This article was sponsored by Church & Dwight Co., Inc.
The human vaginal microbiota consists of a balance of beneficial microbes and opportunistic pathogens, including bacteria and yeast.1 In a healthy vagina, the microbiota exists in a reciprocal relationship with the body.2
Both internal and external factors can disrupt the balance of the vaginal microbiome. When there is an imbalance of vaginal microflora, this is called vaginal dysbiosis. A feature of vaginal dysbiosis is an increase in vaginal pH, which can be caused by reduced concentrations of lactic acid.2 Lactobacillus species, commonly found in the female reproductive tract, are believed to play an important role in the vaginal microbiome due to their production of lactic acid, which helps maintain vaginal pH.2,3
The composition of the vaginal microbiome is constantly changing. Hormonal fluctuations throughout a woman’s reproductive life (eg, menstruation and pregnancy), medications (eg, antibiotics and hormonal contraceptives), sex, and vaginal douching are all factors that can disrupt normal flora.4,5,6,7
To maintain the balance of the vaginal flora, women can benefit from a daily probiotic formulation containing Lactobacillus strains to help maintain microflora in a normal range and help support vaginal health.
Lactobacillus are the dominant species of bacteria found in a healthy and balanced vagina.2 This species of bacteria thrives in an anaerobic environment, such as the vagina, and produces byproducts such as lactic acid, hydrogen peroxide, and bacteriocins. As the main source of lactic acid production in the vagina, Lactobacillus species help maintain vaginal pH below 4.5.1
DIETARY PROBIOTIC SUPPLEMENTS
The International Scientific Association for Probiotics and Prebiotics defines probiotics as “live microorganisms that, when administered in sufficient amounts, confer a health benefit on the host.”8 The two main sources of probiotics are foods with natural or added probiotics (eg, yogurt and infant formula) and dietary supplements.8 Depending on the probiotic strains provided in the dietary supplement product, the health benefits will vary. Some probiotic supplements support digestive or immune health, others have different health benefits.*9
There are several supplements that are specifically formulated to provide support for vaginal health. One such example is RepHresh Pro-B Probiotic Feminine Supplement, an OTC option that is formulated with specific strains, Lactobacillus router RC-14 (formerly classified as L. tip RC-14) and Lactobacillus rhamnosus GR-1, which support vaginal health. Both types of bacteria have been studied and shown to positively affect the composition of the vaginal microbiota.*9
REPHRESH PRO-B PROBIOTIC FEMALE SUPPLEMENT
Taken once daily, RepHresh Pro-B capsules contain 5 billion colony-forming units of 2 clinically tested beneficial probiotic strains, Lactobacillus rhamnosus GR-1 and Lactobacillus router RC-14. A clinical study showed that RepHresh Pro-B Female Probiotic Supplement starts working in just 7 days. It provides 24/7 protection when used daily and helps maintain the balance of yeast and bacterial flora, which in turn supports a healthy vagina.*9 This dietary supplement is free of dairy, egg, fish, peanut, gluten and soy and has a shelf life of 90 days once opened.9
Lactobacillus strains are probiotic strains that have a long history of safe use in humans.10 Women should talk to their health care provider before starting a dietary supplement or if they suspect a vaginal infection, develop an unfamiliar discharge, pain, or any symptoms that cause concern.9
THE ROLE OF THE PHARMACIST
Pharmacists can be a helpful resource for answering any questions about effective and safe probiotic options available at the pharmacy. When a product recommendation is requested, pharmacists can provide information on the differences between each probiotic formulation (eg, digestive health formulation, probiotic-enhanced yogurts, vaginal health formulation) and the benefits associated with the different types.8
Pharmacists have an opportunity to help women who come to the pharmacy and want information about a product that supports vaginal health and want to maintain their vaginal pH within a normal range. Pharmacists can share information about RepHresh Pro-B Female Probiotic Supplement, including its 2 clinically tested probiotic strains to help maintain flora important to overall vaginal health, balancing yeast and bacteria to maintain women’s health.*9
*These statements have not been evaluated by the United States Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
1. Chen X, Lu Y, Chen T, Li R. Female vaginal microbiome in health and bacterial vaginosis. Front Cell Infectious Microbiol. 2021; 11: 631972. doi:10.3389/fcimb.2021.631972
2. Ma B, Forney LJ, Ravel J. The vaginal microbiome: rethinking health and disease. Annu Rev Microbiol. 2012; 66 (1): 371-389. doi:10.1146/annurev-micro-092611-150157
3. Ceccarani C, Foschi C, Parolin C, etc. Vaginal microbiome diversity and metabolism during genital infections. Sci Rep. 2019; 9 (1): 14095. doi:10.1038/s41598-019-50410-x
4. Lin YP, Chen WC, Cheng CM, Shen CJ. Vaginal pH value for clinical diagnosis and treatment of common vaginitis. Diagnosing (BASEL). 2021; 11 (11): 1996. doi:10.3390/diagnostics11111996
5. Spinillo A, Capuzzo E, Nicola S, Baltaro F, Ferrari A, Monaco A. Impact of oral contraception on vulvovaginal candidiasis. Contraception. 1995; 51 (5): 293-297. doi:10.1016/0010-7824(95)00079-p
6. Cribby S, Taylor M, Reid G. Vaginal microbiota and the use of probiotics. Interdiscip Perspect Infect Dis. 2008;2008:256490. doi: 10.1155/2008/256490
7. Amabebe E, Anumba DOC. Vaginal microenvironment: The physiological role of lactobacilli. Before Med (LAUSANNE). 2018; 5:181. doi:10.3389/fmed.2018.00181
8. Hill C, Garner F, Reid G, et al. Consensus statement of the International Scientific Association for Probiotics and Prebiotics on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014 (11): 506–514. doi:10.1038/nrgastro.2014.66
9. RepHresh PRO-B Female Probiotic Supplement. Inserting the package. Church and Dwight Co., Inc. 2022.
10. Probiotics and prebiotics. World Organization of Gastroenterology. Published February 2017. Accessed 24 May 2022. https://www.worldgastroenterology.org/UserFiles/file/guidelines/probiotics-and-prebiotics-english-2017.pdf