Vaginal Probiotics: What Does The Science Say?

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It’s Q&A Day at 10almonds!

Have a question or a request? We love to hear from you!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

So, no question/request too big or small 😎

❝Is there any merit to vaginal probiotics?❞

What a fun question! First let’s break it down, as this could mean two different things:

  1. Probiotics, which you consume, using your mouth, which are marketed as benefiting vaginal health
  2. Probiotics taken as a vaginal pessary/suppository, to act directly there

The former has limited evidence for it, but generally speaking, improving one’s gut health improves all other areas of health, so it’s not surprising if it helps this too.

See for example:

Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis

Some notes:

  • candidal vaginitis means a yeast infection causing vaginal inflammation
  • bacterial vaginosis means a vaginal bacterial imbalance (generally also featuring vaginal inflammation, though it can be asymptomatic)

In the latter case, the “imbalance” in question is usually a shortage of Lactobacillus sp. (that is to say, the diverse species of the Lactobacillus genus) resulting in an overgrowth of other kinds of bacteria, which in turn results in changing the vaginal microbiome to make it warmer and more acidic than it should be.

While a healthy vagina shouldn’t smell of roses, it shouldn’t smell fishy either; if it does, that’s a sign of bacterial vaginosis.

What it’s supposed to be like: slightly bitter, slightly salty, distinctly umami, along with a cocktail of personal pheromones (and if menstruating or otherwise* vaginally bleeding, then of course add: iron/”metallic”). The pheromones will also reflect any hormonal changes, but should never make anything smell bad, just different.

*e.g. due to PCOS, fibroids, etc. Note that in the case of PCOS, it may also smell a little different (if it does, then usually: a little more musky), due to often different hormone levels. Again: it still shouldn’t smell bad, though, just different.

In the above-linked study, taking more live Lactobacillus acidophilus (in yogurt, eating it, with their mouths) improved levels of L. acidophilus in the vagina. While the study authors concluded “this ingestion of yogurt may have reduced episodes of bacterial vaginosis”, which is rather a weak claim, it can be argued that it merely improving the levels of L. acidophilus in the vagina was already a win.

That was a small (n=42, and only 7 followed through to completion) and old (1996) study, and it bears mentioning that most of the studies into this seem to be small and old, but conclude similarly with weakly positive statements.

However, it does make a difference what kind of Lactobacillus is used, for example in this next study…

  • L. fermentum RC-14 worked well (90% success rate)
  • L. rhamnosus GR-1 worked somewhat (40% success rate)
  • L. rhamnosus GG did not work (0% success rate)

So, diversity is key, and getting a wide range of Lactobacillus sp. seems to be a safe bet.

Short version: enjoying probiotics as part of your diet probably improves vaginal health, just like it improves pretty much everything else.

See also: Make Friends With Your Gut (You Can Thank Us Later)

You would think that this would mean that taking probiotics as a vaginal pessary/suppository would be even better, but the results are weaker, as in this study, which produced temporary improvements in about half the study group, with only 3 out of 28 being free of bacterial vaginosis the next month:

Treatment of bacterial vaginosis with lactobacilli

This study got better results, with a 61% success rate:

Effectiveness of Lactobacillus-containing vaginal tablets in the treatment of symptomatic bacterial vaginosis

Important note

Do note that this last category, involving topical treatments (i.e., manually introducing Lactobacillus sp. to the vagina) were all in cases of pre-existing bacterial vaginosis, not as a prophylactic and/or general health-improving thing.

If your vagina seems happy right now, then do not mess with its happy bacterial balance!

And at all times (regardless of whether it seems happy right now or not): do not douche (it does not need it and will not benefit from it; the vagina is self-cleaning*) as this will wash out many of your Lactobacilli and will do absolutely nothing against any Candida there (C. albicans being a rooted fungus, whereas Lactobacillus is a sausage-shaped bacterium with many tiny appendages but no actual ability to stay put), so Candida will flourish in the Lactobacillus’s absence.

*by the vagina, we are referring to the vaginal canal. The vulva—the outside part consisting of the two pairs of labia, the glans clitoris, and clitoral hood—are not self-cleaning, and should just be washed gently per your normal bath/shower routine; that’s perfectly fine and good.

And definitely don’t put any “cleansing” toiletries inside the vagina (or any toiletries at all, for that matter), even if they are sold and marketed for that purpose; they will not help and they will harm.

Also, due to their neighborliness, messing up the microbiome inside the vagina is a common way to also get Candida inside the urethra:

How To Avoid Urinary Tract Infections (UTIs)

One other option

Finally, unless you have a “very good friend” you have a pressing urge to swap germs with, you might want to leave this one to the scientists, but we share this paper just for interest:

The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review

Lastly…

Going back to oral supplementation, if you’d like to try that then check out this for further notes on what, why, how, etc:

How Much Difference Do Probiotic Supplements Make To Health?

Take care!

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  • Lies I Taught in Medical School – by Dr. Robert Lufkin

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    There seems to be a pattern of doctors who practice medicine one way, get a serious disease personally, and then completely change their practice of medicine afterwards. This is one of those cases.

    Dr. Lufkin here presents, on a chapter-by-chapter basis, the titularly promised “lies” or, in more legally compliant speak (as he acknowledges in his preface), flawed hypotheses that are generally taught as truths. In many cases, the “lie” is some manner of “xyz is normal and nothing to worry about”, and/or “there is nothing to be done about xyz; suck it up”.

    The end result of the information is not complicated—enjoy a plants-forward whole foods low-carb diet to avoid metabolic diseases and all the other things to branch off from same (Dr. Lufkin makes a fair case for metabolic disease leading to a lot of secondary diseases that aren’t considered metabolic diseases per se). But, the journey there is actually important, as it answers a lot of questions that are much less commonly understood, and often not even especially talked-about, despite their great import and how they may affect health decisions beyond the dietary. Things like understanding the downsides of statins, or the statistical models that can be used to skew studies, per relative risk reduction and so forth.

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  • 16 Overlooked Autistic Traits In Women

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    We hear a lot about “autism moms”, but Taylor Heaton is an autistic mom, diagnosed as an adult, and she has insights to share about overlooked autistic traits in women.

    The Traits

    • Difficulty navigating romantic relationships: often due to misreading signs
    • Difficulty understanding things: including the above, but mostly: difficulty understanding subtext, when people leave things as “surely obvious”. Autistic women are likely to be aware of the possible meanings, but unsure which it might be, and may well guess wrongly.
    • Masking: one of the reasons for the gender disparity in diagnosis is that autistic women are often better at “masking”, that is to say, making a conscious effort to blend in to allistic society—often as a result of being more societally pressured to do so.
    • Honesty: often to a fault
    • Copy and paste: related to masking, this is about consciously mirroring others in an effort to put them at ease and be accepted
    • Being labelled sensitive and/or gifted: usually this comes at a young age, but the resultant different treatment can have a lifetime effect
    • Secret stims: again related to masking, and again for the same reasons that displaying autistic symptoms is often treated worse in women, autistic women’s stims tend to be more subtle.
    • Written communication: autistic women are often more comfortable with the written word than the spoken
    • Leadership: autistic women will often gravitate to leadership roles, partly as a survival mechanism
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    • Inner dialogue: rich inner dialogue, but unable to express it outwardly—often because of the sheer volume of thoughts per second.
    • Fewer female friends: often few friends overall, for that matter, but there’s often a gender imbalance towards male friends, or where there isn’t, towards more masculine friends at least.
    • Feeling different: often a matter of feeling one does not meet standard expectations in some fashion
    • School: autistic women are often academically successful
    • Special interests: often more “socially accepted” interests than autistic men’s.
    • Flirting: autistic women are often unsure how to flirt or what to do about it, which can result in simple directness instead

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  • Polyphenol Paprika Pepper Penne

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This one’s easier to promptly prepare than it is to pronounce unprepared! Ok, enough alliteration: this dish is as full of flavor as it is full of antioxidants, and it’s great for digestive health and heart health too.

    You will need

    • 4 large red bell peppers, diced
    • 2 red onions, roughly chopped
    • 1 bulb garlic, finely chopped
    • 2 cups cherry tomatoes, halved
    • 10oz wholemeal penne pasta
    • 1 tbsp nutritional yeast
    • 1 tbsp smoked paprika
    • 1 tbsp black pepper
    • Extra virgin olive oil for drizzling

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 200℃ / 400℉ / Gas mark 6

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    3) Cook the penne al dente (this should take 7–8 minutes in boiling salted water). Rinse in cold water, then pass a kettle of hot water over them to reheat. This process removed starch and lowered the glycemic index, before reheating the pasta so that it’s hot to serve.

    4) Place the roasted vegetables in a food processor and blitz for just a few seconds. You want to produce a very chunky sauce—but not just chunks or just sauce.

    5) Combine the sauce and pasta to serve immediately.

    Enjoy!

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    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Quick fixes for bodily annoyances

    Do you ever find yourself desperately trying to cure hiccups, and advice on the Internet is like “breathe in through your ears while drinking vinegar upside-down through your nose”?

    If so, you’re not alone. So, today we’re going to look at some science-based approaches to dealing with common bodily annoyances.

    Hiccups

    Unfortunately, most popular advices simply don’t work, and the only near-guaranteed way to cure these is with anti-convulsive medications whose side-effects may be worse than the hiccups.

    However, before you head to the pharmacy, there is one breathing exercise that has a very simple scientific underpinning: 4:4 breathing. If you’re unfamiliar, it’s just:

    1. Breathe slowly in through your nose to a count of four
    2. Hold your breath for a count of four
    3. Breathe slowly out through your nose to a count of four
    4. Hold your breath for a count of four

    …and repeat. The slower the better. At first, your hiccups will interrupt this, but just “keep calm and carry on”.

    The reason this can work is that breathing is an autonomic function (e.g., it happens without us thinking about it) that, unlike most other autonomic functions, we can all control directly. By taking control of one, others will tend to fall into line with it.

    For example, it is normal that your heart rate will tend to slow or quicken as your breathing slows or quickens, respectively.

    Your hiccups? Autonomic function. Actually a very, very old evolutionary left-over trait, that’s only useful for protecting lungs while breathing underwater. In other words, it’s the bodily function thinks you’re a fish (or a tadpole-like amphibious creature) in the process of developing lungs. Unfortunately, because hiccuping doesn’t harm our chances of passing on our genes, it never got naturally de-selected so we still have it.

    Anyway, the bottom line is: take control of your breathing in the aspects you can directly control, and the aspects you can’t directly control will fall into line. You may need to give it some minutes, don’t give up too quickly.

    Headaches

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    First, the limitation: this will only cure headaches that have been caused by increased localized blood pressure in the forehead. However, that’s more than half of most common headaches.

    Next, how it works…

    We’re mentioning this first, because understanding how it works will give you more confidence in using it.

    Your body has a wonderful homeostatic system, which is the system by which your body maintains its “Goldilocks zones” of not too hot or cold, not to acidine or alkaline, not too hydrated or dehydrated, blood pressure not too high or too low, etc. Sometimes, however, it can get confused, and needs a nudge back to where it should be.

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    So, what to do:

    With your thumb, carefully feel the upper inside corner of your eye socket. So, at the top, and about ¼ of the way out from the bridge of your nose. You should feel a groove. No, not like the Emperor’s New, but, an actual groove in your eye socket. That’s the supraorbital notch (or foramen), and it allows the supraorbital artery, veins, and nerve to run through.

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    As a bonus, this is a great party trick for curing other people’s headaches, when the need arises!

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    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

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    She also looks at the evolutionary tendency of exercise to be connection-building, as part of a community, friend group, or couple.

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    In short: if any book can get you shaking off the cobwebs, this is the one.

    Click here to check out The Joy Of Movement on Amazon today, and get your body moving!

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  • Beyond Balancing The Books – by George Marino, CPA, CFP

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