What are the best probiotics for women?

Probiotics are living microorganisms that can provide a benefit to your health. 

Certain foods contain probiotics, including some unpasteurized fermented foods like kimchi, kombucha, sauerkraut, and kefir. You can also get probiotics in the form of supplements. 

Research suggests that these microbes might improve your digestive, immune, vaginal, and urinary health. There is limited evidence for most probiotic products, but this is a growing area of research.

ZOE runs the largest ongoing study of nutrition and the gut microbiome in the world, with over 40,000 participants so far. Our research has found 15 “good” gut bugs linked with better health and 15 “bad” bugs linked with worse health outcomes. 

You can’t buy these bugs as supplements, but changing your diet can help the “good” bugs thrive in your gut. 

With the ZOE at-home test, you get a breakdown of the bugs in your unique gut microbiome and personalized nutrition advice on how to boost the “good” gut bugs.

Read on to learn more about the best probiotics for women’s health.

Probiotics and women’s health

Probiotics may benefit a variety of women’s health issues. In this article, we’ll explore what the evidence says.

1. Digestive issues

While many factors can cause digestive issues, a gut microbiome imbalance is sometimes the culprit. The gut microbiome is the community of trillions of microbes that live in your gut and play a central role in your digestive and overall health.

Probiotics may help support healthy digestion by promoting the “good” bugs in your gut

Everyone feels bloated occasionally, but regular bloating can be uncomfortable and interfere with daily activities. 

Some Lactobacillus strains might be able to help relieve or prevent bloating. Outside of supplements, foods like yogurt and fermented vegetables can be sources of Lactobacillus strains.

According to a recent review of 70 studies, probiotics may help relieve bloating and abdominal pain in people with digestive issues, such as irritable bowel syndrome. The studies in this analysis all used supplement forms of probiotics, mostly containing strains from the Lactobacillus and Bifidobacterium species. 

However, the studies used different strains, strain combinations, and dosages. 

Because the review included studies using 54 different products and 108 different strains, it isn’t possible to know which strains are responsible for the beneficial effects just yet.

Probiotics may also help promote healthy bowel movements. According to a review involving over 1,100 participants, a bacteria commonly found in fermented vegetables, Bifidobacterium lactis, may help people with constipation poop more often. But scientists need to do more rigorous studies.

There is also some evidence that certain Bifidobacterium strains, like Bifidobacterium lactis, may be able to promote regular bowel movements. 

Everyone’s digestion habits are different, however, and scientists need to do more work to pinpoint which specific probiotic bacteria can help with different digestive issues. 

2. Vaginal health

There are trillions of microbes living in your gut, but the vagina is also home to a thriving community of microorganisms. 

The vaginal microbiome is involved in many aspects of vaginal health, such as protecting you from bacterial vaginosis, sexually transmitted infections, and pelvic inflammatory disease.

Lactic acid bacteria, or lactobacilli, are typically the most prevalent bacteria in the vaginal microbiome. Researchers have suggested a link between high levels of vaginal lactobacilli and better health in some women. 

Many probiotics, including those found in some fermented foods, are lactobacilli. 

Evidence suggests that these bugs may promote vaginal health by creating an acidic environment to ward off harmful bacteria. They may also stimulate the immune system within the vaginal tract and starve unwanted bacteria from the nutrients they need.

For vaginal health, you can either take probiotic supplements or apply them directly to the vagina. However, research suggests they might be more effective when taken orally rather than when directly applied. 

3. Urinary tract health

The bugs in your vaginal microbiome also play a role in your urinary tract health

Results from nine clinical trials involving over 700 people suggest that certain types of lactobacilli may be able to help prevent urinary tract infections in women. However, the researchers noted that more studies are needed to confirm this.

A harmful bacteria called Escherichia coli, or E. coli, causes most urinary tract infections. 

Some evidence suggests that Lactobacillus fermentum may help protect against E. coli and promote a healthy urinary tract. The researchers used this particular strain because of its resistance to the acidic environment of the digestive system. 

However, this was a laboratory study, and scientists need to do more research to see if this will also be successful if women take L. fermentum probiotics. 

4. Menopause

Menopause is a transition that half of the population will experience. 

It’s common for many women to experience uncomfortable symptoms during this time. This includes hot flashes, night sweats, and vaginal dryness. 

The makeup of your vaginal microbiome changes during menopause, typically including a decrease in lactobacilli levels. Evidence has linked this lactobacilli decrease to an increase in typical vaginal menopause symptoms. 

One study associated low levels of vaginal lactobacilli with thinning and drying of the vaginal walls, a common symptom of menopause.

As a treatment, one clinical trial found that Lactobacillus acidophilus supplementation treatment was associated with improved menopausal symptoms.

Ultimately, more research is needed to understand the connection between the vaginal microbiome and menopause. 

A healthier gut may also benefit some menopause symptoms, as ZOE scientists found

5. Immune system

Gut health is one of many factors that influence the health of your immune system. There is a complex link between your gut microbiome and your immune system, and some studies suggest probiotics may be able to help keep you from getting sick.

In a recent analysis of 327,720 users of the ZOE COVID Symptom Study app, researchers found that women who consumed probiotics were 14% less likely to get COVID-19.

6. Bone health

The hormone changes that happen during menopause can significantly impact your bones. Many women experience bone loss after menopause and are at a higher risk of developing osteoporosis. 

Research into probiotics’ effect on bone loss is ongoing, but some evidence suggests that these microbes might be able to help.

In a recent meta-analysis of roughly 500 women from five randomized controlled trial (RCT) studies, researchers found that certain lactobacilli strains may be able to help prevent bone loss in the spine. 

However, this is a relatively new area of research, and the scientists noted that further work is needed.

Are probiotic supplements actually effective?

Experts claim that certain probiotics may be a safe and effective way to boost your health, but these benefits vary based on the strain, dosage, and the person taking them. 

Although taking a quick gummy or pill each day may be convenient, commercially made dietary supplements are not necessarily a catch-all solution. 

The United States Food and Drug Administration (FDA) does not subject dietary supplements to the same testing and regulations as over-the-counter medicines. 

Manufacturers are responsible for putting out a safe product, but the bacteria in a particular supplement may not necessarily be the strain that’s going to improve your health. 

Some evidence suggests that the probiotics in foods may be more beneficial than supplements for overall health.

ZOE scientists have identified 15 “good” bugs linked with good health and 15 “bad” bugs linked with poor health. Currently, there are no available supplements that contain these 15 “good” bugs. 

The best way to promote them is by eating a healthy, varied diet, with plenty of plant foods. But if you want to know the exact foods that can help the good bugs in your gut thrive, start by taking our free quiz

How to get probiotics from your diet

At ZOE, we believe that probiotics from food are more beneficial for your gut microbiome and health than probiotics from the supplements that are currently available. 

ZOE co-founder Prof. Tim Spector shares some tips for improving your gut health:

  • Fermented foods: Live yogurt, kimchi, kombucha, sauerkraut, and some cheeses are good sources of probiotics. Eat small amounts of these daily, rather than large portions every once in a while.

  • A variety of plants: Try to eat 30 different plants per week. Nuts, seeds, whole grains, fruits, and vegetables are rich in fiber and other nutrients that support a healthy gut. 

  • Prebiotics: These feed the good bacteria in your gut. It’s best to include a variety of different colored plants, as each color comes with slightly different benefits.

What are the best probiotics for you?

Certain strains of probiotics might help improve your health, but the effect is not the same for each person. Dr. Will Bulsiewicz — ZOE’s U.S. Medical Director, board-certified gastroenterologist, and New York Times best-selling author — describes it like this:

“Probiotics are a bit difficult to predict because they’re a bit like a foreign exchange student arriving in a high school. The cliques are already established, and then this new person walks in and it’s possible that they change the dynamics, but it’s also possible that nothing changes it at all.”

Because everyone has a unique gut microbiome, there is no universal approach to boosting gut health. 

With the ZOE at-home test, you can learn what bugs are living in your very own gut. Using this, we will provide you with personalized nutrition advice to encourage the “good” bugs to flourish. 

Summary

Probiotics are microbes that provide some benefit to your health. Studies suggest that certain strains of probiotics may be able to help boost your gut, vaginal, urinary, and immune health. 

However, studies exploring the benefits of probiotics vary widely in the strains and combinations of strains they use. This makes it very difficult to know which bacteria actually carry the most health benefits for you.

While probiotic supplements may seem like the most convenient way to boost your gut health, they might not be the most effective or reliable option. 

At ZOE, we believe that the best way to get these probiotics is through food. Since everyone’s gut microbiome is different, there is no one-size-fits-all recommendation.

Sources

Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. (2014). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3994184/

Can probiotics help against diarrhea? (2019). https://www.ncbi.nlm.nih.gov/books/NBK373095/

Evaluation of adherence and anti-infective properties of probiotic Lactobacillus fermentum strain 4-17 against Escherichia coli causing urinary tract infection in humans. Microbial Pathogenesis. (2019). https://www.sciencedirect.com/science/article/abs/pii/S0882401019305388

Health benefits of taking probiotics. (2020). https://www.health.harvard.edu/vitamins-and-supplements/health-benefits-of-taking-probiotics

Healthy vaginal microbiota and influence of probiotics across the female life span. Frontiers in Microbiology. (2022). https://www.frontiersin.org/articles/10.3389/fmicb.2022.819958/full

Influence of probiotic supplementation on climacteric symptoms in menopausal women - a mini review. International Journal of Applied Pharmaceutics. (2018). https://innovareacademics.in/journals/index.php/ijap/article/view/29156

Interactions between the microbiota and the immune system. Science. (2015). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420145/

Menopause and bone loss. (2022). https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss

Menopause is associated with postprandial metabolism, metabolic health, and lifestyle: the ZOE PREDICT study. The Lancet. (2022). https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4051462

Modest effects of dietary supplements during the COVID-19 pandemic: insights from 445 850 users of the COVID-19 Symptom Study app. BMJ Nutrition, Prevention & Health. (2021). https://nutrition.bmj.com/content/early/2021/04/20/bmjnph-2021-000250

Probiotic supplements and bone health in postmenopausal women: a meta-analysis of randomised controlled trials. BMJ Open. (2021). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929795/

Regulatory oversight and safety of probiotic use. Emerging Infectious Diseases. (2010). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294522/

Systematic review: probiotics in the management of lower gastrointestinal symptoms - an updated evidence-based international consensus. Alimentary Pharmacology & Therapeutics. (2018). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5900870/

The comparison of food and supplement as probiotic delivery vehicles. Critical Reviews in Food Science and Nutrition. (2016). https://pubmed.ncbi.nlm.nih.gov/25117939/

The effect of Lactobacillus acidophilus YT1 (MENOLACTO) on improving menopausal symptoms: a randomized, double-blinded, placebo-controlled clinical trial. Journal of Clinical Medicine. (2020). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408745/

The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition. (2014). https://academic.oup.com/ajcn/article/100/4/1075/4576460?login=false

The female vaginal microbiome in health and bacterial vaginosis. Frontiers in Cellular and Infection Microbiology. (2021). https://www.frontiersin.org/articles/10.3389/fcimb.2021.631972/full

The role of lactobacilli and probiotics in maintaining vaginal health. Archives of Gynecology and Obstetrics. (2013). https://link.springer.com/article/10.1007/s00404-013-3064-9

Urinary tract infections. (n.d.). https://www.kidney.org/sites/default/files/uti.pdf

Use of Lactobacillus spp. to prevent recurrent urinary tract infections in females. Medical Hypotheses. (2018). https://www.sciencedirect.com/science/article/abs/pii/S0306987718301208