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:
- Probiotics, which you consume, using your mouth, which are marketed as benefiting vaginal health
- 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:
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 (acidic) yet at the same time 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, and in extreme cases it may also be approaching sweet-and-salty rather than bitter-and-salty), 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:
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:
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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What the Most Successful People Do Before Breakfast – by Laura Vanderkram
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First, what this is not:this is not a rehash of “The 5AM Club”, and nor is it a rehash of “The Seven Habits of Highly Effective People”.
What it is: packed with tips about time management for real people operating here in the real world. The kind of people who have non-negotiable time-specific responsibilities, and frequent unavoidable interruptions. The kind of people who have partners, families, and personal goals and aspirations too.
The “two other short guides” mentioned in the subtitle are her other books, whose titles start the same but instead of “…before Breakfast”, substitute:
- …on the Weekend
- …at Work
However, if you’re retired (we know many of our subscribers are), this still applies to you:
- The “weekend” book is about getting the most out of one’s leisure time, and we hope you have that too!
- The “work” book is about not getting lost in the nitty-gritty of the daily grind, and instead making sure to keep track of the big picture. You probably have this in your personal projects, too!
Bottom line: if, in the mornings, it sometimes seems like your get-up-and-go has got up and gone without you, then you will surely benefit from this book that outstrips its competitors in usefulness and applicability.
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Exercise, therapy and diet can all improve life during cancer treatment and boost survival. Here’s how
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With so many high-profile people diagnosed with cancer we are confronted with the stark reality the disease can strike any of us at any time. There are also reports certain cancers are increasing among younger people in their 30s and 40s.
On the positive side, medical treatments for cancer are advancing very rapidly. Survival rates are improving greatly and some cancers are now being managed more as long-term chronic diseases rather than illnesses that will rapidly claim a patient’s life.
The mainstays of cancer treatment remain surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy and hormone therapy. But there are other treatments and strategies – “adjunct” or supportive cancer care – that can have a powerful impact on a patient’s quality of life, survival and experience during cancer treatment.
PeopleImages.com – Yuri A/Shutterstock Keep moving if you can
Physical exercise is now recognised as a medicine. It can be tailored to the patient and their health issues to stimulate the body and build an internal environment where cancer is less likely to flourish. It does this in a number of ways.
Exercise provides a strong stimulus to our immune system, increasing the number of cancer-fighting immune cells in our blood circulation and infusing these into the tumour tissue to identify and kill cancer cells.
Our skeletal muscles (those attached to bone for movement) release signalling molecules called myokines. The larger the muscle mass, the more myokines are released – even when a person is at rest. However, during and immediately after bouts of exercise, a further surge of myokines is secreted into the bloodstream. Myokines attach to immune cells, stimulating them to be better “hunter-killers”. Myokines also signal directly to cancer cells slowing their growth and causing cell death.
Exercise can also greatly reduce the side effects of cancer treatment such as fatigue, muscle and bone loss, and fat gain. And it reduces the risk of developing other chronic diseases such as heart disease and type 2 diabetes. Exercise can maintain or improve quality of life and mental health for patients with cancer.
Emerging research evidence indicates exercise might increase the effectiveness of mainstream treatments such as chemotherapy and radiation therapy. Exercise is certainly essential for preparing the patient for any surgery to increase cardio-respiratory fitness, reduce systemic inflammation, and increase muscle mass, strength and physical function, and then rehabilitating them after surgery.
These mechanisms explain why cancer patients who are physically active have much better survival outcomes with the relative risk of death from cancer reduced by as much as 40–50%.
Mental health helps
The second “tool” which has a major role in cancer management is psycho-oncology. It involves the psychological, social, behavioural and emotional aspects of cancer for not only the patient but also their carers and family. The aim is to maintain or improve quality of life and mental health aspects such as emotional distress, anxiety, depression, sexual health, coping strategies, personal identity and relationships.
Supporting quality of life and happiness is important on their own, but these barometers can also impact a patient’s physical health, response to exercise medicine, resilience to disease and to treatments.
If a patient is highly distressed or anxious, their body can enter a flight or fight response. This creates an internal environment that is actually supportive of cancer progression through hormonal and inflammatory mechanisms. So it’s essential their mental health is supported.
Chemotherapy can be stressful on the body and emotional reserves. Shutterstock Putting the good things in: diet
A third therapy in the supportive cancer care toolbox is diet. A healthy diet can support the body to fight cancer and help it tolerate and recover from medical or surgical treatments.
Inflammation provides a more fertile environment for cancer cells. If a patient is overweight with excessive fat tissue then a diet to reduce fat which is also anti-inflammatory can be very helpful. This generally means avoiding processed foods and eating predominantly fresh food, locally sourced and mostly plant based.
Some cancer treatments cause muscle loss. Avoiding processed foods may help. Shutterstock Muscle loss is a side effect of all cancer treatments. Resistance training exercise can help but people may need protein supplements or diet changes to make sure they get enough protein to build muscle. Older age and cancer treatments may reduce both the intake of protein and compromise absorption so supplementation may be indicated.
Depending on the cancer and treatment, some patients may require highly specialised diet therapy. Some cancers such as pancreatic, stomach, esophageal, and lung cancer can cause rapid and uncontrolled drops in body weight. This is called cachexia and needs careful management.
Other cancers and treatments such as hormone therapy can cause rapid weight gain. This also needs careful monitoring and guidance so that, when a patient is clear of cancer, they are not left with higher risks of other health problems such as cardiovascular disease and metabolic syndrome (a cluster of conditions that boost your risk of heart disease, stroke and type 2 diabetes).
Working as a team
These are three of the most powerful tools in the supportive care toolbox for people with cancer. None of them are “cures” for cancer, alone or together. But they can work in tandem with medical treatments to greatly improve outcomes for patients.
If you or someone you care about has cancer, national and state cancer councils and cancer-specific organisations can provide support.
For exercise medicine support it is best to consult with an accredited exercise physiologist, for diet therapy an accredited practising dietitian and mental health support with a registered psychologist. Some of these services are supported through Medicare on referral from a general practitioner.
For free and confidential cancer support call the Cancer Council on 13 11 20.
Rob Newton, Professor of Exercise Medicine, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Easiest Way To Slow Brain Aging By Up To 20%
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…and other items from this week’s health science news:
Help others, to help your brain
We’ll get straight to it: spending about 2–4 hours a week helping people outside your household is associated with a roughly 15%–20% slower rate of age-related cognitive decline over time.
Notably, both formal volunteering and informal helping show comparable cognitive benefits, so it doesn’t have to be anything fancy, it just has to be helping people.
What seems most important is not the amount of time itself so much as the consistency—moderate, sustained engagement delivers the strongest and most consistent benefits, while heavier time commitments are not required. This shows itself to be particularly true as time goes on, since benefits accumulate year after year when helping becomes a stable routine, whereas withdrawing from helping is linked to worse cognitive function.
You may be wondering about the science behind this, and it was quite a big study: the analysis followed 31,303 people aged 51 and older for up to two decades, and yes, the results still held after accounting for wealth, education, and physical and mental health, suggesting the association is not explained by these factors alone.
As for how this happens, the researchers hypothesize that helping supports brain health by reducing stress-related inflammation and strengthening social connections that provide cognitive and emotional support.
So, how about you? If your first thought wasn’t “Oh, like my [thing that you regularly do and have consistently done over time]”, then now’s a great time to get started!
Read in full: Helping others for a few hours a week may slow brain aging
Related: 9 Little Habits To Have A Better Day
Whooping cough on the rise again in the US
The news is not good on this one. Whooping cough cases rose sixfold in 2024, and remain high in 2025, with more than 26,600 US cases reported by December 2025, over 4x the total for all of 2023.
Some parts of the US are doing worse than others, with some states are seeing levels not recorded for decades, including Oregon exceeding its 1950 annual record and Kentucky reporting three infant deaths in 2025 after none since 2018.
Unfortunately, public awareness is not strong: 30% of US adults do not know that pertussis is the same as whooping cough, and 35% do not know that a preventive vaccine exists. On which note, the CDC recommends the DTaP vaccine for young children in a 5-dose series, and Tdap for preteens, adults, and pregnant women during weeks 27–36 of pregnancy.
Nor do most know what the symptoms are: while 77% recognize coughing fits as a symptom, fewer identify low-grade fever, vomiting after coughing, or a runny nose.
So, to set yourself ahead of the crowd…
Read in full: Whooping cough cases rise sharply across the United States
Related: Vaccine Mythbusting
Mitochondria and mental health
Researchers (Dr. Lydia Wu-Chung et al.) tested the hypothesis that psychological and social experiences—such as stress, isolation, and trauma—affect mental health by altering mitochondrial function in brain cells. the proposed mechanism is that mitochondria act as a bridge between psychosocial experiences and physiological brain changes, helping explain how stress “gets under the skin.”
What they found was that altered mitochondrial function is associated with anxiety, depression, post-traumatic stress disorder, Alzheimer’s disease, cardiovascular disease, diabetes, and certain cancers. That’s a lot!
This is not too surprising, though, as the brain’s high energy demand makes it especially sensitive to mitochondrial inefficiency, which can impair neurotransmission, plasticity, mood regulation, and memory.
The relationship appears to be bidirectional also, as chronic stress can reduce mitochondrial efficiency over time, helping explain fatigue, cognitive difficulties, and mood disturbances seen in long-term stress.
Based on this research, she says that improving mitochondrial health may be a good option for many people to increase energy availability, reduce inflammation, and improve brain signaling.
As for how to do that? Endurance and aerobic exercise show the strongest and most consistent evidence for enhancing mitochondrial number and enzyme activity, while mindfulness programs and psychotherapy have shown changes in mitochondrial activity or number, but evidence for these latter associations is mixed and not always correlated with symptom improvement. So, exercise seems the main way to do it, for best results.
And in terms of things to avoid: social isolation can worsen mitochondrial function by reinforcing low energy, anxiety, and withdrawal, making recovery cycles harder to break.
So, maybe do that exercising with others, if you can!
Read in full: Mitochondria may be missing link between mental health and brain function
Related: 7 Ways To Boost Mitochondrial Health To Fight Disease
Take care!
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Your Daily Dose Of B12 From Just 15g Of Pea Shoots!
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.
…and other items from this week’s health news:
Efficient and inexpensive B12-bearing pea shoots
Because plants don’t create vitamin B12, and meat and dairy carry assorted health risks, what’s a person to do, who wants to be healthy?
Well, there is yeast, which has the best of both worlds, but maybe you don’t want nutritional yeast with every meal. There’s supplementation too, but wouldn’t it be nicer to get it from our diet?
Researchers (Dr. Bethany Eldridge et al.) have found an answer, having developed pea shoots that naturally contain high levels of vitamin B12 using indoor aeroponic farming.
How it works: much like how cows are supplemented with B12 that is then passed on to humans to eat them, they simply supplemented the pea plants, via their exposed roots in an aeroponics setting. Drawing nutrients up from the roots, the leaves accumulated enough B12 that a 15-gram serving of pea shoots provides more than the recommended daily allowance of vitamin B12.
The researchers estimate adding B12 through this method could increase the price of a bag of pea shoots by less than 1 penny, making it extremely inexpensive at scale:
Read in full: New aeroponic technology delivers essential Vitamin B12 through salad crops ← small error in the article; it says cyanocobalamin is the most bioavailable form of B12; it isn’t, that would be methylcobalamin or adenosylcobalamin. However, they did test the cyanocobalamine stored in the pea shoots and found that it was bioavailable, including after harvesting and storage. To be clear, the “most bioavailable” claim error was only in the pop-science article, not in the paper to which it links.
Related: Which B Vitamins? It Makes A Difference
Worse than “just” measles
Measles is bad enough already, to the point that it has a body count in the US in the past year, mostly unvaccinated children.
However, even if one recovers from an initial measles infection, there’s another problem that can strike later.
Subacute sclerosing panencephalitis (SSPE) is a rare but usually fatal neurological disease caused by the measles virus persisting in the brain for years after the original infection. Early signs often include stumbling, personality changes, jerking movements, seizures, hallucinations, and gradual loss of speech and mobility as brain damage progresses. The disease usually worsens steadily, leading to severe disability such as paralysis or inability to swallow, and it is almost always fatal.
Again, children suffer most. Or rather, the adolescents that these children briefly survived to become. That’s because children who catch measles very young—especially before age 5 or during infancy—have the highest risk of later developing SSPE.
Due to declining vaccinations in the US and parts of Europe, clinicians have begun seeing cases again after decades when they were extremely rare, including a California child who died after contracting measles as an infant. Doctors expect many more SSPE cases to appear in years to come as the “delayed echo” of the recent waves of infections.
Some quick notes on treatment and prevention:
- Treatment: doctors currently have no cure for SSPE, and available therapies only slow the disease slightly rather than reversing brain damage.
- Prevention: the two-dose measles vaccine dramatically reduces infection risk—from about 90% to roughly 3% after exposure—making vaccination the most effective way to prevent SSPE entirely.
Read in full: Doctors warn of a deadly complication from measles outbreaks
Related: Vaccine Mythbusting
Save money, save your heart
What’s better, simple red meat, or plant-based meats?
Research (linked below) has answered this question and found that replacing red meat with processed plant-based meat substitutes significantly (and rapidly!) lowers levels of the cardiovascular-risk metabolite trimethylamine N-oxide (TMAO).
The benefits at a glance:
- TMAO levels: the plant-based meat diet significantly lowered circulating TMAO levels compared with the red-meat diet by about 0.61 log units, showing that the metabolite can change within only a few days of dietary substitution.
- Cholesterol changes: during the plant-based phase, total cholesterol dropped by about 7 mg/dL and LDL cholesterol by about 6 mg/dL, although the trial was powered primarily to detect TMAO changes rather than lipid outcomes.
Were there any drawbacks? Yes, two:
- Participants gained an average of 0.6 kg during the plant-based phase, which researchers suggested may reflect fluid retention from the higher sodium content of processed plant-based patties. In practical terms, this means that…
- one can still have too much of a good thing, and while the swap is a mostly healthier one, it’s still important to watch the sodium levels, and
- if you are going to consume more sodium for some reason (most of us will have a saltier meal once in a while), it’s good to balance that with water and non-sodium electrolytes, especially potassium, which counterbalances sodium in the body’s homeostatic system.
- A few participants reported mild gastrointestinal symptoms, including abdominal discomfort and diarrhea, during the plant-based diet phase. Basically, since this was an interventional trial, this was a case of “people who aren’t used to eating plant-based don’t yet have a gut that’s accustomed to plant-based fiber levels“, and would not be relevant after a short period, when the gut adapts.
Read in full: Swapping red meat for plant-based meat rapidly lowers a key heart risk metabolite, trial finds
Related: Are plant-based burgers really bad for your heart? Here’s what’s behind the scary headlines
Take care!
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Fennel vs Onion – Which is Healthier?
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Our Verdict
When comparing fennel to onion, we picked the fennel.
Why?
First note, in case you didn’t see the picture: we are talking about white onions here (also called brown onions, by virtue of their attire).
Looking at the macros, fennel has nearly 2x the fiber and a little more protein, while onion has more carbs. An easy win in this category for the fennel.
In the category of vitamins, fennel has more of vitamins A, B2, B3, B5, B9, C, E, K, and choline (most of them by generous margins and some by especially large margins, we are talking, for example, 480x the vitamin A, 29x the vitamin E, and 157x the vitamin K), while onions have more of vitmains B1 and B6. Another clear win for fennel.
When it comes to minerals, fennel has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while onion is not higher in any minerals. No prizes for guessing: fennel wins this category too.
You may be curious as to how they add up on the polyphenol front, and the answer is, they don’t, much. Wonderful as these two vegetables are, an abundance of polyphenols is not amongst their strengths; fennel has some lignans and onion has some flavonols, but we’re talking tiny numbers here (in contrast, red onion would have aced it with 120mg/100g quercetin, amongst others, but red onion wasn’t on trial today).
Adding up the sections makes a clear win for fennel today.
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score?
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Endometriosis Testing In Minutes, Not Years
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Endometriosis affects a lot of people, with common figures being cited as 1 in 7 women, or 1 in 10 women.
Whatever the true prevalence, one thing is for certain: it sure is prevalent.
And yet, the typical time it takes it get a diagnosis is around 9 years on average, with a range of 4–11 years, per Dr. Krina Zondervan et al., 2018 (learn more).
To make matters worse current tests include ultrasound scans, MRI or a laparoscopy, this latter being where a camera is inserted surgically. None of these are fun, and they’re not usually easy to access, either.
The many problems with the diagnostic process have led to such happenings as: Woman had two organs removed before doctors discovered endometriosis
See also: Is surgery necessary for my endometriosis or suspected endo?
So, what’s new?
Multi-omics to the rescue
By looking at various biomarkers, it’s possible to diagnose diseases much more quickly and easily.
Two such methods have recently been identified as very useful for diagnosing endometriosis.
In one case, a starting point for understanding is is in the blood:
❝Multi-omics profiling revealed coordinated immunometabolic alterations associated with EM, characterized by interconnected inflammatory and metabolic alterations in peripheral blood. These findings provide evidence that systemic immune-metabolic dysregulation is associated with EM and support further evaluation of blood-based biomarker strategies for non-invasive detection❞
Read in full: Multi-omics profiling identifies an immunometabolic signature associated with endometriosis
However, as it turns out, saliva can give us a more conclusive answer:
❝Here, we characterized the molecular and functional landscape of EM-derived sEVs across disease stages and biological sources. sEVs isolated from eutopic endometrium, ectopic lesions, peritoneal fluid, and plasma from mild- and severe-stage EM patients and healthy controls were analyzed by surface marker profiling, proteomics, lipidomics, and integrated multi-omics, with functional effects assessed in human uterine microvascular endothelial cells. sEV composition varied by disease stage and sample type, with EM lesion-derived sEVs demonstrating stage-dependent loss of epithelial-associated markers and enrichment of immune-associated signatures, while EM plasma-derived sEVs exhibited altered adhesion- and platelet-associated profiles.❞
Another method relies on an electroviscerogram (electrical scan of the viscera) using electrodes placed externally, and, in very few words:
❝EVG with GIMA biomarker detection distinguished participants with and without endometriosis based upon endometriosis-specific GIMA biomarkers threshold scoring.❞
In more words (i.e., the paper in full): Gastrointestinal Myoelectrical Activity (GIMA) Biomarker for Noninvasive Diagnosis of Endometriosis
That’s a lot of science, but what does this mean in practical terms?
Sometimes we give science for something new and promising and say “we hope to see this available soon”; in this case, this science has been from the past few years, and the tests are now available.
Perhaps a good indicator is which tests the famously thrifty-and-evidenced-based NHS offers in the UK, since there is no profit motive to sell expensive tests, and things are only done if the evidence shows they reduced disease burden and increase health-related quality of life.
With that in mind, it’s the latter two of the three tests we mentioned. In other words, the saliva test and the electrodes test:
❝With Endotest, women give a saliva sample, which is sent off to a lab to check for tiny biological markers called microRNAs. This indicates the presence of endometriosis. The lab result is returned to the GP or another healthcare professional to inform the next steps in diagnosis and care.
EndoSure can detect the condition by measuring electrical signals in the gut using sensor pads on the abdomen. Women fast for six to eight hours beforehand, and during the 45-minute test are asked to drink water until full, helping the device record gut activity accurately. Results are available as soon as the test is complete.
A third test, DotEndo, needed more research before it could get the green light, NICE said.❞
NICE = National Institute for Health and Care Excellence
Source: Rapid endometriosis tests to be made available on NHS in England and Wales
But I’m not in England and Wales!
Indeed, most of our readers are in N. America.
However, now you know what tests to enquire after!
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