Can probiotics help with vaginal candidiasis (Vaginal Overgrowth Yeast)?

From the Guidelines

Probiotics should not be used as a treatment for vaginal candidiasis, as there is no evidence to support their effectiveness in treating this condition. According to a 2022 review of the evidence for the 2021 Centers for Disease Control and Prevention of sexually transmitted infections treatment guidelines, published in the journal Clinical Infectious Diseases 1, azole antifungals remain the treatment of choice for uncomplicated vaginal candidiasis. The review also states that no evidence supports the use of alternative treatments, including probiotics.

When considering treatment options for vaginal candidiasis, it is essential to prioritize evidence-based treatments that have been proven to be effective in reducing morbidity, mortality, and improving quality of life. In this case, the use of azole antifungals, such as fluconazole, is recommended as the first-line treatment.

Some key points to consider when treating vaginal candidiasis include:

• Yeast culture remains the gold standard for diagnosis
• Azole antifungals are the treatment of choice for uncomplicated cases
• Newer drugs, such as ibrexafungerp, may be promising for treatment, but more research is needed
• Alternative treatments, including probiotics, are not supported by evidence and should not be used as a replacement for standard antifungal medications.

It is crucial to follow evidence-based guidelines and consult with a healthcare professional for proper diagnosis and treatment of vaginal candidiasis, rather than relying on unproven alternative treatments.

From the Research

Probiotics and Vaginal Overgrowth Yeast

• Probiotics have been studied as a potential adjunctive or alternative therapeutic strategy to antifungals in the management of vulvovaginal candidiasis (VVC) 2.
• The use of probiotics in the treatment and prevention of VVC has shown promising results, with some studies suggesting that they can improve vaginal health and reduce symptoms 3, 4.
• Certain strains of probiotics, such as Lactobacillus acidophilus, Lactobacillus rhamnosus GR-1, and Lactobacillus fermentum RC-14, have been found to be effective in preventing the colonization and infection of the vagina by Candida albicans 3, 5.
• A clinical trial found that the combination of fluconazole and probiotics (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) was more effective in treating VVC than fluconazole alone 5.
• Another study found that oral and vaginal supplementation with probiotics for 4 weeks played a significant role in the elimination of vaginal candidiasis symptoms 4.
• However, the evidence is not yet conclusive, and further research is needed to fully understand the potential benefits and limitations of using probiotics in the management of VVC 2, 3, 6.

Mechanisms of Action

• Probiotics may work by inhibiting the growth of Candida albicans and/or its adherence to the vaginal epithelium 3.
• They may also help to restore the natural balance of the vaginal microbiome, which can help to prevent the overgrowth of Candida albicans 2, 6.

Safety and Efficacy

• Probiotics are generally considered to be safe and well-tolerated, with few adverse effects reported 2, 3, 4.
• However, the efficacy of probiotics in the management of VVC can vary depending on the specific strain and dosage used, as well as the individual patient's response 2, 3, 6.