What is the role of probiotics in women's health?

Today’s post is prepared in special acknowledgement of International Women’s Day and will explore the role that probiotics and the gut microbiome play in various aspects of women’s health throughout different life stages.

Whether through the lens of general health or with a specific focus on the microbiota, there is no denying that women experience a distinct trajectory from men.

Major life events like pregnancy and menopause are clear examples of this, as are health conditions like PCOS (Polycystic ovary syndrome) and endometriosis that are unique to women.

Women must also contend with concerns around the microbiota that extend beyond the gut, with the vaginal microbiome playing important roles in their health.

With that in mind, the core topics that we’ll cover in today’s post include:

• PCOS (Polycystic ovary syndrome)

• Vaginal Health (BV)

• Menopause & Bone Health

• Gestational Diabetes

Let’s dive into the science!

How about the vaginal microbiome?

Did you know that only 1 in 5 women say they know exactly the meaning of the term “vaginal microbiota”?

The vaginal microbiome consists largely of bacteria from the Lactobacillus grouping, comprising up to 90% of the bacterial species present(1).

These healthy bacteria serve multiple roles but one of the most important is producing lactic acid which maintains a slightly acidic environment in the vagina and deters the growth of harmful bacterial species. 

What can negatively impact the vaginal microbiota?

Antibiotic use, hormonal changes and lifestyle factors can disrupt the balance of these healthy bacteria and allow those harmful bacteria to take on a larger role – this process can lead to a condition known as bacterial vaginosis.

According to the WHO, around 25% of women globally are affected.

Multiple studies have been conducted in this area and we do have human evidence to suggest that probiotic use in women with bacterial vaginosis (BV) can positively influence the vaginal microbiome whether used in isolation or in combination with antibiotic treatment.

In fact, Florastor’s S. boulardii CNCM I-745 probiotic has been demonstrated to restore the microbiome profile of 88% of patients who were treated for bacterial vaginosis with antibiotics.

This is a highly relevant finding given that imbalances in the vaginal microbiota can increase one’s risk of candidiasis, negatively influence fertility and lead to a higher risk of premature birth.

Polycystic Ovary Syndrome (PCOS)

PCOS, also known as polycystic ovary syndrome, affects 1 in 10 women of reproductive age and is a leading cause of anovulation and infertility.

PCOS is a complex condition characterized by irregularities in hormone levels, insulin resistance, genetic factors and more.

It’s also true that women with PCOS tend to have different microbiome profiles and higher rates of antibiotic usage as compared to women who do not have PCOS.

These are fascinating insights that implicate the gut microbiome in PCOS, a notion that is further supported by growing experimental evidence demonstrating that probiotic use may offer some level of benefit for these women.

We have, for example, evidence to suggest that the use of a multi-strain probiotic in conjunction with dietary and lifestyle changes may offer further improvements to quality of life and key markers around androgens and menstrual cycle characteristics in women with PCOS.

Gestational diabetes

Gestational Diabetes arises when a woman with no diabetes diagnosis ends up with elevated blood sugar levels during pregnancy.

Although it occurs in less than 10% of pregnancies, there is little questioning the fact that a gestational diabetes diagnosis can be an unsettling one for a pregnant woman.

Gestational diabetes also increases risk of other significant pregnancy-related health complications like preeclampsia.

A healthy gut microbiome plays a significant role in influencing glucose metabolism and insulin resistance, so there is no surprise that probiotics have been studied as a supplement of interest for this particular women’s health concern.

In July of 2024 the Clinical Nutrition journal published a systematic review and meta-analysis looking at human controlled trials where women with gestational diabetes were provided a probiotic.

They found, on average, fasting blood glucose levels dropped by 0.23 mmol/L and an improvement in markers of insulin resistance were also noted.  

The results, like many of the other studies and contexts discussed today, provide insight into the fact that probiotic use during key life stage’s can meaningfully contribute to improving relevant markers of women’s health.

Menopause

Menopause is generally diagnosed after a full 12 months without menstruation and often occurs between ages 45 and 55.

The decrease in estrogen levels that accompanies this life stage tends to accelerate bone loss, which makes bone health a topic of great interest for menopausal women and elevates the importance of achieving adequate Vitamin D status in this population.

Florastor Immunity, which has Vitamins C, D and zinc added, could be a more suitable choice in post-menopausal women for this reason.

Interestingly enough, there is also a great deal of scientific interest surrounding probiotic use and bone health in postmenopausal women.

Systematic review and meta-analysis out of the both the British Medical Journal and Frontiers Endocrinology Journal found that probiotic use in postmenopausal women may help maintain bone density in the lumbar spine as compared to no probiotic use during this life stage. 

Scientists speculate that probiotics may positively interact with bone health in a variety of ways including through reducing inflammatory markers, increasing estrogen production in the intestines and increasing the production of SCFA compounds which improve the absorption of nutrients like calcium which are fundamental to good bone health. 

This is nothing short of another GLOWING example of why maintaining a healthy gut microbiome is such a universally important consideration for women’s health.