Best Probiotics for Women – Introduction
Microorganisms and bacteria are usually associated with their harmful and detrimental effects in causing illness or diseases. But not all of them are considered bad; some of these tiny organisms, also referred to as “good” or “friendly” bacteria, can be beneficial for human health and wellbeing. These are known as probiotics.
Probiotics, as defined by WHO (World Health Organization) and FAO (Food and Agriculture Organization of the United Nations), are: “The live microorganisms which, when administered in adequate amounts, confer a health benefit to the host.” 
Probiotics have been shown to be beneficial for women in a number of different ways, including enhancing vaginal health, gastrointestinal health, and the immune system. Probiotics can be taken from any source, depending upon the availability, such as food, beverages, and through supplements. In this article, we will discuss the most beneficial probiotics for women based on the requirements of their bodies.
Best Probiotics for Women for Different Purposes
Supporting Vaginal Health
One of the most well-known benefits of probiotics is their role in supporting women’s vaginal health. The vaginal environment is maintained by the mucosal epithelial barrier, endocrine regulation, and normal flora in the vagina.
Several aerobic, facultative anaerobic, and obligate anaerobic species can be found in the vaginal flora of reproductive-age women. They all play a crucial role in maintaining the optimum pH of the vagina, i.e., 3.8 to 4.2.  A healthy vaginal microbiome is dominated by Lactobacillus species, which produce lactic acid and create an acidic environment that inhibits the proliferation of harmful microorganisms.
When the balance of vaginal microorganisms is disturbed, such as by vaginal infections, sexual activity, aging, and vaginal douching, the population of Lactobacillus bacteria can decrease, allowing pathogenic bacteria and yeast to grow.  This imbalance can lead to the development of Bacterial Vaginosis (BV), yeast infections, and trichomoniasis.
Probiotics such as Lactobacillus strains have been shown to support vaginal health by restoring the balance of bacteria in the vagina. These probiotics can either be taken orally or applied topically to the skin. There is a growing body of evidence suggesting the positive impact of probiotics over vaginal health.
Lactobacillus species such as Lactobacillus rhamnosus GR-1, Lactobacillus fermentum RC-14, Lactobacillus bulgaris, Lactobacillus acidophilus, Lactobacillus reuteri RC-14, Lactobacillus acidophilus, Lactobacillus brevis CD2, Lactobacillus salivarius FV2, Lactobacillus plantarum FV9, Lactobacillus rhamnosus, Lactobacillus delbrueckii subsp. lactis DM8909, Lactobacillus fermentum LF15, Lactobacillus crispatus and Lactobacillus plantarum LP01; Bifidobacterium lactis and Streptococcus thermophilus have shown to reduce bacterial vaginosis symtoms. 
Probiotics such as Lactobacillus plantarum, Lactobacillus gasseri, Lactobacillus crispatus, Lactobacillus rhamnosus, Lactobacillus jensenii, Lactobacillus casei and Lactobacillus paracasei and Bifidobacterium adolescentis, have also shown a positive relationship in cervical cancer treatment.
Also, Lactobacillus rhamnosus GR-1, L. reuteri RC-14, L. brevis (CD2), L. salivarius subsp.salicinius (FV2), and L. plantarum (FV9) aids in improving vaginal environment. 
Supporting Maternal and Fetal Health
Probiotic supplementation is usually considered safe and beneficial for pregnant women, as they can help support both maternal and fetal health. Probiotics have been found helpful in reducing pregnancy-related symptoms including nausea, vomiting and stomach related problems. The potential benefits of probiotic during and after the pregnancy includes:
- Reducing the risk of preeclampsia (elevated blood pressure after 20 weeks of pregnancy or birth) by the consumption of probiotic milk containing Lactobacillus acidophilus (LA-5), Bifidobacterium lactis (Bb12), and Lactobacillus rhamnosus GG (LGG) has been shown. 
- In late pregnancy, giving a dose of L. salivarius PS2 orally appears to be an effective way to protect vulnerable individuals from developing infected mastitis. 
- Supplementing pregnant women with Lactobacillus was found to be effective for reducing risk of atopic eczema and impacting gestational age, and death rates. 
Similarly, only a few probiotic strains, including Lactobacillus rhamnosus HN001, have been studied for gestational diabetes (GD). Women who used this probiotic while pregnant had a generally lower incidence of gestational diabetes. The results were substantial for women who were at higher risk, such as those over 35 and those who had previously experienced GD. In actuality, none of the women in the research experienced GD, even though they had it in the past. 
Improving Gut Health
Probiotics have been shown to improve the gut health by improving the intestinal and gut microflora. Women are more likely than men to get irritable bowel syndrome (IBS), which affects 8 to 22% of the population. The reasons vary, but a loss of good gut bacteria is frequently one of them. L. rhamnosus GG was found to have minimal impact on IBS symptoms whereas L. plantarum 299V had a measurable positive impact. Lactobacillus rhamnosus GG, Bifidobacterium bifidum and Streptococcus thermophilus have been shown to reduce the occurrence of diarrhea.
Similarly, a mixture of four lactobacillus strains including (Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus bulgaricus, and Lactobacillus plantarum), three strains of bifidobacteria (Bifidobacterium infantis, Bifidobacterium breve, and Bifidobacterium longum) and S. thermophilus has proven effective in reducing the recurrence of chronic relapsing pouchitis. (Inflammation in the pouch lining after surgery for ulcerative colitis or other illnesses).
Certain probiotic strains have been identified for their role in supporting gut health, such as:
- Lactobacillus Rhamnosus GG;
- Streptococcus Boulardii;
- Lactobacillus Casei;
- Lactobacillus Plantarum;
- Lactobacillus Acidophilus;
- Lactobacillus Bulgaricus;
- Bifidobacteria. 
The combination of Bifidobacterium and Lactobacillus strains can also reduce functional intestinal constipation because of the influence of bacterial flora, which also improves the quality of food and increases the frequency of intestinal movement.  Similarly, according to another study, patients with Functional Bowel Disorders who take Bifidobacterium lactis Bi-07 and Lactobacillus acidophilus NCFM twice daily experience a reduction in their bloating and gas symptoms. 
Improving Mental Health
According to the World Health Organization, the incidence of mental health conditions like depression and anxiety is generally higher in women than in men. Probiotics would be beneficial in overcoming these issues.
There is a bidirectional pathway through which the brain and gut communicate with each other known as gut-brain axis. The intestinal microbiota produces neurotransmitter precursors that travel to the brain, where they regulate neurotransmitter levels, which influences mood and cognitive ability of a person.
Probiotics, which are also called “psychobiotics,” have been shown to improve mental health by changing the microbiome in the gut. Multiple researches have been reported on the efficacy of probiotics in reducing the negative symptoms of mental disease. 
The oral supplementation of Bifidobacterium bifidum and Lactobacillus helveticas have been shown positive consequences on mood and psychological distress.
The ingestion of yogurt containing a probiotic (Lactobacillus casei shirota) enhanced the mood of those who initially were feeling low.
Oral supplementation of a mixture of several probiotics (Bifidobacterium bifidum W23, Lactobacillus acidophilus W37, Bifidobacterium lactis W52, , Lactobacillus salivarius W24, Lactobacillus brevis W63, Lactobacillus casei W56, and Lactococcus lactis W19 and W58) have been resulted to improve the aggressive and ruminating behavior.
Probiotics taken daily showed a significant rise in mood, with lower levels of depression, rage, and fatigue as well as better sleep. The probiotic mixture contained Lactobacillus fermentum LF16, L. rhamnosus LR06, L. plantarum LP01, and Bifidobacterium longum BL04. 
Boosting the Immune System
Probiotics have been shown to strengthen the immune system, which is essential for preventing and treating illnesses and infections. Beneficial bacteria can aid in the improvement of the immune system, by increasing the production of immune cells and antibodies and by preventing inflammation. For example:
- According to the findings of one study, taking a probiotic supplement that included the strains of Lactobacillus casei, Lactobacillus paracasei, and L. fermentum prior to the onset of cold and flu season helped reduce the number of cases of upper respiratory tract infections. 
- Another study showed the potential of L. plantarum to boost host immunity by modulating both pro-inflammatory and anti-inflammatory cytokines. 
- Furthermore, the strain of Lactobacillus paragasseri SBT2055 according to the findings of another research may be able to lessen the severity of symptoms associated with the common cold. 
- Researchers have discovered in lab experiments that a particular strain of Lactobacillus paracasei may shield the gut from infection by Listeria, a more dangerous variety of bacteria. 
Maintaining Healthy Body-Weight
According to the Centers for Disease Control and Prevention, women tend to lose more body fat than men. They are more conscious regarding their physical appearance and body size. Depending on our weight, the types of bacteria that live in our gut change. When an obese person loses weight, their gut flora resembles that of a thin person more closely. Obese people have different gut microbiome compositions than lean people.
Probiotics have been found helpful in maintaining normal body weight by the following mechanisms.
Lactobacillus acidophilus ATCC 314, Lactobacillus bulgaricus FTCC 0411, Lactobacillus acidophilus FTCC 0291, Lactobacillus bulgaricus FTDC 1311 and Lactobacillus casei ATCC 393 have shown to reduce cholesterol by a different mechanisms in in vitro studies, which may be a promise for future study in human subjects. 
According to a 2017 study, eating foods containing probiotic Lactobacillus bacteria may lower levels of both total cholesterol and low-density lipoprotein, or “bad” cholesterol. 
It has been shown that the probiotic strains including Lactobacillus acidophilus CUL21 (NCIMB 30156), Lactobacillus acidophilus CUL60 (NCIMB 30157), Bifidobacterium bifidum CUL20 (NCIMB 30153), Lactobacillus plantarum CUL66 (NCIMB 30280), and Bifidobacterium animalis subsp. lactis CUL34 (NCIMB 30172) have been resulted in reducing Low-Density Lipoprotein (LDL) cholesterol and obesity. 
Hypertension, also known as high blood pressure, is a common medical condition that is disproportionately prevalent among women all over the world. Recent studies have suggested that probiotics could help lower blood pressure in hypertensive women, which would be beneficial for overall health. Furthermore, a meta-analysis found that taking probiotics like lactobacilli and bifidobacteria led to a moderate and highly significant drop in either systolic blood pressure or diastolic blood pressure compared to taking a placebo. So, probiotics should be used as a way to treat high blood pressure. 
In yet another study, researchers found that taking probiotics led to an increase in the amount of vitamin D in the blood, which is an important factor in lowering the risk of developing hypertension. 
Promoting Skin Health
Probiotics can help women by providing health benefits such as maintaining the balance of good and bad microflora, protecting the skin immune system, producing vitamin B2, possessing anti-inflammatory and anti-allergic effects, providing skin youthfulness and freshness, improving skin barrier properties, preventing and improving eczema and atopic disorders, aiding in acne therapy. It is also beneficial for skin inflammation, skin homeostasis, hair growth, and stress responses, and protecting against UV-induced skin damage and wounds. 
Lactobacillus paracasei and Bifidobacterium lactis led to a reduction in the skin’s neurosensitivity. Individuals who suffer from eczema, rosacea, or very dry, irritated skin may be better able to accept products without experiencing stinging or burning.  
Lactobacillus has been shown to reduce inflammation of the skin and improve the barrier function of the skin. It might make acne and redness less noticeable. 
Bacillus coagulans may boost free radical scavengers, which can help slow the aging process of the skin. 
L. rhamnosus GG, L. rhamnosus LC705, B. animalis Bb-12, L. acidophilus NCFB-L61748, L. bulgaricus ATCC 11842, S. thermophilus T101, and P. freudenreichii Shermanii strain JS show antiinflammatory characterstics to the skin. 
Probiotics, both oral and topically applied, appear to be useful in the treatment of several inflammatory skin conditions and have a potential benefit in the prevention and treatment of skin cancer. Following are the strains of probiotics that reduce the proliferation of cancerous cells by inducing apoptosis:
- Bifidobacterium adolescentis SPM0212;
- Enterococcus faecium RM11;
- Lactobacillus fermentum RM28;
- Bacillus polyfermenticus;
- Pediococcus pentosaceus FP3, Lactobacillus salivarius FP25/FP35, Enterococcus faecium FP51;
- Lactobacillus plantarum A7, Lactobacillus rhamnosus GG;
- Clostridium butyricum ATCC, Bacillus subtilis ATCC 9398;
- Bacillus polyfermenticus KU3;
- Lactococcus lactis NK34;
- Lactobacillus casei ATCC 393. 
Overall, the evidence suggests that certain strains of probiotics, such as Lactobacillus and Bifidobacterium, may have beneficial effects on overall health and well-being. Probiotics should be incorporated into a woman’s diet either through the use of dietary supplements or through the consumption of foods that are rich in probiotics. Yogurt, kefir, sauerkraut, and kimchi are all excellent examples of such foods. It is always advisable to consult a doctor or a nutritionist to determine the optimal dosing and duration of probiotic treatment.
- Khalighi A, Behdani R, Kouhestani S. Probiotics: A Comprehensive Review of Their Classification, Mode of Action and Role in Human Nutrition [Internet]. Probiotics and Prebiotics in Human Nutrition and Health. InTech; 2016. Available from: Probiotics: A Comprehensive Review of Their Classification, Mode of Action and Role in Human Nutrition | IntechOpen
- Hildebrand JP, Kansagor AT. Vaginitis. [Updated 2022 Nov 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470302
- García-Closas, M., Herrero, R., Bratti, C., Hildesheim, A., Sherman, M. E., Morera, L. A., & Schiffman, M. (1999). Epidemiologic determinants of vaginal pH. American journal of obstetrics and gynecology, 180(5), 1060–1066. https://doi.org/10.1016/s0002-9378(99)70595-8
- Wu, S., Hugerth, L. W., Schuppe-Koistinen, I., & Du, J. (2022). The right bug in the right place: opportunities for bacterial vaginosis treatment. NPJ biofilms and microbiomes, 8(1), 34. The right bug in the right place: opportunities for bacterial vaginosis treatment – PMC (nih.gov)
- Mei, Z., & Li, D. (2022). The role of probiotics in vaginal health. Frontiers in cellular and infection microbiology, 12, 963868. https://doi.org/10.3389/fcimb.2022.963868
- Nordqvist, M., Jacobsson, B., Brantsæter, A. L., Myhre, R., Nilsson, S., & Sengpiel, V. (2018). Timing of probiotic milk consumption during pregnancy and effects on the incidence of preeclampsia and preterm delivery: a prospective observational cohort study in Norway. BMJ open, 8(1), e018021. https://doi.org/10.1136/bmjopen-2017-018021
- Fernández, L., Cárdenas, N., Arroyo, R., Manzano, S., Jiménez, E., Martín, V., & Rodríguez, J. M. (2016). Prevention of Infectious Mastitis by Oral Administration of Lactobacillus salivarius PS2 During Late Pregnancy. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 62(5), 568–573. https://doi.org/10.1093/cid/civ974
- Kuang, L., & Jiang, Y. (2020). Effect of probiotic supplementation in pregnant women: a meta-analysis of randomised controlled trials. The British journal of nutrition, 123(8), 870–880. https://doi.org/10.1017/S0007114519003374
- Wickens, K. L., Barthow, C. A., Murphy, R., Abels, P. R., Maude, R. M., Stone, P. R., Mitchell, E. A., Stanley, T. V., Purdie, G. L., Kang, J. M., Hood, F. E., Rowden, J. L., Barnes, P. K., Fitzharris, P. F., & Crane, J. (2017). Early pregnancy probiotic supplementation with Lactobacillus rhamnosus HN001 may reduce the prevalence of gestational diabetes mellitus: a randomised controlled trial. The British journal of nutrition, 117(6), 804–813. https://doi.org/10.1017/S0007114517000289
- Tuohy, K. M., Probert, H. M., Smejkal, C. W., & Gibson, G. R. (2003). Using probiotics and prebiotics to improve gut health. Drug discovery today, 8(15), 692–700. https://doi.org/10.1016/s1359-6446(03)02746-6
- Mitelmão, F. C. R., Bergamaschi, C. C., Gerenutti, M., Hächel, K., Silva, M. T., Balcão, V. M., & Vila, M. M. D. C. (2021). The effect of probiotics on functional constipation in adults: Double-blind, randomized, placebo-controlled study. Medicine, 100(10), e24938. https://doi.org/10.1097/MD.0000000000024938
- Ringel-Kulka, T., Palsson, O. S., Maier, D., Carroll, I., Galanko, J. A., Leyer, G., & Ringel, Y. (2011). Probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 versus placebo for the symptoms of bloating in patients with functional bowel disorders: a double-blind study. Journal of clinical gastroenterology, 45(6), 518–525. https://doi.org/10.1097/MCG.0b013e31820ca4d6
- Sarkar, A., Lehto, S. M., Harty, S., Dinan, T. G., Cryan, J. F., & Burnet, P. W. J. (2016). Psychobiotics and the Manipulation of Bacteria-Gut-Brain Signals. Trends in neurosciences, 39(11), 763–781. Psychobiotics and the Manipulation of Bacteria–Gut–Brain Signals – PMC (nih.gov)
- Marotta, A., Sarno, E., Del Casale, A., Pane, M., Mogna, L., Amoruso, A., Felis, G. E., & Fiorio, M. (2019). Effects of Probiotics on Cognitive Reactivity, Mood, and Sleep Quality. Frontiers in psychiatry, 10, 164. https://doi.org/10.3389/fpsyt.2019.00164
- Zhang, H., Yeh, C., Jin, Z., Ding, L., Liu, B. Y., Zhang, L., & Dannelly, H. K. (2018). Prospective study of probiotic supplementation results in immune stimulation and improvement of upper respiratory infection rate. Synthetic and systems biotechnology, 3(2), 113–120. https://doi.org/10.1016/j.synbio.2018.03.001
- Zhao, W., Peng, C., Sakandar, H. A., Kwok, L. Y., & Zhang, W. (2021). Meta-Analysis: Randomized Trials of Lactobacillus plantarum on Immune Regulation Over the Last Decades. Frontiers in immunology, 12, 643420. https://doi.org/10.3389/fimmu.2021.643420
- Kobatake, E., Iwama, Y., Arai, T., Shioya, N., Kise, M., & Kabuki, T. (2022). Intake of Lactobacillus paragasseri SBT2055 improves subjective symptoms of common cold during winter season in healthy adults: A randomized, double-blind, placebo-controlled parallel-group comparative study. Frontiers in nutrition, 9, 1063584. https://doi.org/10.3389/fnut.2022.1063584
- Koo, O. K., Amalaradjou, M. A., & Bhunia, A. K. (2012). Recombinant probiotic expressing Listeria adhesion protein attenuates Listeria monocytogenes virulence in vitro. PloS one, 7(1), e29277. https://doi.org/10.1371/journal.pone.0029277
- Lye Huey-Shi, Rahmat-Ali GulamRusul, Liong Min-Tze. Mechanisms of cholesterol removal by lactobacilli under conditions that mimic the human gastrointestinal tract International Dairy Journal. 2010 Mar;20(3):169-175.
- Wu, Y., Zhang, Q., Ren, Y., & Ruan, Z. (2017). Effect of probiotic Lactobacillus on lipid profile: A systematic review and meta-analysis of randomized, controlled trials. PloS one, 12(6), e0178868. https://doi.org/10.1371/journal.pone.0178868
- Michael, D.R., Jack, A.A., Masetti, G. et al. A randomised controlled study shows supplementation of overweight and obese adults with lactobacilli and bifidobacteria reduces bodyweight and improves well-being. Sci Rep 10, 4183 (2020). https://doi.org/10.1038/s41598-020-60991-7
- Qi, D., Nie, X. L., & Zhang, J. J. (2020). The effect of probiotics supplementation on blood pressure: a systemic review and meta-analysis. Lipids in health and disease, 19(1), 79. https://doi.org/10.1186/s12944-020-01259-x
- Upadrasta, A., & Madempudi, R. S. (2016). Probiotics and blood pressure: current insights. Integrated blood pressure control, 9, 33–42. https://doi.org/10.2147/IBPC.S73246
- Roudsari, M. R., Karimi, R., Sohrabvandi, S., & Mortazavian, A. M. (2015). Health effects of probiotics on the skin. Critical reviews in food science and nutrition, 55(9), 1219–1240. https://doi.org/10.1080/10408398.2012.680078
- Farage M. A. (2019). The Prevalence of Sensitive Skin. Frontiers in medicine, 6, 98. https://doi.org/10.3389/fmed.2019.00098
- Lize Delanghe, Irina Spacova, Joke Van Malderen, Eline Oerlemans, Ingmar Claes, Sarah Lebeer; The role of lactobacilli in inhibiting skin pathogens. Biochem Soc Trans 30 April 2021; 49 (2): 617–627. doi: https://doi.org/10.1042/BST20200329
- Porubsky, C. F., Glass, A. B., Comeau, V., Buckley, C., Goodman, M. B., & Kober, M.-M. (2018). The Role of Probiotics in Acne and Rosacea. InTech. doi: 10.5772/intechopen.79044
- Górska, A., Przystupski, D., Niemczura, M. J., & Kulbacka, J. (2019). Probiotic Bacteria: A Promising Tool in Cancer Prevention and Therapy. Current microbiology, 76(8), 939–949. https://doi.org/10.1007/s00284-019-01679-8
Diverticulosis vs Diverticulitis