A, not available.

Table 2

Nugent scoring outcomes of patients in Group 2 given 8×108L. rhamnosus GR-1 and L. fermentum RC-14 twice daily (that is 1.6×109 daily dose)

Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
101 YV Normal Normal Normal Normal Normal Normal Normal
102 YV Int. Int. Normal Normal Normal Int. Normal
103 UTI Int. Normal Normal Int. Normal Normal Normal
105 YV/UTI BV BV Int. Int. Int. Normal Normal
106 YV/UTI BV BV Int. Normal Normal Normal Normal
107 YV/BV Normal Normal Int. N/A Int. Int. Int.
108 UTI BV BV Int. N/A Int. N/A N/A
109 YV/UTI Normal Normal Normal Normal Normal Normal Normal
121 YV Normal Normal Normal Normal Normal Normal Normal
139 YV Int. Int. Int. Normal Normal Normal Normal
143 BV/YV Normal Normal Int. Normal Normal Normal N/A
145 YV Normal Normal Normal Normal Normal Normal Normal
Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
101 YV Normal Normal Normal Normal Normal Normal Normal
102 YV Int. Int. Normal Normal Normal Int. Normal
103 UTI Int. Normal Normal Int. Normal Normal Normal
105 YV/UTI BV BV Int. Int. Int. Normal Normal
106 YV/UTI BV BV Int. Normal Normal Normal Normal
107 YV/BV Normal Normal Int. N/A Int. Int. Int.
108 UTI BV BV Int. N/A Int. N/A N/A
109 YV/UTI Normal Normal Normal Normal Normal Normal Normal
121 YV Normal Normal Normal Normal Normal Normal Normal
139 YV Int. Int. Int. Normal Normal Normal Normal
143 BV/YV Normal Normal Int. Normal Normal Normal N/A
145 YV Normal Normal Normal Normal Normal Normal Normal

None, no past history of urogenital infection; BV, asymptomatic bacterial vaginosis and scores within the BV Nugent range of 7–10; YV, yeast vaginitis; UTI, urinary tract infection; Normal, scores within the normal Nugent range of 0–3; Int., scores within the intermediate Nugent range of 4–6; N/A, not available.

Table 2

Nugent scoring outcomes of patients in Group 2 given 8×108L. rhamnosus GR-1 and L. fermentum RC-14 twice daily (that is 1.6×109 daily dose)

Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
101 YV Normal Normal Normal Normal Normal Normal Normal
102 YV Int. Int. Normal Normal Normal Int. Normal
103 UTI Int. Normal Normal Int. Normal Normal Normal
105 YV/UTI BV BV Int. Int. Int. Normal Normal
106 YV/UTI BV BV Int. Normal Normal Normal Normal
107 YV/BV Normal Normal Int. N/A Int. Int. Int.
108 UTI BV BV Int. N/A Int. N/A N/A
109 YV/UTI Normal Normal Normal Normal Normal Normal Normal
121 YV Normal Normal Normal Normal Normal Normal Normal
139 YV Int. Int. Int. Normal Normal Normal Normal
143 BV/YV Normal Normal Int. Normal Normal Normal N/A
145 YV Normal Normal Normal Normal Normal Normal Normal
Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
101 YV Normal Normal Normal Normal Normal Normal Normal
102 YV Int. Int. Normal Normal Normal Int. Normal
103 UTI Int. Normal Normal Int. Normal Normal Normal
105 YV/UTI BV BV Int. Int. Int. Normal Normal
106 YV/UTI BV BV Int. Normal Normal Normal Normal
107 YV/BV Normal Normal Int. N/A Int. Int. Int.
108 UTI BV BV Int. N/A Int. N/A N/A
109 YV/UTI Normal Normal Normal Normal Normal Normal Normal
121 YV Normal Normal Normal Normal Normal Normal Normal
139 YV Int. Int. Int. Normal Normal Normal Normal
143 BV/YV Normal Normal Int. Normal Normal Normal N/A
145 YV Normal Normal Normal Normal Normal Normal Normal

None, no past history of urogenital infection; BV, asymptomatic bacterial vaginosis and scores within the BV Nugent range of 7–10; YV, yeast vaginitis; UTI, urinary tract infection; Normal, scores within the normal Nugent range of 0–3; Int., scores within the intermediate Nugent range of 4–6; N/A, not available.

Table 3

Nugent scoring outcomes of patients in Group 3 given once daily 6×109L. rhamnosus GR-1 and L. fermentum RC-14

Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
114 UTI/YV Normal Normal Normal Normal Normal Normal Normal
119 UTI/YV Int. Int. Int. Int. Normal Int. Int.
123 YV Normal Normal Normal Normal Normal N/A Normal
124 YV BV BV Int. Int. BV BV BV
126 None Int. BV Int. Int. Int. Int. Int.
127 YV Int. Int. Int. Int. Int. Int. Int.
128 UTI/BV/YV BV BV N/A Int. Normal Int. Int.
129 UTI/BV/YV Normal Normal Normal Normal Normal Normal Int.
130 UTI BV BV BV Int. Int. Int. Normal
131 UV Int. Int. Normal Int. Int. Int. Normal
132 None BV BV BV BV BV BV BV
Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
114 UTI/YV Normal Normal Normal Normal Normal Normal Normal
119 UTI/YV Int. Int. Int. Int. Normal Int. Int.
123 YV Normal Normal Normal Normal Normal N/A Normal
124 YV BV BV Int. Int. BV BV BV
126 None Int. BV Int. Int. Int. Int. Int.
127 YV Int. Int. Int. Int. Int. Int. Int.
128 UTI/BV/YV BV BV N/A Int. Normal Int. Int.
129 UTI/BV/YV Normal Normal Normal Normal Normal Normal Int.
130 UTI BV BV BV Int. Int. Int. Normal
131 UV Int. Int. Normal Int. Int. Int. Normal
132 None BV BV BV BV BV BV BV

None, no past history of urogenital infection; BV, asymptomatic bacterial vaginosis and scores within the BV Nugent range of 7–10; YV, yeast vaginitis; UTI, urinary tract infection; Normal, scores within the normal Nugent range of 0–3; Int., scores within the intermediate Nugent range of 4–6; N/A, not available.

Table 3

Nugent scoring outcomes of patients in Group 3 given once daily 6×109L. rhamnosus GR-1 and L. fermentum RC-14

Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
114 UTI/YV Normal Normal Normal Normal Normal Normal Normal
119 UTI/YV Int. Int. Int. Int. Normal Int. Int.
123 YV Normal Normal Normal Normal Normal N/A Normal
124 YV BV BV Int. Int. BV BV BV
126 None Int. BV Int. Int. Int. Int. Int.
127 YV Int. Int. Int. Int. Int. Int. Int.
128 UTI/BV/YV BV BV N/A Int. Normal Int. Int.
129 UTI/BV/YV Normal Normal Normal Normal Normal Normal Int.
130 UTI BV BV BV Int. Int. Int. Normal
131 UV Int. Int. Normal Int. Int. Int. Normal
132 None BV BV BV BV BV BV BV
Patient No. History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
114 UTI/YV Normal Normal Normal Normal Normal Normal Normal
119 UTI/YV Int. Int. Int. Int. Normal Int. Int.
123 YV Normal Normal Normal Normal Normal N/A Normal
124 YV BV BV Int. Int. BV BV BV
126 None Int. BV Int. Int. Int. Int. Int.
127 YV Int. Int. Int. Int. Int. Int. Int.
128 UTI/BV/YV BV BV N/A Int. Normal Int. Int.
129 UTI/BV/YV Normal Normal Normal Normal Normal Normal Int.
130 UTI BV BV BV Int. Int. Int. Normal
131 UV Int. Int. Normal Int. Int. Int. Normal
132 None BV BV BV BV BV BV BV

None, no past history of urogenital infection; BV, asymptomatic bacterial vaginosis and scores within the BV Nugent range of 7–10; YV, yeast vaginitis; UTI, urinary tract infection; Normal, scores within the normal Nugent range of 0–3; Int., scores within the intermediate Nugent range of 4–6; N/A, not available.

Table 4

Nugent scoring outcomes of patients in Group 4 given once daily 1010L. rhamnosus GG control

Patient# History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
134 UTI/YV Normal Int. Int. Normal Int. Int. Int.
135 YV BV BV N/A N/A Int. Int. Int.
136 BV/YV Normal Normal Normal Normal Normal Normal Normal
137 UTI/YV Int. Int. Int. Normal Int. Int. BV
138 YV BV BV BV Normal Normal Normal Normal
140 UTI/YV Int. Int. Int. Int. Int. Int. Int.
141 None BV BV BV N/A N/A N/A BV
142 YV/BV Normal Int. Normal Normal Normal Normal Normal
144 YV Normal Normal Normal Int. Int. Int. Int.
Patient# History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
134 UTI/YV Normal Int. Int. Normal Int. Int. Int.
135 YV BV BV N/A N/A Int. Int. Int.
136 BV/YV Normal Normal Normal Normal Normal Normal Normal
137 UTI/YV Int. Int. Int. Normal Int. Int. BV
138 YV BV BV BV Normal Normal Normal Normal
140 UTI/YV Int. Int. Int. Int. Int. Int. Int.
141 None BV BV BV N/A N/A N/A BV
142 YV/BV Normal Int. Normal Normal Normal Normal Normal
144 YV Normal Normal Normal Int. Int. Int. Int.

None, no past history of urogenital infection; BV, asymptomatic bacterial vaginosis and scores within the BV Nugent range of 7–10; YV, yeast vaginitis; UTI, urinary tract infection; Normal, scores within the normal Nugent range of 0–3; Int., scores within the intermediate Nugent range of 4–6; N/A, not available.

Table 4

Nugent scoring outcomes of patients in Group 4 given once daily 1010L. rhamnosus GG control

Patient# History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
134 UTI/YV Normal Int. Int. Normal Int. Int. Int.
135 YV BV BV N/A N/A Int. Int. Int.
136 BV/YV Normal Normal Normal Normal Normal Normal Normal
137 UTI/YV Int. Int. Int. Normal Int. Int. BV
138 YV BV BV BV Normal Normal Normal Normal
140 UTI/YV Int. Int. Int. Int. Int. Int. Int.
141 None BV BV BV N/A N/A N/A BV
142 YV/BV Normal Int. Normal Normal Normal Normal Normal
144 YV Normal Normal Normal Int. Int. Int. Int.
Patient# History Day 0 Day 7 Day 14 Day 21 Day 28 Day 35 Day 42
134 UTI/YV Normal Int. Int. Normal Int. Int. Int.
135 YV BV BV N/A N/A Int. Int. Int.
136 BV/YV Normal Normal Normal Normal Normal Normal Normal
137 UTI/YV Int. Int. Int. Normal Int. Int. BV
138 YV BV BV BV Normal Normal Normal Normal
140 UTI/YV Int. Int. Int. Int. Int. Int. Int.
141 None BV BV BV N/A N/A N/A BV
142 YV/BV Normal Int. Normal Normal Normal Normal Normal
144 YV Normal Normal Normal Int. Int. Int. Int.

None, no past history of urogenital infection; BV, asymptomatic bacterial vaginosis and scores within the BV Nugent range of 7–10; YV, yeast vaginitis; UTI, urinary tract infection; Normal, scores within the normal Nugent range of 0–3; Int., scores within the intermediate Nugent range of 4–6; N/A, not available.

As shown in Table 4 and summarized in Table 5, the control GG group showed no improvement in the number of subjects with normal vaginal flora at the end of 28 days of treatment. On the contrary, treatment with the GR-1/RC-14 combination twice daily (still almost one log less than one dose of the GG control) resulted in 50% more normal scores than before treatment started. Within 2 weeks of completion of treatment, the vaginal flora remained normal (comparing day 0 and day 28) in 90% of women given the twice daily GR-1/RC-14 lactobacilli, and this was significantly better than the GG control (P=0.017).

Table 5

Summary of women with a healthy Nugent score for their vaginal flora before treatment and at days 28 and 42 following treatment with L. rhamnosus GR-1 and L. fermentum RC-14 (Groups 1–3) or L. rhamnosus GG

Percentage of women with healthy vaginal flora
Group 1 (8×108) Group 2 (1.6×109) Group 3 (6×109) Group 4 (1010 GG)
Before treatment 40 50 27 44
At end of treatment 60 82 45 38
Two weeks after treatment 56 90 30 33
Percentage of women with healthy vaginal flora
Group 1 (8×108) Group 2 (1.6×109) Group 3 (6×109) Group 4 (1010 GG)
Before treatment 40 50 27 44
At end of treatment 60 82 45 38
Two weeks after treatment 56 90 30 33

As defined by Nugent scoring.

Table 5

Summary of women with a healthy Nugent score for their vaginal flora before treatment and at days 28 and 42 following treatment with L. rhamnosus GR-1 and L. fermentum RC-14 (Groups 1–3) or L. rhamnosus GG

Percentage of women with healthy vaginal flora
Group 1 (8×108) Group 2 (1.6×109) Group 3 (6×109) Group 4 (1010 GG)
Before treatment 40 50 27 44
At end of treatment 60 82 45 38
Two weeks after treatment 56 90 30 33
Percentage of women with healthy vaginal flora
Group 1 (8×108) Group 2 (1.6×109) Group 3 (6×109) Group 4 (1010 GG)
Before treatment 40 50 27 44
At end of treatment 60 82 45 38
Two weeks after treatment 56 90 30 33

As defined by Nugent scoring.

Of the subjects who had a history of yeast vaginitis during the previous 5 years, 7/13 (54%) who did not have a normal flora at entry, developed a normal flora within 28 days of treatment with GR-1/RC-14, while one 1/4 (25%) of the GG controls converted to normal. Of the five subjects who had a history of BV and presented with a BV Nugent score, one (No. 128) converted to a normal flora with GR-1/RC-14 treatment, while none of the GG controls converted. Of subjects with a past history of UTI, treatment with one of the three GR-1/RC-14 doses was better at converting an abnormal flora on day 0 to a normal flora within 28 days (P=0.043).

The conversion to a normal flora within 28 days was significant for women in Group 2 (P=0.017), with a tendency towards significance for Group 3 (P=0.147), and lack of significance for Group 1 (P=0.611 on day 28; P=0.994 on day 42) compared to control Group 4. The dosage forms higher than 8×108 appeared to be necessary for clinical effect.

4 Discussion

The pool of subjects was quite typical of healthy women in a fairly well educated, middle class community. However, the nature of the study attracted more women with a history of previous urogenital infection than in a random population, and these women likely represent consumers wishing to utilize functional foods as a means of maintaining health . The women were not at high risk of sexually transmitted diseases, unlike some populations studied elsewhere , such as those with BV and at greater risk of HIV-1 through sexual intercourse . Their overall history of bladder and vaginal infection was not unexpected, given the high incidence of these diseases amongst women. The low incidence of a history of BV was also not surprising, given its poor diagnosis in community clinics. The prevalence of normal flora at 40% at the start of the study was lower than the 76.5% reported by Schwebke et al. , perhaps illustrating the innate abnormality of women with a history of urogenital infections and antibiotic treatment.

The finding that the flora was normal in the majority of subjects after treatment with lactobacilli strains GR-1 and RC-14, and not the control patients taking L. rhamnosus GG, suggested strongly that the two strain combination therapy had an impact on the flora. The ingestion of the GR-1/RC-14 probiotic therapy resulted in the vaginal flora being restored to normal within 28 days in 82% in one group of patients. This is much higher than normal Nugent values reported in a general healthy population of women . Whether or not a longer duration of treatment would mean that the flora could be maintained as normal in all subjects remains to be determined. In subjects who started with a normal flora, 12/13 (92%) retained normality at day 28 and one scored intermediate following GR-1/RC-14 therapy. This is almost double the 48% of women found elsewhere to maintain a normal flora over a menstrual cycle as determined by Nugent scoring . This suggests that daily probiotic use could be considered as a means to maintain a healthy urogenital flora.

The question of how long on therapy did it take to increase the number of normal Nugent scores was not an aim of the study, and while there is an increase in Groups 1 and 2 on day 7 and day 21, no statement of significance can be made.

The dosage forms did not reveal significant differences, and it appears that the range of doses selected for study was too narrow.

There was no significant difference between Group 1 and the control at day 28 or day 42, suggesting that a daily dose greater than 8×108 is required for an effect. The twice daily dose of GR-1/RC-14 contained considerably fewer organisms than those in the GG control product. The results for L. rhamnosus GG are consistent with its inability to colonize the vagina or protect the host from recurrence of UTI .

The prevalence of asymptomatic bacterial vaginosis was 26% (11/42) at study commencement as assessed by Nugent evaluation. This is similar to the 20% figure found in a larger study of 635 women . The conversion of BV scores to normal with GR-1/RC-14 therapy (64%) is higher than the spontaneous conversion rate reported at 12% in a previous study , implying potential clinical significance with probiotic therapy.

For women prone to recurrence of UTI, GR-1/RC-14 and not GG therapy corresponded with maintenance of a lactobacilli dominated vaginal flora. This reaffirms an earlier finding that prophylactic antibiotics could one day be replaced by oral probiotics as a means to prevent UTI .

The study was not designed to determine if the ingested strains were the ones that colonized the vagina. Rather, even if the effect was a result of the therapy creating an environment better able to support indigenous lactobacilli growth , the clinical outcome is still important.

In summary, the findings indicate that a daily oral dose of 108 viable probiotic lactobacilli can restore and maintain the urogenital health of women.

Acknowledgements

The assistance of Ms. D. Lam and Drs. J. Hammond, B. Henning, J. Owen, and E. Smith is much appreciated.

van de Wijgert J.H.H.M. Mason P.R. Gwanzura L. et al. . (2000) Intravaginal practices, vaginal flora disturbances, and acquisition of sexually transmitted diseases in Zimbabwean women. J. Infect. Dis. 181, 587–594. Chaim W. Mazor M. Leiberman J.R. (1997) The relationship between bacterial vaginosis and preterm birth. Arch. Gynecol. Obstet. 259, 51–58. Ellis A.K. Verma S. (2000) Quality of life in women with urinary tract infections: is benign disease a misnomer. J. Am. Board Fam. Pract. 13, 392–397. Reid G. Bruce A.W. (2001) Selection of Lactobacillus strains for urogenital probiotic applications. J. Infect. Dis. 183 (Suppl. 1), S77–S80. Reid G. Bruce A.W. Taylor M. (1995) Instillation of Lactobacillus and stimulation of indigenous organisms to prevent recurrence of urinary tract infections. Microecol. Ther. 23, 32–45. Reid G. Bruce A.W. Fraser N. Heinemann C. Owen J. Henning B. (2001) Oral probiotics can resolve urogenital infections. FEMS Immunol. Med. Microbiol. 30, 49–52. Keane F.E. Ison C.A. Taylor-Robinson D. (1997) A longitudinal study of the vaginal flora over a menstrual cycle. Int. J. STD AIDS 8, 489–494. Schwebke J.R. Richey C.M. Weiss H.L. (1999) Correlation of behaviours with microbiological changes in vaginal flora. J. Infect. Dis. 180, 1632–1636. Nugent R.P. Krohn M.A. Hillier S.L. (1991) Reliability of diagnosing bacterial vaginosis is improved by a standardization method of Gram stain interpretation. J. Clin. Microbiol. 29, 297–301. Kontiokari T. Sundgvist K. Nuutinen M. Pokka T. Koskela M. Uhari M. (2001) Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. Br. Med. J. 522, 1–4. Childs N.M. (1997) The functional food consumers: who are they and what do they want? Implications for product development and positioning. In: New Technologies for Healthy Foods and Nutraceuticals ( Yalpani M. , Ed.), pp. 313–326. ATL Press, Shrewsbury, MA. Sewankambo N. Gray R.H. Wawer M.J. et al. . (1997) HIV-1 infection associated with abnormal vaginal flora morphology and bacterial vaginosis. Lancet 350, 530–531. Gratacos E. Figueras F. Barranco M. et al. . (1998) Spontaneous recovery of bacterial vaginosis during pregnancy is not associated with an improved perinatal outcome. Acta Obstet. Gynecol. Scand. 77, 37–40. Hillier S.L. Krohn M.A. Nugent R.P. Gibbs R.S. (1992) Characteristics of three vaginal flora patterns assessed by Gram stain among pregnant women. Am. J. Obstet. Gynecol. 166, 938–944. © 2001 Federation of European Microbiological Societies.

Is that a Summers Eve Advertisement above us? Who remembers those and how they enticed all of us to believe we would smell spring-y fresh like we were running through a meadow if we were to buy and use a douche?! Here is Mrs. Gonino applying the science behind why douching should be a no-no and how spring-y fresh can be achieved naturally.

Another post inspired by my daughter..

“Mom, I think maybe I need to do a douche.”

After I made her repeat her statement , because I wasn’t quite sure I had heard correctly, my knee jerk response was to say , rather tersely, we don’t douche, we don’t ever douche!

The blank look on her face told me I was going to need to offer more information than that before she was going to buy into my advice.

In retrospect, my knee jerk reaction was triggered by the shocking revelation that douching is still a thing ( an absurd thing! )especially for healthy young women. Surely douching went out with my mother’s generation , right?! Evidently not..So, my intent with this post is to enlighten moms , grandmoms , girls, and women of all ages to spread the message about safe and natural balancing of vaginal flora.

Flora, such a sweet and spring-y sounding word🌻 🌾🌿

Flora in the human body is the good bacteria that naturally exists when optimally balanced.Healthy balanced flora in the digestive tract is the foundation for a strong immune system , even creating nutrients, like the B Vitamins.When this inner body ecosystem becomes unbalanced by a variety of reasons I’ll talk about later, the flora can be overtaken by fungal, or yeast, overgrowth.

Dr Majid Ali, describes fungus as Pre Life Organisms (PLO’s.)Fungus can never be obliterated in the human body ( no use in even trying to do so,) it is what we are actually created from in the beginning of life , as well as designed for the purpose of ending the life cycle. “Ashes to ashes, dust to dust,” if you will.Healthy vaginal flora basically has no symptoms or signs.No odor, itching or discharge. If anything, there will be a slightly pleasant odor.

Now we know what to aim for , right ?

But what about the things that cause flora imbalances? What are they , and what can we do to restore healthy balance, without needless toxic exposure to these ever so delicate tissues?

The following are the typical, with a few of the not so well known, culprits.

. Oral antibiotics ( creating leaky gut, allowing fungal overgrowth into the bloodstream)

. Birth control pills (creates hormonal imbalances)

. Pregnancy (remember PLO’s necessary for creating human life)

. Multiple sex partners ( introducing different types of fungus into the mix )

. Poor nutrition (high in simple carbs, alcohol, sugars,etc.)

. Chronic body acid PH

Now for the not so well known culprits:

. Unhealthy sex partners, with unhealthy habits ( oral fungal overgrowth, for example.)

. Over cleansing the digestive tract (colonics, enemas, herbal cleanses, laxatives) without consistently replacing the good bacteria and allowing time for them to seed and recolonize, thereby healing leaky porous gut.

. DOUCHING ! Ughh .. especially with those commercially sold products that contain chemicals.

1) They do not work, even washing out what little good flora that may exist, requiring..

2) More douching with more chemical exposure to tender vaginal tissues!

. Eating sugary yogurts for gaining good bacteria

Ladies, we believe God created the body to be self healing, correcting and balancing. Usually all that is required of us is to change , correct and control the exposures and assaults that create and perpetuate the imbalances in the first place, thus allowing the body to do its thing.Of course long standing or multiple health issues may require more aggressive treatment such as antifungal medications or intravenous, immune system building efforts .Most simple yeast infections can be quickly and simply remedied with the following natural treatment, that usually provides significant relief in 24 hours. If needed, this regimen can be repeated a couple of times in a twenty four hour period.

. Dip an all natural tampon ( the only kind you should be using regularly) into plain yogurt or kefir. Insert into vagina and remove in an hour. DO NOT sleep in it! It only takes a small amount, in a small amount of time to begin the colonization process. Allow the body the time it needs to do its healing and rebalancing naturally, at its own speed and it will reward you in return.

The importance of oral probiotics cannot be overstated. We recommend a couple of different types of strains daily, such as Bifido and Ruggeri , one of those should be enteric coated , meaning it does not open until it reaches the small intestines. When those bottles are emptied, buy two more different strains, always with one being enteric coated, and so on.Just as important is keeping the cells hydrated with PH balancing minerals and salts , along with lots of clean water.

So there it is, ladies, sans the emotional knee jerking and as Allie would attest to, a tendency towards the dramatic;))

Happy and healthy girling, ya’ll !!

#LoveHeals

Linda Gonino

Long-term Lactobacillus rhamnosus BMX 54 application to restore a balanced vaginal ecosystem: a promising solution against HPV-infection

  1. 1.

    Aroutcheva A, Gariti D, Simon M, Shott S, Faro J, Simoes JA, Gurguis A, Faro S. Defense factors of vaginal lactobacilli. Am J Obstet Gynecol. 2001;185:375–9.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  2. 2.

    Conti C, Malacrino C, Mastromarino P. Inhibition of herpes simplex virus type 2 by vaginal lactobacilli. J Physiol Pharmacol. 2009;60:19–26.

    • PubMed
    • Google Scholar
  3. 3.

    Matu MN, Orinda GO, Njagi ENM, Cohen CR, Bukusi EA. Vitro inhibitory activity of human vaginal lactobacilli against pathogenic bacteria associated with bacterial vaginosis in Kenyan women. Anaerobe. 2010;16:210–5.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  4. 4.

    Bultman SJ. Emerging roles of the microbiome in cancer. Carcinogenesis. 2014;35:249–55.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  5. 5.

    Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S. Human papillomavirus and cervical cancer. Lancet. 2007;370:890–907.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  6. 6.

    Clarke MA, Rodriguez AC, Gage JC, et al. A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection. BMC Infect Dis. 2012;12:33.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  7. 7.

    Turner JR. Intestinal mucosal barrier function in health and disease. Nat Rev Imm. 2009;9:799–809.

    • CAS
    • Article
    • Google Scholar
  8. 8.

    Taha TE, Hoover DR, Dallabetta GA, et al. Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. AIDS. 1998;12:1699–706.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  9. 9.

    Solomon D, Davey D, Kurman R, et al. The 2001 Bethesda system: terminology for reporting results of cervical cytology. JAMA. 2002;287:2114–9.

    • Article
    • PubMed
    • Google Scholar
  10. 10.

    Lee JE, Lee S, Lee H, et al. Association of the vaginal microbiota with human papillomavirus infection in a Korean twin cohort. PLoS One. 2013;8:e63514.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  11. 11.

    Holst E. Bacterial vaginosis microbiological and clinical findings. Eur J Clin Microbiol. 1987;6:536–41.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  12. 12.

    Bornstein J, Bentley J, Bösze P, et al. 2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy. Obstet Gynecol. 2012;120:166–72.

    • Article
    • PubMed
    • Google Scholar
  13. 13.

    Recine N, Palma E, Domenici L, et al. Restoring vaginal microbiota: biological control of bacterial vaginosis. A prospective case-control study using Lactobacillus rhamnosus BMX 54 as adjuvant treatment against bacterial vaginosis. Arch Gynecol Obstet. 2016;293:101–7.

    • Article
    • PubMed
    • Google Scholar
  14. 14.

    Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983;74:14–22.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  15. 15.

    Mitra A, MacIntyre DA, Marchesi JR, Lee YS, Bennett PR, Kyrgiou M. The vaginal microbiota, human papillomavirus infection and cervical intraepithelial neoplasia: what do we know and where are we going next? Microbiome. 2016;4:58.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  16. 16.

    Song D, Kong WM, Zhang TQ, Jiao SM, Chen J, Han C, Liu TT. The negative conversion of high-risk human papillomavirus and its performance in surveillance of cervical cancer after treatment: a retrospective study. Arch Gynecol Obstet. 2017;295:197–203.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  17. 17.

    Gillet E, Meys JF, Verstraelen H, Verhelst R, De Sutter P, Temmerman M, Vanden Broeck D. Association between bacterial vaginosis and cervical intraepithelial neoplasia: systematic review and meta-analysis. PLoS One. 2012;7:e45201.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  18. 18.

    Nam KH, Kim YT, Kim SR, Kim SW, Kim JW, Lee MK, Nam EJ, Jung YW. Association between bacterial vaginosis and cervical intraepithelial neoplasia. J Gynecol Oncol. 2009;20:39–43.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  19. 19.

    Bosch FX, Lorincz A, Muñoz N, Meijer CJ, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol. 2002;55:244–65.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  20. 20.

    Motevaseli E, Shirzad M, Akrami SM, Mousavi AS, Mirsalehian A, Modarressi MH. Normal and tumour cervical cells respond differently to vaginal lactobacilli, independent of pH and lactate. J Med Microbiol. 2013;62:1065–72.

    • Article
    • PubMed
    • Google Scholar
  21. 21.

    Pendharkar S, Magopane T, Larsson PG, de Bruyn G, Gray GE, Hammarström L, Marcotte H. Identification and characterisation of vaginal lactobacilli from south African women. BMC Infect Dis. 2013;13:43.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  22. 22.

    Jespers V, van de Wijgert J, Cools P, et al. Vaginal biomarkers study group. The significance of lactobacillus crispatus and L. Vaginalis for vaginal health and the negative effect of recent sex: a cross-sectional descriptive study across groups of African women. BMC Infect Dis. 2015;15:115.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  23. 23.

    De Backer E, Verhelst R, Verstraelen H, et al. Quantitative determination by real-time PCR of four vaginal lactobacillus species, Gardnerella vaginalis and Atopobium vaginae indicates an inverse relationship between L. Gasseri and L. Iners. BMC Microbiol. 2007;7:115.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  24. 24.

    Spurbeck RR, Arvidson CG. Lactobacilli at the front line of defense against vaginally acquired infections. Future Microbiol. 2011;6:567–82.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  25. 25.

    Iyer C, Kosters A, Sethi G, Kunnumakkara AB, Aggarwal BB, Versalovic J. Probiotic lactobacillus reuteri promotes TNF-induced apoptosis in human myeloid leukemia-derived cells by modulation of NF-kappaB and MAPK signalling. Cell Microbiol. 2008;10:1442–52.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  26. 26.

    Hemarajata P, Versalovic J. Effects of probiotics on gut microbiota: mechanisms of intestinal immunomodulation and neuromodulation. Therap Adv Gastroenterol. 2013;6:39–51.

    • CAS
    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  27. 27.

    Orlando A, Messa C, Linsalata M, Cavallini A, Russo F. Effects of lactobacillus rhamnosus GG on proliferation and polyamine metabolism in HGC-27 human gastric and DLD-1 colonic cancer cell lines. Immunopharmacol Immunotoxicol. 2009;31:108–16.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  28. 28.

    Orlando A, Refolo MG, Messa C, Amati L, Lavermicocca P, Guerra V, Russo F. Antiproliferative and proapoptotic effects of viable or heat-killed lactobacillus paracasei IMPC2.1 and Lactobacillus rhamnosus GG in HGC-27 gastric and DLD-1 colon cell lines. Nutr Cancer. 2012;64:1103–11.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  29. 29.

    Sharma S, Singh RL, Kakkar P. Modulation of Bax/Bcl-2 and caspases by probiotics during acetaminophen induced apoptosis in primary hepatocytes. Food Chem Toxicol. 2011;49:770–9.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  30. 30.

    Tamrakar R, Yamada T, Furuta I, Cho K, Morikawa M, Yamada H, Sakuragi N, Minakami H. Association between lactobacillus species and bacterial vaginosis-related bacteria, and bacterial vaginosis scores in pregnant Japanese women. BMC Infect Dis. 2007;7:128.

    • Article
    • PubMed
    • PubMed Central
    • Google Scholar
  31. 31.

    Boccardo E, Lepique AP, Villa LL. The role of inflammation in HPV carcinogenesis. Carcinogenesis. 2010;31:1905–12.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  32. 32.

    Anukam K, Osazuwa E, Ahonkhai I, et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes Infect. 2006;8:1450–4.

    • CAS
    • Article
    • PubMed
    • Google Scholar
  33. 33.

    YaW Reifer C, Miller LE. Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebocontrolled study. Am J Obstet Gynecol. 2010;203:120–5.

    • Google Scholar
  34. 34.

    Reid G, Burton J. Use of lactobacillus to prevent infection by pathogenic bacteria. Microbes Infect. 2002;4:319–24.

    • Article
    • PubMed
    • Google Scholar
  35. 35.

    Cadieux P, Burton J, Gardiner G, Braunstein I, Bruce AW, Kang CY, Reid G. Lactobacillus strains and vaginal ecology. JAMA. 2002;287:1940–1.

    • Article
    • PubMed
    • Google Scholar
  36. 36.

    Reid GK, Mills AP, Bruce AW. Implantation of lactobacilli Casei var-rhamnosus into the vagina. Lancet. 1994;344:1229.

    • CAS
    • Article
    • PubMed
    • Google Scholar

Does your vagina really need a probiotic?

The marketing appears to be ahead of the science when it comes to vaginal probiotics.

Published: July, 2019

Probiotics are everywhere these days, in drinks, pills, and powders, and marketers are suggesting that you need to take them not only for your gut — but also for your vagina.

Many women are heeding the message, says Dr. Caroline Mitchell, assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School. Vaginal probiotic supplements are hugely popular. This includes both probiotic pills and suppository capsules that are inserted into the vagina using an applicator.

To continue reading this article, you must login.

Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School.

  • Research health conditions
  • Check your symptoms
  • Prepare for a doctor’s visit or test
  • Find the best treatments and procedures for you
  • Explore options for better nutrition and exercise

Learn more about the many benefits and features of joining Harvard Health Online “

How to have a healthy vagiana?

Leave a Reply

Your email address will not be published. Required fields are marked *