Friendly bacteria play a large role in the health of both intestines and vagina. The urinary tract is also affected by the types of bacteria in these two areas, because unfriendly bacteria can migrate to the urethra and cause urinary tract infections.

Probiotic products provide a dose of good bacteria that normally live in healthy individuals. Oral probiotics can easily reach the intestines, but what about the vagina?

In healthy women, Lactobacillus bacteria dominate the vaginal flora. There are many different species, and multiple strains of each one. A group in Spain found that the common species L. crispatus, L. jensenii, and L. gasseri all have potential for probiotic development. Lactobacillus crispatus vaginal suppositories have been tested in clinical trials, and were both safe and effective at preventing recurring urinary tract infections.

My last Pap smear report included the comment, “Bacteria (coccobacilli) present morphologically consistent with shift in vaginal flora, i.e., bacterial vaginosis.” At the time, I had no symptoms, so my doctor did not recommend treatment. But since then I've had some mild burning sensations, not enough to send me back to the doctor's office, but enough to raise my interest in probiotics for the vagina.

I found one brand, Candaclear™, on the Internet. The web sites warn that this product is heat sensitive, and special shipping arrangements have to be made for delivery in hot weather. So I found a local specialty pharmacy that carries it.

The labeling is a bit cryptic. The ingredients are listed in a box that looks like a dietary product label. The directions say, “Administer one lozenge per day.” Each lozenge contains two strains of Lactobacillus acidophilus plus 2.1 milligrams of garlic concentrate and 0.1 milligram of oil of rose absolute. I assume this qualifies Candaclear™ for marketing as a dietary supplement. Lactobacillus acidophilus is the same bacteria found in yogurt. But the package does include a handy tool, which is easy to figure out by any woman who has ever used a tampon.

I tried this product and it worked for me, even though it was not exactly the same as the Lactobacillus crispatus strain that was successful in the clinical trials. I'm eagerly awaiting the development of other vaginal probiotics.

by Linda Fugate, Ph.D.

References:
1. Uehara S, Monden K, Nomoto K, Seno Y, Kariyama R, Kumon H. “A pilot study evaluating the safety and effectiveness of Lactobacillus vaginal suppositories in patients with recurrent urinary tract infection”, Int J Antimicrob Agents 2006 Aug;28 Suppl 1:S30-4.

2. Czaja CA, Stapleton AE, Yarova-Yarovaya Y, Stamm WE. “Phase I trial of a Lactobacillus crispatus vaginal suppository for prevention of recurrent urinary tract infection in women”, Infect Dis Obstet Gynecol. 2007;2007:35387.

3. Martin R, Soberon N, Vaneechoutte M, Florez AB, Vazquez F, Suarez JE. “Characterization of indigenous vaginal lactobacilli from healthy women as probiotic candidates”, Int Microbiol. 2008 Dec;11(4):261-6.