While there was some early enthusiasm for probiotics with lactobacillus rhamnosus and reuteri, the data hasn’t really panned out. There have been quite a few studies looking at probiotics for improving the vaginal ecosystem, where “improving” is typically defined as treating or preventing infections, but sometimes these studies just look at the ability of probiotics taken orally to find their way into the vagina. We Have Yet to Replicate the Phenomenal Power of Vaginal Lactobacilli Modulation of the immune system locally in the vagina. Lactobacilli may accomplish this by sticking to the cells themselves and physically competing for space on the cells, or by releasing substances that prevent adherence. Prevention of other bacteria and yeast from sticking to cells in the vagina (sticking to the cells is an important step in causing problems). Production of bacteriocins which are substances that can kill bacteria.Ĭompetition with other bacteria and yeast for nutrients. We think that lactobacilli work by way of several mechanisms, including, but not limited to the following:įermentation of glycogen (sugar) producing lactic acid, which lowers the pH, affecting how some bacteria grow.

How all the bacteria interact to keep the vagina healthy is highly complex. For example, iron in menstrual blood can help some, but not all, bacteria grow, and some bacteria stick to menstrual blood causing numbers to drop because the bacteria is essentially flushed out with menstruation. In addition, this might change based on the day of the menstrual cycle. However, these community states fluctuate, so a snapshot showing how much of each lactobacilli (and other bacteria) are present in the morning will look different from a snapshot taken in the evening. Overall, the main species of lactobacilli found in the vagina are: Four of these five community states are dominated by lactobacilli, and one has less lactobacilli. So person A may have an entirely different combination of vaginal bacteria or different community state as compared with person B, and yet they can still both be perfectly healthy. In fact, there are five main bacterial communities (think clubs) in the vagina, called community states. The vagina is filled with different types of bacteria.

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