Short Answer:
- The best time to take probiotics is to start taking the probiotic pills orally as soon as you start using the NeuEve AV Clear (AV NIL) to clear L. iners.
- After switching to the maintenance phase, you can insert the probiotic capsule vaginally once daily on days when you are not using a NeuEve suppository.
The two probiotic delivery methods, along with the AV Clear treatment plan, may help you clear your L. iners more quickly and prevent it from returning.
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If you are interested in learning more about probiotics, you may read the following:
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 Lactobacillus iners is cleared, your good Lactobacillus bacteria will grow and become the dominant species.
When the microbiome is balanced, the number of beneficial bacteria exceeds that of pathogenic bacteria. The word “balanced” here refers to the health status, not to equal weight between good and bad bacteria.
A balanced microbiome needs at least a 10-to-1 ratio of good bacteria vs. bad bacteria, 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 counteract them.
For example, if there is 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 a 10-to-1 guard-to-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 bad bacteria from coming back.
If you have taken antibiotics recently, your friendly Lactobacillus bacteria might have been wiped out by the antibiotics, and only Lactobacillus iners remains, as it often resists antibiotics. Thus, you will need to take probiotics to reseed 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 have developed discomfort symptoms.
A vaginal microbiome lab test is expensive. It costs about $150/test, but probiotics cost much less. It may not be worth the effort and cost to take a lab test just to see if your protective Lactobacillus bacteria are low.
If you have an L. iners infection indicated by a lab test, there are no other methods to clear it; it will remain high, and your protective bacteria may be low. It would be a good idea to take probiotic supplements anyway.
Additionally, taking a good probiotic supplement may not cause side effects even if you have sufficient Lactobacillus bacteria.
3) Can I take just the probiotics to clear L. iners?
A vaginal L. iners infection occurs when the protective Lactobacillus bacteria are reduced. 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 the bad L. iners 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 L. iners, 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). Thus, using NeuEve alone often helps restore your vaginal health because after you add water to the pond, the fish will increase naturally.
However, if you do not have any good bacteria left, reseeding good bacteria by taking probiotics will be helpful.
When you use NeuEve AV Clear to clear L. iners, you can take oral probiotics at the same time, because oral probiotics do not interfere with a vaginal treatment product.
However, if you use a probiotic capsule to insert into the vagina, it would be a good idea to use it between the dates of NeuEve suppository applications after you have switched to the maintenance phase. Our NeuEve brand probiotic capsule is well designed to be used both by oral ingestion and by vaginal insertion.
If you use a probiotic capsule at the same time as a NeuEve AV Clear suppository, it may dilute or interfere with the latter, rendering it less effective. Thus, we do not recommend that you use a vaginal probiotic insert while you are using a NeuEve AV Clear suppository for clearing L. iners at the same time.
However, after your L. iners is cleared and you have switched to the maintenance phase, inserting a probiotic capsule once daily between the dates of the maintenance NeuEve suppository applications will have reduced interference, maximizing the effect.
Note: Our NeuEve brand probiotics are ready for delivery in our warehouse. However, its webpage is not yet live. The price is $38/bottle of 60 caps. If you need to purchase probiotics, contact us at Help@neueve.com. We will help you purchase it before it is launched.
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. However, orally ingested pills may take a longer time for the good bacteria to colonize the vagina because they have to go through a long passage through the digestive tract. Many bacterial cells may not survive the long journey.
The formulation of vaginal inserts is often more complex. Some manufacturers 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 and also cause burning in sensitive women.
The advantage of a vaginal insert is that the good bacteria can colonize the vagina directly and can be more effective. A clinical study has demonstrated that orally taking probiotic pills helps Lactobacillus colonization in the vagina, reducing infections. However, oral ingestion may take a longer time and may not be successful for all users. The combination of both may work better.
6) Can I use an oral probiotic pill as a vaginal insert?
Some customers have tried it and reported positive results. Regarding safety, if something is edible, it should be safe. The vegan capsule may dissolve in about 20-30 minutes after insertion to release its contents. The best time to insert a vaginal probiotic is after you have completed the treatment suppositories and switched to the maintenance phase. You can insert an oral probiotic pill made with vaginal Lactobacillus, like the NeuEve brand probiotics, into the vagina once daily at bedtime in between the days of the NeuEve suppository applications. This approach helps maximize the effectiveness of the treatments.
7) How can I extend the shelf life of probiotics?
Since probiotics are perishable and sensitive to heat, you should store them in the refrigerator as soon as you receive the product to extend their shelf life. The products are most effective when they are new.
8) How long should I take probiotics, and when can I stop?
About probiotic supplements, we would suggest taking them for no more than one month after your symptoms have completely cleared. It is 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 suppository, it indicates that beneficial probiotic bacteria may dominate your vaginal microbiome. In such cases, you can safely discontinue taking the probiotic supplement.
9) Helpful tips
A customer reported that using an applicator to place the suppository and the probiotic capsule inside helped to avoid leaving a pocket in the vaginal without being touched by the suppository and the probiotic capsule. Placing the suppository and capsule at a higher place can help improve their effect.
**Disclaimer: This article is for information purposes only. It is about natural products, nutrients, and/or methods for managing women's health and wellness. It is not medical advice for the treatment of any disease.