1) Do I need to take probiotics?
If your lab test shows that you have sufficient protective Lactobacillus bacteria (all Lactobacillus species combined are over 70% except Lactobacillus iners), you may not need to take a probiotic supplement. Once the bad bacteria are cleared, your good Lactobacillus bacteria will grow up and become the dominant species.
When the microbiome is balanced, the number of good bacteria is more than that of bad bacteria.
The word “balanced” here refers to the health status, not on equal weight between good and bad bacteria.
A balanced microbiome needs at least 10-to-1 ratio of good bacteria vs. bad ones, not a simple 50/50. The reason is that a small number of bad bacteria can cause great damage and need more good bacteria to counter against.
For example, if there are only one security guard and one thief on a street of many stores, the thief can steal things in stores where the guard is absent. However, if you have at least 10 guards-to-1 thief ratio, the street will likely be safe. This means that a balanced vaginal microbiome needs more good bacteria against bad bacteria at about a 10-to-1 ratio.
Therefore, if your lab test shows that you do not have good protective Lactobacillus bacteria or the number is low (<70%), taking probiotics can help you speed up the recovery and also help stop BV bacteria from coming back.
If you have taken antibiotics recently, your friendly Lactobacillus bacteria might have been wiped out by the antibiotics. Thus, you will need to take probiotics to re-seed protective Lactobacillus bacteria.
2) What if I do not have a recent lab test?
You may assume that your protective Lactobacillus bacteria might be low. Otherwise, you might not develop AV.
A vaginal microbiome lab test costs about $150/test, but probiotics cost much less. It may not be worth the effort to take a lab test to see if your protective Lactobacillus bacteria are low.
If you have AV, it would be a good idea to take probiotic supplements anyway. Taking probiotics may not cause side effects even if you have sufficient Lactobacillus bacteria.
3) Can I take just the probiotics to clear AV?
A vaginal infection occurs when the protective Lactobacillus bacteria reduce and the bad bacteria increase, This imbalance in the microbiome is called vaginal dysbiosis. The hidden cause may be a change in the environment. To treat dysbiosis, it is important to address the environmental change.
For explanation purposes, let us assume that good bacteria are fish, and bad bacteria are frogs. When the pond water is reduced, fish die and frogs thrive. Water reduction in the pond is the hidden cause of the population shift in animal species.
Without filling water into the pond (changing the environment), adding more fish (probiotics) into a dried pond will result in more dead fish.
Therefore, taking probiotics alone may not clear AV, because the hidden cause is not addressed.
4) When is the best time to take probiotics?
NeuEve changes the environment of the vagina (like adding water to the pond). If you take probiotics during or after the use of NeuEve, they may colonize the vagina.
When you use AV NIL to clear AV, you can take oral probiotics at the same time as you are doing the AV NIL treatment, because oral probiotics do not interfere with a vaginal treatment product.
Many customers reported that the Life-Space Women's Probiotics worked well.
Life-Space Women's Probiotics deliver a group of 5 beneficial Lactobacillus bacteria, including the well-studied RC-14 and GR-1 contained in Fem Dophilus pills.
However, if you use a vaginal probiotic insert, it would be a good idea to use it when you are in maintenance mode after you complete the AV NIL treatment. A customer has recommended V-probiotics. This is not our product, but you may find it on Amazon.
When you use AV NIL to clear AV, you use it once daily. There is no between days to insert a different suppository. Some customers proposed to use AV NIL at night and insert a probiotic suppository during the daytime. However, it may dilute the ingredients of AV NIL, rendering it less effective. Thus, we do not recommend that you use a vaginal probiotic insert while you are doing the AV NIL treatment.
However, after your treatment is completed and you are doing the maintenance with NeuEve Gold, Silver, or BV Clear, you can use a vaginal probiotic insert between their days of application. When you use two different suppositories on different days, the interference against each other is reduced.
5) Which is better, the oral pill vs. the vaginal insert?
The formulation of oral probiotic pills is simple. It fills freeze-dried Lactobacillus powers into a capsule without any additional ingredients. Therefore, it often has a longer shelf life. But, oral pills may take a longer time for the good bacteria to colonize the vagina because they have to go through a long passage of the digestive tract.
The formulation of vaginal inserts is often more complex. The manufacturer wanted to make it more effective by adding other ingredients like acids into the formula so that it could regulate pH. The trade-off is that the added acids may reduce the shelf life of Lactobacillus. So, it is important to use it while it is fresh. The advantage of a vaginal insert is that the good bacteria can colonize the vagina directly and can be more effective.
The combination of both may work better.
6) Can I use an oral probiotic pill as a vaginal insert?
We do not recommend it because an off-label use of a product can void the liability of the product. If a side effect happens, the product manufacturer may be less likely to help you as you did not follow the suggested application.
We would suggest that you follow the instructions provided by the manufacturer. A clinical study has shown that taking probiotic pills orally can help Lactobacillus colonization in the vagina to reduce infections.
7) How can I extend the shelf life of probiotics?
Since probiotics are perishable and sensitive to heat, you should store them in a refrigerator as soon as you receive the product to extend their shelf life. The products are the most effective when they are new.
8) How long should I take probiotics and when can I stop?
About probiotic supplements, we advise taking them for not more than 1 month after your symptoms have completely cleared. It's important to note that over-supplementing probiotics can potentially lead to a condition called CV (cytolytic vaginosis). To determine the appropriate duration for taking the probiotic supplement, you can use a pH paper test to estimate your vaginal pH levels.
If your vaginal pH remains at or below 4.5 approximately 1 week after using a NeuEve BV Clear, Gold, Silver, or Silk product, it indicates that your vaginal microbiome may be dominated by beneficial probiotic bacteria. In such cases, you can safely discontinue taking the probiotic supplement.
The best time to take probiotics is to start with oral probiotic pills as soon as you start the AV NIL treatment. After you complete the treatment and switch to the maintenance mode, you can use vaginal probiotic inserts in between days of the NeuEve suppository applications. The combination of two types of probiotics along with the NeuEve treatment plan may help you clear your AV sooner and stop AV from coming back.
**Disclaimer: This article is for information purposes only. It is about natural products, nutrients, and/or methods for managing menopause-related discomforts (not diseases). It is not medical advice for the treatment of any disease.