Menopause Support

Menopause vaginal probiotics

1. Why consider a vaginal probiotic during menopause?

Since menopause can deplete or diminish healthy bacteria in the vagina, vaginal probiotics during menopause are a logical way to replenish healthy lactobacilli as we age. As such, vaginal probiotics can help protect and care for vaginal health during menopause.

According to Jessica Lloyd, head of MyVagina and a vaginal microbiome expert: “A menopausal vagina typically has low levels of all bacteria, not just lactobacilli. This lack of protective flora may result in the overgrowth of pathogens that can cause bacterial vaginosis or aerobic vaginitis, along with sometimes an increase in urinary tract infections.”

She says the pH of a menopausal vagina will also increase, and the actual number may vary depending on which microbes are present. The pH tends to be around 5.5. This can be problematic because a healthy vaginal microbiome sits at around 3.5-4.5 on the pH scale. Those above 4.5 are at risk of contracting bacterial vaginosis.

During menopause there are many ways to support adjusting the pH and helping to increase a depleted vaginal microbiome.

2. What healthy bacteria strains should I look for in my menopause probiotic?

Amelia’s vaginally inserted probiotic will provide a boost of healthy bacteria including Lactobacillus crispatus and Lactobacillus gasseri.

These species colonise almost every single healthy vagina across the globe and have excellent adhesive abilities to the vaginal wall cells. They create the most dominant healthy bacterial colonies which helps to generate lactic acid and regulate the pH.

In fact, L. crispatus is known by some scientists affectionately as the ‘superhero’ of the vagina and the most beneficial healthy bacteria in the vaginal microbiome. L. crispatus is present in the healthy vaginal microbiome of 65% of women while L. gasseri is present in more than 40% of women.

3. Should I choose an oral probiotic or vaginal probiotic during menopause?

The benefit of vaginal suppository or pessary probiotics over oral probiotics during menopause is they deliver a higher dose of healthy bacteria straight to the vagina. Being at the site of action, good bugs can directly replenish the vagina’s environment by colonising it and producing beneficial substances, like lactic acid, that would further protect and support a healthy vaginal microbiome.

Oral probiotics often have similar strains to vaginal pessary probiotics, but they need to go through the gastric system to get to the vagina. As the gastric system is a harsh, acidic environment, many of the good bugs from the probiotic may die before they reach the site of action in the vagina.

And while studies have shown oral probiotics do colonise in the vagina eventually, it can take longer than vaginal pessaries. Vaginal administered probiotics are usually administered less frequently and for shorter periods of time (5-10 days). Orally administered probiotics are usually applied over the course of 30 to 60 days.

4. Should I be only using a vaginal probiotic during menopause?

The answer is certainly no. Vaginal probiotics can play a powerful supporting role during menopause, however it’s not the full picture. Many women are prescribed vaginally applied estrogen or other hormone replacement therapy. It’s crucial to ensure that you consult with a healthcare practitioner to find the right treatment for you.