Supplements for Vaginal Health: Are They Harmful or Helpful?

If you've dealt with vaginal issues like chronic yeast infections for long enough, you'll do just about anything to get rid of the problem for good. That includes taking supplements that promise to improve vaginal health.

Does this scenario sound familiar? You Google a vaginal health symptom and then hop over to Instagram to scroll, and (like magic!) you're now targeted with sponsored ads from companies offering supplements and products that seem like the answer to your vaginal woes. 

But how do you know which ones actually promote vaginal health, which ones may be a waste of money, and, in the worst-case scenario, which ones may do more harm than good? 

Types of vaginal supplements 

• Probiotics: Probiotics are supplements that contain live microorganisms that confer a health benefit. You can take probiotics via dietary supplements, in food, or a vaginal suppository. The goal behind taking probiotics for vaginal health is to help populate the vagina with beneficial bacteria, especially if you are low in healthy bacteria. 
• Prebiotics: Prebiotics aren't bacterial strains but serve directly as a food source for good bacteria or help stimulate an environment for bacteria to flourish.
• Vitamins: This includes vitamins that are specifically marketed to support vaginal health.

What supplements are good for vaginal health?

From probiotics to prebiotics to vitamins for vaginal health, we break down the existing research to explain the efficacy of some of the most popular vaginal supplements. 

Probiotics

Probiotic supplements are all the rage in the wellness world and marketed as a cure-all, but while research shows that oral probiotics might be helpful for your gut health, the same can’t be said for vaginal health. Part of the problem is the inconsistency in study designs which makes them hard to compare

Some studies have shown that taking high doses of oral probiotic supplements over a long period can have an effect, but it’s likely not the most efficient approach. There's no evidence that probiotics supplements can prevent vaginal infections, but they may help balance the vaginal microbiome in specific situations:

• After taking antibiotics, probiotics can replenish the good bacteria destroyed along with bad bacteria. 
• Vaginally applied probiotics have a greater chance of success. For women dealing with bacterial vaginosis (BV), vaginal probiotic treatment can help prevent recurrence of symptoms. Studies have shown that vaginal probiotics with Lactobacillus bacteria have promise for preventing and treating BV.

The takeaway: The research on probiotics for vaginal health is still mixed. However, recent studies suggest that they could promote a healthy vaginal microbiome after a course of antibiotics or if you suffer from chronic BV. Speak with your OBGYN  before taking probiotics.

Vitamin E 

Vitamin E can be taken orally in a supplement form, but for this post, we'll be talking about vitamin E vaginal suppositories since, as of right now, there are no studies on the effect of vitamin E supplements taken orally on vaginal health.

Some studies show that vitamin E suppositories can help with vaginal dryness, but more research needs to be done. Here’s what we know to date:

• A 2016 study looked at postmenopausal women experiencing vaginal dryness due to vaginal atrophy. Half of the women were given vitamin E suppositories, and half were given estrogen vaginal cream (which has been shown to improve symptoms of vaginal atrophy) for 10 weeks. Notably, four of the study participants had to stop using vitamin E due to unwanted side effects like burning and increased vaginal discharge. 
• The 22 women who did complete the vitamin E treatment found roughly the same relief as the estrogen users, which indicates there is some potential for vitamin E suppositories as a non-hormonal option for vaginal dryness. 

The takeaway: Some evidence shows that vitamin E can be helpful for vaginal dryness, but more studies are needed due to the overall lack of research and the limited sample size of the studies that have been done. There is also a chance of irritation and side effects if you try it, which you should be aware of. 

Hyaluronic acid 

You've probably heard of the benefits of introducing hyaluronic acid into your skincare regimen. Well, the research on using it for vaginal dryness is also promising! Relatively recent research shows that hyaluronic acid (applied directly to the vagina) can be a good alternative to estrogen therapy for vaginal dryness and irritation. 

Here’s what we know from the research: 

• According to a systematic review of nine studies, hyaluronic acid was found to be beneficial for postmenopausal women suffering from vaginal dryness (one of the most common menopause symptoms). All nine studies showed improvement in vaginal dryness, itching, and sexual function, and six studies improved in vaginal burning. 
• Hyaluronic acid has been shown to improve vaginal dryness and pain during sex in women undergoing cancer treatment who can’t take estrogen therapy. 

P.S. We all love a good two-in-one but don’t use a facial product with hyaluronic acid on or in your vagina. If you’re thinking about using hyaluronic acid for vaginal dryness, contact a health provider. 

The takeaway: There is some evidence that hyaluronic acid applied to the vagina topically or via a suppository can help aid vaginal dryness. 

Sea buckthorn oil 

Sea buckthorn oil is another ingredient commonly used in facial skincare products but can also be consumed orally. 

Here’s what we know about the effectiveness of sea buckthorn oil on vaginal atrophy (aka when the tissues inside the vagina become thin, dry, and inflamed) when consumed orally:

• One study published in 2014 followed 98 post-menopausal women who orally consumed either a placebo or 3 grams of sea buckthorn oil daily for three months. The results were conflicting, and more evidence was needed to show a real difference in the women who took seabuckthorn oil. 

Another use for sea buckthorn oil is applying it vaginally. In another study published in 2019, researchers assessed a vaginal cream that contained seabuckthorn oil and hyaluronic acid. 

Researchers found a significant decrease in vaginal pH in women who used the cream compared to a no-treatment control. With this study, it's important to note that it had a small sample size, and we're still determining if the positive results were due to the addition of hyaluronic acid. 

The takeaway: Thanks to conflicting results and limited sample size, the jury is still out on whether or not orally consuming sea buckthorn oil can reliably improve vaginal symptoms. At the moment, there's not enough evidence to support claims that it works orally or vaginally.  The better news is that it's not shown to be harmful to vaginal health, so if it’s working for you, it likely won’t make your problems worse.  

Omega-3 and fish oil 

Omega-3 supplements are marketed to help with a ton of health concerns — with vaginal health being one of them. Before diving into the research surrounding omega-3 supplements for vaginal health, it's essential to know that omega-3 and fish oil supplements are not the same. So, not all these supplements have the exact ratio of omega-3 fatty acids and ingredients, and the dose can vary by supplement. 

One of the claims surrounding omega-3 and fish oil supplements for vaginal health is that it can support estrogen levels. Estrogen plays a key role in hormonal and vaginal health. It helps produce glycogen, the primary food source for protective bacteria called Lactobacillus that help keep your vaginal environment acidic. When it comes to your vaginal health, estrogen is kind of like Goldilocks — too little estrogen can increase your risk for bacterial vaginosis, while too much of it can bring on a yeast infection. 

But the reality is that the relationship between omega-3 and estrogen is still very much unknown. Here’s what we know from the research:

• Two studies that claim omega-3 fatty acids support feminine health used very different supplements and have conflicting results. 

• This study from 2018 found that the women who took fish oil supplements had increased levels of estrogen in their blood, compared to a placebo group, after eight weeks. 
• A second study published in 2020 followed 100 pregnant women who took daily omega-3 supplements and found that blood estrogen levels increased from baseline to 12 weeks of taking the supplement. Still, the same was true for the placebo group, most likely because they were pregnant. 

A recently published study looked at how fish oil may affect the vaginal microbiome in pregnant women.

• Researchers found that fish oil did not seem to affect the primary or dominant components of the microbiome but did seem to decrease the levels of the low-abundance organisms. 
• There weren't any significant shifts in the overall community state types. 

Even with these findings, it's unclear just how much of an effect omega-3 fish oils may change the vaginal microbiome. 

At this point, we sound like a broken record, but more research (especially research on non-pregnant women) is needed to understand the relationship entirely. 

The takeaway: Omega-3 and fish oil supplements may benefit your vagina, but we need a lot more research to understand precisely how and why it might be worth incorporating into your vaginal healthcare routine.  

Lactoferrin 

Lactoferrin is a protein naturally made by your immune system that inhibits the growth of harmful bacteria and promotes the development of good bacteria, specifically Lactobacillus. 

Research has shown that when lactoferrin is taken alongside vaginal probiotics, it may help increase their effectiveness. Keep in mind that if you take lactoferrin, there is a slight risk of digestive tract distress. However, this could be due to the probiotics it is usually formulated with. When lactoferrin is taken on its own, it tends to have very few side effects.

The takeaway: If you’re experiencing cyclical vaginal infections or symptoms, you may have read about the oral lactoferrin supplement, which research shows may help increase the effectiveness of vaginal probiotics when taken alongside them.

Lactulose

Lactobacillus makes lactic acid by fermenting simple carbohydrates like glucose, sucrose, lactose, or galactose using glycolysis (their central metabolic pathway). 

When taken orally, lactulose treats liver disease and constipation (it’s a laxative). It is a compound comprising two sugars (disaccharide) — one galactose and one fructose linked by a bond resistant to lactase. This formation of sugars can not be absorbed in the small intestine, but it is metabolized in the gut, which produces methane (so it can cause flatulence), acetic acid, and lactic acid. 

Though there are no human trials on taking lactulose vaginally, one in-vitro study in 2018 found that lactulose did enhance the growth of vaginal lactobacilli. It also limited the growth of a fungus called Candida albicans (which causes yeast infections) and A. vaginae, but did not affect the growth of other BV-related bacteria like Gardnerella, P. bivia, or Mobiluncus.

The takeaway: You might have heard of claims surrounding taking lactulose to "feed lactobacilli and starve bad bacteria/pathogens," but know that to date, there is no human research on taking lactulose vaginally. 

How to look after your vaginal health

While some supplements may help ease symptoms or support your overall vaginal health (more evidence pending), you shouldn’t rely on them as a quick fix. There are, however, several science-backed things you can do to promote optimal vaginal health: 

• Practice safe sex. Unprotected sex can be a trigger for vaginal dysbiosis and sexually transmitted infections (STIs). Using condoms or dental dams during sex can help. 
• Get a regular STI test. The CDC recommends getting screened for STIs at least once a year or anytime you have a new sex partner. If left untreated, STIs can cause long-term reproductive health complications. 
• Ditch the douche. Douching can disrupt your vaginal pH balance and put you at a higher risk of infections like BV, STI acquisition, and even pelvic inflammatory disease (PID). 
• Practice menstrual hygiene. Change your pad or tampon at least every 4 hours or as often as needed, depending on your flow.
• Keep up with pap tests. They’re no one’s idea of fun, but they monitor your cervical health and find any abnormal changes before they can turn into cancer. 
• Test your vaginal microbiome. Evvy's Vaginal Microbiome Test gets to the bottom of what's causing your symptoms and helps you find real, effective solutions for your body. 
• Look after your overall health. Having a healthy and balanced diet, getting adequate rest, and exercising are also key.