You’ve probably heard about the importance of probiotics for the gut microbiome…but what about the vaginal microbiome? It’s just as crucial for your health, especially as you age. Keeping your microbiome strong and varied down there could help with UTI, yeast infections, and overall comfort. But do you need a separate women’s probiotic for vaginal health?
As a researcher and lecturer on the vaginal microbiome for well over a decade, my answer is a resounding yes, you need to pay attention to the health and diversity of your vaginal microbiome in the very same way you’d attend to the health of your gut microbiome. Or skin microbiome.
Ok, if I’m honest, I’d say your vaginal microbiome is even more important. But as a triple-board certified gynecologist, I may be a bit biased in this regard.
Let me walk you through some of the science surrounding vaginal health, probiotics, and the best ways to keep your microbiome strong throughout your life.
Meet The Gut-Vagina Axis
Mainstream science is finally beginning to understand the ways your gut and your vaginal microbiome are intimately connected. We’re calling this relationship the gut-vagina axis. (1)
Here's the short version: the bacteria living in your digestive tract don't just stay there. They travel. They communicate. They influence bacterial communities throughout your entire body — including the microbiome protecting your vagina, bladder, and vulva.
Furthermore, the vaginal canal’s close proximity to the end of your digestive tract (your rectum and anus) also means there’s the potential for microbes to make their way into the vagina from your gut, and from your gut into your vagina.
Ultimately, when your gut microbiome is thriving and diverse, it sends beneficial bacteria downstream to the vaginal microbiome.
Ideally, these good bacteria take up residence in your vaginal tract, crowding out harmful organisms and maintaining the slightly acidic environment that could keep infections at bay.
What Happens When Your Vaginal Microbiome Is In Dysbiosis?
When your gut microbiome is depleted or imbalanced, the protection it normally provides to your vaginal microbiome weakens. During perimenopause and menopause, when declining estrogen is already disrupting your vaginal ecosystem, the consequences can be significant.
This can lead to issues (even if you’ve never had them before) like:
Recurrent urinary tract infections (UTI)
Yeast infections
Bacterial vaginosis (BV)
Vaginal dryness and atrophy
Pain with sex
Painful urination
If you’re sexually active, a vaginal microbiome that is out of balance can also lead to a higher risk of sexually transmitted infections (STIs).
Lactobacillus Strains Of The Vaginal Microbiome
There are many, many different strains of microbes that inhabit your vaginal microbiome. But the most prominent one is Lactobacillus. (2,3)
The Lactobacillus in the vagina does an admirable job of keeping bad actors (like bacteria that cause UTI or BV) out of the area. And Lactobacillus also produces lactic acid, hydrogen peroxide, and bacteriocins, which are crucial for maintaining the acidic pH of the vagina and vulva. When your vaginal pH is at an ideal level, it creates a stronger environment that’s harder to throw off balance.
In fact, research suggests that lower levels of Lactobacillus are linked to negative vaginal health issues, including (4):
- Preterm birth
- Bacterial vaginosis
- Sexually transmitted infections
While there are well over a hundred different strains of Lactobacillus found in the vagina, there are a few that are notable (especially when it comes to the best probiotics for women, which we’ll talk more about in a minute).
Some of the more well-researched strains include:
The Role Of Diet For Your Vaginal Microbiome
Fermented foods are amazing. And you know I’m constantly repping a diet high in fiber and a wide variety of plant foods. In fact, I created an entire lifestyle based on this concept, called Keto-Green.
Get 11 of my best Keto-Green recipes here
So, yes, a diverse diet rich in fiber, fermented foods, and plant variety supports your overall microbiome. These habits are foundational, and I encourage every woman to prioritize them.
But here's the reality for most of us:
Modern diets are limited. Research suggests our ancestors consumed 150+ different plant species annually. Most modern Americans eat fewer than 20. This dramatic reduction in dietary diversity has impoverished our internal ecosystems.
Fermented foods can be inconsistent. The bacterial content of commercial yogurt, sauerkraut, and kombucha varies wildly. You don't know which strains you're getting or whether they'll survive your stomach acid. And you're almost certainly not getting some of the most powerful lactobacillus strains for women…they're not commonly found in food products.
Menopause adds extra challenges. Declining estrogen fundamentally changes the vaginal environment, reducing glycogen (the food source for beneficial bacteria) and raising pH. Even a well-fed gut microbiome struggles to maintain vaginal health against these hormonal headwinds.
Life gets in the way. Between work, family, stress, and the thousand other demands of midlife, consistently eating 30+ different plants per week and homemade fermented foods daily just isn't realistic for most women.
Does this mean diet doesn't matter? Absolutely not. It means diet is necessary but often not sufficient. Especially during the menopausal transition, when your body needs extra support.
What About Douching?
It’s important to mention here that douching for vaginal health is NOT recommended by gynecologists or supported by science. However, despite the research and recommendations against douching, it’s still popular and used by approximately 1 in 5 women to “clean” the vagina.
The reality is that douching disrupts the vaginal flora and is not necessary. The vagina is a self-cleaning organ.
In fact, douching has been linked to pelvic inflammatory disease, BV, pregnancy complications, and sexually transmitted diseases. (5)
Menopause And The Vaginal Microbiome
During your reproductive years, estrogen does something remarkable for your vaginal health: it stimulates the cells lining your vaginal walls to produce glycogen, a type of stored sugar.
Lactobacillus bacteria, the good guys, feed on this glycogen and convert it into lactic acid. This keeps your vaginal pH low and acidic (around 3.5 to 4.5), creating an environment where harmful bacteria and yeast simply can't thrive.
It's an elegant system. Estrogen feeds the tissue, the tissue feeds the bacteria, and the bacteria protect the environment. Everyone wins.
Then perimenopause arrives, and estrogen starts its unpredictable decline.
Here's what happens:
The tissue changes. Without adequate estrogen, vaginal walls become thinner, less elastic, and produce far less glycogen. The Lactobacillus bacteria that depend on glycogen for food begin to starve.
The pH rises. With fewer Lactobacillus bacteria producing lactic acid, your vaginal pH climbs from that protective acidic range up toward 5.0, 6.0, or even higher. This more alkaline environment rolls out the welcome mat for opportunistic bacteria and yeast.
The bacterial neighborhood shifts. Studies comparing premenopausal and postmenopausal women show dramatic differences in vaginal microbiome composition. Lactobacillus species that once dominated (sometimes making up 90% or more of the bacterial population) can dwindle to a fraction of their former numbers. In their place, you may see increases in bacteria associated with bacterial vaginosis, UTIs, and other infections.
The protective barrier weakens. Lactobacillus bacteria don't just acidify the environment; they physically occupy space on vaginal tissue, blocking pathogens from attaching. They produce hydrogen peroxide and other antimicrobial compounds. They compete for resources. When their populations crash, all of these protective mechanisms diminish.
The ripple effects begin. A less protected vaginal environment means more vulnerability to infection. The tissue itself, now thinner and drier, is more easily irritated and injured. Small tears during intimacy can let bacteria in. The nearby bladder becomes more susceptible to infection as protective bacteria no longer guard the urethral opening.
This cascade explains why so many women who never had vaginal or bladder issues suddenly develop them in their late 40s, 50s, and beyond.
The good news? This process is modifiable. You can't stop estrogen from declining (though topical DHEA could help locally), but you can actively replenish the beneficial bacteria your body is losing.
That's where targeted probiotic support potentially becomes helpful.
Bottom Line: Do You Need A Women’s Probiotic For Vaginal Health?
Well over a decade ago, I started lecturing on the vaginal microbiome and its role in maintaining vaginal health. At the time, women’s probiotics were considered cutting-edge medicine.
And now, even though we’ve learned so much about the microscopic organisms that keep things balanced in so many systems throughout the body, advances in vaginal probiotics have somewhat lagged behind those meant to address other areas.
So I decided to formulate one myself.
VB Probiotic is the culmination of years of research and dedication to finding the absolute best, clinically studied strains that actually work for women.
It’s built on science — no filler, just targeted support for midlife and beyond.
Click here to order and be the first to try this formula I’m so very proud of.
