Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Lactobacillus acidophilus is used to support or treat vaginitis, particularly bacterial vaginosis and vulvovaginal candidiasis, based on both scientific investigation and a mechanistic rationale. The normal vaginal microbiota is dominated by Lactobacillus species, including L. acidophilus, which help maintain an acidic environment (pH <4.5) that inhibits the growth of pathogenic organisms. Vaginitis often involves a disruption of this balance, leading to overgrowth of pathogens such as Gardnerella vaginalis, Candida albicans, or Trichomonas vaginalis.

Several clinical studies and meta-analyses suggest that probiotic supplementation with lactobacilli (either orally or intravaginally) can help restore normal flora and improve symptoms, especially as an adjunct to standard antifungal or antibiotic therapy. For example, randomized controlled trials have shown that L. acidophilus can reduce recurrence rates of bacterial vaginosis and vulvovaginal candidiasis when used alongside conventional treatments. The proposed mechanisms include direct inhibition of pathogens through the production of lactic acid and bacteriocins, as well as competitive exclusion of harmful microbes.

However, while promising, the overall quality and consistency of clinical evidence is moderate, with some studies showing benefit and others showing limited or no effect. Variability in probiotic strains, dosages, and administration routes complicates interpretation. Therefore, the evidence supporting L. acidophilus for vaginitis is rated at 3 out of 5—there is scientific support, but further high-quality research is needed to define optimal usage.

More about lactobacillus acidophilus
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