Condition
Bacterial Vaginosis (BV)
Bacterial vaginosis is a common condition in which protective Lactobacillus bacteria in the vagina decline and others, like Gardnerella, overgrow, often causing thin gray discharge and a fishy odor. Lactobacillus probiotics have the strongest evidence, with moderate support for vitamin D and vaginal boric acid, and symptoms improved in one calendula trial. That trial had only 80 women, and large trials of L. acidophilus alone are limited.
Sources: PMID 29441319
- Supplements studied
- 4
- Graded outcomes
- 2
- Trials
- 2
- People studied
- 2,450
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Vaginal Health L. acidophilus is a natural constituent of vaginal flora and has moderate evidence supporting its use for vaginal health. Studies confirm mother-to-child transmission of L. acidophilus at delivery. Clinical use for bacterial vaginosis prevention is supported by its colonization capacity, though large RCTs specific to L. acidophilus alone are limited. | Improves (the measure goes up) | Small effect | 2 studies | |||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Bacterial Vaginosis Symptoms Moderate Improvement | Improves (the measure goes down) | Moderate effect | 1 study | 80 people | ||
Studies that measured bacterial vaginosis symptoms | ||||||
Probiotics
- Bacterial Vaginosis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Bacterial Vaginosis Symptoms | Improves (the measure goes down) | 1 study | 1,662 people | |||
Studies that measured bacterial vaginosis symptoms | ||||||
Vitamin C
- Bacterial Vaginosis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Bacterial Vaginosis Symptoms | Improves (the measure goes down) | 1 study | 277 people | |||
Studies that measured bacterial vaginosis symptoms | ||||||
Key findings
- Vaginal HealthImproves (the measure goes up)
- Bacterial Vaginosis SymptomsImproves (the measure goes down)
The Bacterial Vaginosis Supportive Care protocol
2 primary supplements · 5 supporting supplements
- Probiotics (Lactobacillus)10–20 billion CFU Lactobacillus-containing probiotic (L. rhamnosus, L. reuteri, L. crispatus) daily; oral or vaginal
- Vitamin D2,000–4,000 IU daily (target 40–60 ng/mL)
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for Bacterial Vaginosis (BV). If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
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Studies cited
100 studies from PubMed
- The effects of probiotic supplementation on cardiometabolic health in patients with prediabetes: a systematic review, meta-analysis, and GRADE assessment.
- Lactococcus lactis strain Plasma activates plasmacytoid dendritic cells and mitigates common cold-like symptoms in healthy adults: a meta-analysis of individual participant data.
- Probiotics and Immune Health: Current Knowledge and Future Perspectives
- Probiotics for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
- Potential benefits of L. acidophilus in dyslipidemic rats
- Effect of a Probiotic Supplement Containing Lactobacillus Acidophilus and Bifidobacterium Animalis Lactis on Urine Oxalate in Calcium Stone Formers with Hyperoxaluria: A Randomized, Placebo-controlled, Double-blind and In-vitro Trial
- Probiotics for Prevention and Treatment of Diarrhea: A Systematic Review and Meta-Analysis
- Probiotics for the Prevention and Treatment of Depression: A Systematic Review and Meta-Analysis
- Effects of Probiotics on Metabolic Syndrome: A Systematic Review of Randomized Clinical Trials
- Probiotics and Weight Loss: A Systematic Review and Meta-Analysis
- The Gut Microbiome, Probiotics, and Their Impact on Skin Health: A Review
- Preventive Effect of Lactobacillus acidophilus XY27 on DSS-Induced Ulcerative Colitis in Mice
- Immune enhancing effects of Lactobacillus acidophilus on Newcastle disease vaccination in chickens
- Lactobacillus acidophilus attenuates toxin production by Vibrio cholerae and shigella dysenteriae following intestinal epithelial cells infection
- Health Benefits of Probiotics: A Review
- Probiotics: Comprehensive Review of Growth Promotion Mechanisms and Action in Food Products
- Probiotics: Classification, Mode of Action and Role in Human Nutrition
- Safety of Probiotics: A Comprehensive Review
- Probiotics, Prebiotics and Inflammation: A Review of the Science
- Probiotics and Healthy Ageing: A Systematic Review and Meta-Analysis
- Primary prevention of Clostridium difficile infections with a specific probiotic combining Lactobacillus acidophilus, L. casei, and L. rhamnosus strains: assessing the evidence
- Lactobacillus acidophilus Alleviated Salmonella-Induced Goblet Cells Loss and Colitis by Notch Pathway
- Lactobacillus acidophilus ameliorates pain and cartilage degradation in experimental osteoarthritis
- Efficacy of a standardized extract of Matricariae chamomilla L., Melissa officinalis L. and tyndallized Lactobacillus acidophilus (HA122) in infantile colic: An open randomized controlled trial
- Uromodulin-SlpA binding dictates Lactobacillus acidophilus uptake by intestinal epithelial M cells
- World Gastroenterology Organisation Global Guidelines: Probiotics and Prebiotics
- Probiotics for Human Use: Current Advances and Future Perspectives
- Lactobacillus acidophilus Mixture in Treatment of Children Hospitalized With Acute Diarrhea
- Efficacy of prolonged ingestion of Lactobacillus acidophilus L-92 in adult patients with atopic dermatitis
- Lactobacillus acidophilus attenuates Salmonella-induced intestinal inflammation via TGF-β signaling
- The effects of Lactobacillus acidophilus as feed supplement on skin mucosal immune parameters, intestinal microbiota, stress resistance and growth performance of black swordtail
- Lactobacillus acidophilus CP23 with weak immunomodulatory activity lacks anchoring structure for surface layer protein
- Lactobacillus acidophilus modulates the virulence of Clostridium difficile
- Effects of oral administration of Lactobacillus acidophilus L-92 on the symptoms and serum cytokines of atopic dermatitis in Japanese adults: a double-blind, randomized, clinical trial
- Effects of oral administration of Lactobacillus acidophilus L-92 on the symptoms and serum markers of atopic dermatitis in children
- Probiotic Lactobacillus acidophilus and L. casei mix sensitize colorectal tumoral cells to 5-fluorouracil-induced apoptosis
- Influence of vitamin C supplementation on oxidative and immune changes after an ultramarathon
- Transmission of Lactobacillus jensenii and Lactobacillus acidophilus from mother to child at time of delivery
- The effect of versus metronidazole on bacterial vaginosis in women: A double-blind randomized controlled trial.
- Therapeutic effectiveness of a Calendula officinalis extract in venous leg ulcer healing.
- Evaluation of Calendula officinalis as an anti-plaque and anti-gingivitis agent.
- Comparing the effects of Calendula officinalis and clotrimazole on vaginal Candidiasis: A randomized controlled trial.
- Treatment of acute wounds in hand with L.: A randomized trial.
- Antioxidant capacity of calendula officinalis flowers extract and prevention of radiation induced oropharyngeal mucositis in patients with head and neck cancers: a randomized controlled clinical study.
- No differences between Calendula cream and aqueous cream in the prevention of acute radiation skin reactions--results from a randomised blinded trial.
- Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer.
- Use of calendula ointment after episiotomy: a randomized clinical trial.
- Low-level laser therapy and Calendula officinalis in repairing diabetic foot ulcers.
- Calendula extract: effects on mechanical parameters of human skin.
- Probiotics for people with cystic fibrosis.
- Probiotics for the prevention of gestational diabetes mellitus: A meta-analysis of randomized controlled trials.
- The effects of probiotics supplements on metabolic indices and clinical signs in patients with diabetic retinopathy, a randomized double blind clinical trial.
- Effect of applying Lactiplantibacillus plantarum subsp. plantarum N793 to the scalps of men and women with thinning hair: a randomized, double-blind, placebo-controlled, parallel-group study.
- Randomized Clinical Trial to Evaluate the Effect of Probiotic Intake on Androgenic Alopecia.
- Impact of probiotics on sleep quality and mood states in patients with insomnia: a systematic review and meta-analysis.
- Gaba-producing lactobacilli boost cognitive reactivity to negative mood without improving cognitive performance: A human Double-Blind Placebo-Controlled Cross-Over study.
- The effect of probiotic consumption on lipid profile, glycemic index, inflammatory markers, and liver function in NAFLD patients: A systematic review and meta-analysis of randomized controlled trials.
- Efficacy of probiotics in the treatment of oral mucositis in head and neck cancer patients: A systematic review and meta-analysis.
- The effect of probiotics on severe oral mucositis in cancer patients undergoing chemotherapy and/or radiotherapy: A meta-analysis.
- Oral probiotic supplementation to alleviate diarrhea induced by fluoropyrimidines or irinotecan-based chemotherapy: A systematic review and meta-analysis.
- The impact of probiotics on core autism symptoms - A systematic review and meta-analysis of randomized clinical trials.
- Efficacy and safety of Bacteroides fragilis BF839 for pediatric autism spectrum disorder: a randomized clinical trial.
- Probiotics for autism spectrum disorder: An updated systematic review and meta-analysis of effects on symptoms.
- The efficacy and safety of probiotics in the adjuvant treatment of psoriasis: a systematic review and meta-analysis of randomized controlled trials.
- Effects of probiotic supplementation on testosterone levels in healthy ageing men: A 12-week double-blind, placebo-controlled randomized clinical trial.
- A 12-Week, Single-Centre, Randomised, Double-Blind, Placebo-Controlled, Parallel-Design Clinical Trial for the Evaluation of the Efficacy and Safety of Lactiplantibacillus plantarum SKO-001 in Reducing Body Fat.
- Effects of oral supplementation of probiotics on body weight and visceral fat in obese patients: a meta-analysis and systematic review.
- The effects of probiotics administration during pregnancy on preeclampsia and associated maternal, fetal, and newborn outcomes: a systematic review and meta-analysis.
- Effects of probiotics supplementation on glycemic profile in adults with type 2 diabetes mellitus: A grade-assessed systematic review and dose-response meta-analysis of randomized controlled trials.
- The Effect of Probiotics on Obesity with Comorbid Depression: A Systematic Review and Meta-Analysis.
- A network meta-analysis of probiotics in the treatment of childhood asthma.
- Efficacy of probiotics as adjuvant therapy in bronchial asthma: a systematic review and meta-analysis.
- Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication of Helicobacter pylori: a meta-analysis.
- Efficacy of probiotics regimens for Helicobacter pylori eradication: A systematic review, pairwise, and network meta-analysis of randomized controlled trials.
- Effect of probiotics on C-reactive protein levels in schizophrenia: Evidence from a systematic review and meta-analysis.
- Probiotics Supplementation for Improving Glucolipid Parameters in Individuals with Prediabetes: A Systematic Review and Meta-Analysis of Randomized Trials.
- Systematic review and meta-analysis on probiotics as treatment for food allergies among pediatric patients: A 2024 update.
- Efficacy of Oral Probiotic Supplementation in Preventing Vulvovaginal Infections During Pregnancy: A Randomized and Placebo-Controlled Clinical Trial.
- Clinical effects of probiotics on the treatment of gingivitis and periodontitis: a systematic review and meta-analysis.
- Evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled Trials.
- Clinical efficacy of probiotic supplementation in the treatment of knee osteoarthritis: a meta-analysis.
- The effect of probiotics on select cognitive domains in mild cognitive impairment and Alzheimer's disease: A systematic review and meta-analysis.
- Efficacy of probiotic supplementation in influencing cognitive function in Alzheimer's disease: A systematic review and meta-analysis.
- Effectiveness of probiotic supplements on cognitive function in mild cognitive impairment and Alzheimer's disease: A meta-analysis of randomized controlled trials.
- Probiotics are a good choice for the treatment of bacterial vaginosis: a meta-analysis of randomized controlled trial
- Efficacy and safety of Saccharomyces boulardii CNCM I-745 for the treatment of pediatric acute diarrhea in China: a systematic review and meta-analysis.
- Efficacy of probiotics in reducing the duration and severity of acute gastroenteritis in children: A meta-analysis of randomized controlled trials.
- Investigating the effects of probiotics during the menopause transition: A systematic review & meta-analysis.
- Effects of probiotic supplements on bone mineral density and bone turnover markers in postmenopausal women: A systematic review.
- Impact of probiotic supplementation on serum levels of brain-derived neurotrophic factor: GRADE-based dose-response meta-analysis.
- Probiotic Supplementation and Inflammatory Status in Coronary Artery Disease: A Systematic Review and Meta-Analysis.
- Ascorbic acid supplementation improves skeletal muscle oxidative stress and insulin sensitivity in people with type 2 diabetes: Findings of a randomized controlled study
- Vitamin C may have similar beneficial effects to Gemfibrozil on serum high-density lipoprotein-cholesterol in type 2 diabetic patients
- Supplementation of vitamin C reduces blood glucose and improves glycosylated hemoglobin in type 2 diabetes mellitus: a randomized, double-blind study
- The effect of vitamin C supplementation on diabetic hyperlipidaemia: a double blind, crossover study
- Unchanged renal haemodynamics following high dose ascorbic acid administration in normoalbuminuric IDDM patients
- Ascorbic acid supplementation improves postprandial glycaemic control and blood pressure in individuals with type 2 diabetes: Findings of a randomized cross-over trial
- Effects of eicosapentaenoic acid and vitamin C on glycemic indices, blood pressure, and serum lipids in type 2 diabetic Iranian males
- Effect of vitamin C on inflammation and metabolic markers in hypertensive and/or diabetic obese adults: a randomized controlled trial
- Does short-term vitamin C reduce cardiovascular risk in type 2 diabetes?