Probiotics for bacterial vaginosis (BV), especially those with Lactobacillus strains, can help restore healthy vaginal pH by replenishing the good bacteria BV reduces. This not only helps manage symptoms but may also prevent BV from coming back.

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How Probiotics Help With BV

Bacterial vaginosis (BV) happens when the natural balance of bacteria in the vagina gets disrupted. Normally, good bacteria called Lactobacillus keep the vagina slightly acidic, which helps stop infections. However, things like sex, douching, antibiotics, or hormone changes can raise the vaginal pH and let harmful bacteria grow.

Probiotics are good bacteria that help fix this balance. They can:

  • Bring back healthy bacteria: They add more good Lactobacillus to the vagina to keep it healthy and acidic.
  • Fight bad bacteria: Some probiotics produce substances that stop harmful bacteria from growing.
  • Lower the chances of BV coming back: Taking probiotics after medicine can help keep BV away longer.
  • Ease uncomfortable symptoms: Probiotics can reduce itching, unusual discharge, and odors by calming irritation.

Probiotics can work well on their own or with other BV treatments. Because they are natural and usually safe, they offer a gentle way to protect vaginal health and help prevent future infections.

How quickly do probiotics help with BV?

While probiotics may begin helping within five days, fully clearing BV—especially recurring cases—can take several weeks or even months. The time it takes depends on the individual and how severe the infection is. Taking antibiotics together with probiotics generally speeds up recovery.

Which Probiotics Work Best?

The best probiotics for treating BV are based on Lactobacilli, such as:

  • Lacticaseibacillus rhamnosus
  • Lactobacillus acidophilus
  • Lactobacillus fermentum
  • Lactobacillus reuteri

These strains are most effective because they help restore the vagina’s natural balance by producing lactic acid, which lowers pH and makes it harder for harmful bacteria to grow.

Some, like Lacticaseibacillus rhamnosus and Lactobacillus reuteri, have also been shown to stick to vaginal walls and block infection-causing microbes. Together, they support a healthier microbiome and help reduce the risk of BV coming back.

Supplement Options

Many probiotic supplements are available, including those formulated with Lactobacilli strains that support vaginal health and help manage BV. These come in many forms—capsules, powders, wafers, liquids, and vaginal suppositories.

Lactobacilli are also found in certain fermented foods, including:

  • Yogurt
  • Kefir
  • Kimchi
  • Kombucha
  • Miso
  • Pickles
  • Sauerkraut
  • Tempeh

For treating BV, some evidence suggests that oral probiotics are most effective, though other studies indicate that direct vaginal application may offer faster relief. Applying plain yogurt topically is generally considered safe, but avoid using fermented foods like kimchi or pickles, as their acidity and spices can irritate sensitive vaginal tissue.

Although you may not be able to completely prevent BV, regularly including probiotics in your diet is one of the best ways to help reduce the risk and maintain a healthy vaginal pH.

Finding the Right Dose

Probiotic supplements vary in strength, typically ranging from 1 to 50 billion colony-forming units (CFUs). While there’s no standard dose, it’s generally recommended to start with at least 1 billion CFUs.

Your healthcare provider can help determine the right dose and timing for you. Common probiotic regimens include:

  • Two capsules daily for six weeks
  • Two capsules for seven days, then a seven-day break, followed by another seven days
  • Once weekly for several months (if taken vaginally)
  • Continuous daily use for recurring BV

If you’re also taking antibiotics, your provider may suggest taking probiotics at least two hours afterward.

Possible Side Effects

Probiotics are generally safe for healthy individuals, but they may cause mild side effects, such as:

  • Upset stomach
  • Bloating
  • Gas
  • Constipation
  • Increased thirst

Although rare, probiotics may pose risks for people with weakened immune systems or serious underlying health conditions, including the potential for infections.

In the United States, the Food and Drug Administration (FDA) does not regulate dietary supplements the way it regulates prescription medications. As a result, some supplement products may not contain the ingredients listed on the label. When choosing a supplement, look for products independently tested or certified by organizations such as the National Sanitation Foundation (NSF), United States Pharmacopeia (USP), or ConsumerLab. For personalized guidance, consult your healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.

Other Ways to Treat BV

 Bacterial vaginosis is most commonly treated with one of the following antibiotics:

  • Flagyl (metronidazole)
  • Cleocin, Clindesse, Xaciato (clindamycin)
  • Tindamax (tinidazole)

In some cases, your healthcare provider may also recommend alternative or additional treatments, such as:

  • Boric acid
  • Vaginal vitamin C
  • Xifaxan (rifaximin)
  • Sucrose gel

These treatments can come as oral medications or vaginal creams or gels. For recurring BV (infections that keep coming back), your provider may prescribe both oral and vaginal treatments at the same time.

Studies show that combining probiotics with antibiotics can be more effective than using either one alone.

What Is the Strongest Treatment for BV?

The strongest treatment for bacterial vaginosis (BV) is antibiotics like metronidazole or clindamycin. Always finish the entire course as your healthcare provider recommends.

Key Takeaways

  • Probiotics help treat and prevent BV by restoring healthy vaginal bacteria.
  • Lactobacillus strains like L. rhamnosus and L. reuteri are most effective.
  • Probiotics are available in fermented foods and supplements, and work best when taken by mouth.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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Additional Reading

Brandi Jones MSN-Ed, RN-BC

By Brandi Jones, MSN-ED RN-BC

Jones is a registered nurse and freelance health writer with more than two decades of healthcare experience.

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