best probiotics for bv - bacterial vaginosis

Bacterial vaginosis (BV) can be an incredibly frustrating condition to live with. Luckily, some of the best probiotics for BV can be found easily and may be very helpful in dealing with this issue. More often than not, bacterial vaginosis is something that women deal with for months or years, with little help from their doctors. In this article, I’ll go over exactly what bacterial vaginosis is, the typical BV treatment, how to address recurring BV, and how probiotics for bacterial vaginosis can help.

Updated June 2021.

In doing research for this post, I came across so many stories from women all over the Internet and it really broke my heart to read them. Women who experienced extreme pain during sex, said they were embarrassed to have any sexual contact, were constantly thinking about how “fishy” they smelled, or worried if they would ever find someone who could love them. There were many women who told their stories of living with BV for years, and could not find a solution.

So this article is dedicated to you – I hope using some of the best probiotics for BV allows you to find relief.

Disclosure: Some of the links in this post are affiliate links, which means that I receive compensation when you buy from these vendors. Please note that I vet each product and do not recommend products that I do not believe in. Thank you for supporting me!

What is BV (Bacterial Vaginosis)?

Bacterial vaginosis (BV) is an imbalance of good and bad bacteria (also referred to as dysbiosis) in the vagina. BV is thought to be a sexually-transmitted disease.

BV is the most common cause of vaginal symptoms and it is believed that ~29% of women of childbearing age have bacterial vaginosis. The rates of BV differ between ethnicities, with Black women being at the highest risk (51%), followed by Mexican women (32%), and white women (23%). (1)

Normally, the majority of the bacteria in the vagina are from the Lactobacillus genus. When Lactobacilli are in high numbers, these bacteria keep the vaginal environment acidic by producing lactic acid, which helps to prevent “bad” bacteria from taking over. This is also why taking probiotics for BV can be helpful in keeping the vaginal environment acidic enough to prevent dysbiosis.

When you develop bacterial vaginosis, there is a shift away from Lactobacillus bacteria toward a more diverse mix of bacteria. This imbalance of bacteria leads to an increase in the pH of the vagina, which can cause a number of symptoms.

Men cannot get bacterial vaginosis, though they may harbor some of the bacteria (Gardnerella vaginalis) that is thought to play a role in the development of BV in women. (2)

Bacterial Vaginosis (BV) Symptoms

Despite how common BV is, it does not always cause symptoms. In fact, 84% of women with BV do not exhibit any symptoms at all. (1)

That said, there are some tell-tale signs of BV. Symptoms of BV are often chronic and usually fairly mild. They include:

  • Thin, white or grey vaginal discharge
  • A strong fishy odor, especially after sex
  • Itching, burning, or pain in or around the vagina

Bacterial Vaginosis vs Yeast Infection

Despite the fact that yeast infections are talked about much more, they are the second most common cause of vaginal symptoms, beat out only by bacterial vaginosis.

So what’s the difference between the symptoms of bacterial vaginosis and a yeast infection?

Common symptoms of a yeast infection include itchiness or burning in or around the vagina, and a white discharge that often looks like cottage cheese. This discharge is typically odorless and might have a yeasty smell (like beer or bread). (3)

This differs from the thin consistency and strong fishy odor of the discharge associated with bacterial vaginosis.

Of course, the best thing to do if you have any of these symptoms is to visit your healthcare provider who can perform an exam and testing to determine which of these infections you might have.

Bacterial Vaginosis (BV) Causes

While researchers aren’t quite sure exactly what causes BV, there are certain lifestyle factors that may make you more likely to get BV.

Factors that may increase your risk of developing BV include (4):

  • Sexual activity. Having a new sexual partner or multiple sexual partners increases your risk of BV. Women who have not had sex rarely have BV.
  • Douching. Douching disrupts the balance of bacteria as well as the pH of the vagina, putting you at higher risk of BV.

Conventional BV Treatment

Some doctors do not recommend treatment of BV, especially if you have no symptoms. This is because the typical antibiotic treatment for BV can cause you to develop a yeast infection, essentially trading one infection for another. Many cases of BV also spontaneously resolve on their own.

However, treating BV makes you less likely to contract other STDs, including HIV. In addition, you are less likely to suffer from infections after gynecological surgery like an abortion or hysterectomy if you treat BV prior to surgery.

Lastly, if you are pregnant, having BV can increase the risk of having a preterm birth or a low birth-weight baby (<5.5 pounds at the time of birth). (4)

Most practitioners will choose to treat women who complain of symptoms of BV, women with BV who are about to undergo gynecological surgery, or pregnant women with BV, especially if you’ve had a preterm birth in the past.

Typical treatment for BV is a course of antibiotics. Antibiotics for BV include metronidazole (oral or vaginal), clindamycin (oral or vaginal), tinidazole (oral), or secnidazole (oral). Thankfully, doctors are now starting to recognize that using some of the best probiotics for BV can also be useful!

Recurring BV

Many women have recurring BV infections and find pharmaceutical antimicrobial treatment ineffective over the long-term. In addition to this, the side effects of antibiotics (such as yeast infections) can often make antibiotics seem not worth it.

If rings a bell, you might want to know how to stop recurring BV infections permanently or how to get rid of BV without antibiotics.

One thing to note here is that researchers believe that treating the sexual partners of those with BV may reduce recurrence rates. Early research in the field showed that this was not effective, but it was later discovered that this early research was not up to snuff. Researchers are now diving deeper into this topic and will hopefully have a definitive answer for us soon as to whether or not treatment of sexual partners can help reduce the recurrence of BV. (2)

In the meantime, there are numerous BV over-the-counter treatments as well as home remedies for BV that can make treatment a success and decrease the likelihood of a recurrent infection. One of my favorite options is probiotics – so let’s talk about some of the best probiotics for BV.

Best Probiotics for BV

probiotics for bv - probiotic supplements

Because bacterial vaginosis is an imbalance of the good and bad bacteria in the vagina, taking probiotics orally or inserting probiotic bacteria vaginally can be useful in treating BV.

Taken orally, probiotic bacteria can actually help rebalance the vaginal flora. (5)

If you are interested in inserting probiotics vaginally for BV, make sure to discuss this option with your healthcare provider.

Below are some of the best probiotics for BV.

Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 for BV

One of the most studied combinations of probiotic strains for bacterial vaginosis is Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. (Remember that knowing the strain of the probiotics you’re taking is incredibly important — you can’t just take any probiotic!)

Study 1

In a study of 32 women with BV, half the women were given metronidazole and a combination of these two probiotic strains, while the other half were given metronidazole and a placebo. They received the antibiotics for the first 7 days of the study. As for the probiotics, they took two capsules (each capsule containing at least one million bacilli per strain) for the first 30 days, and then 1 capsule per day for the remaining 30 days of the study.

For those in the probiotic group, 81% (13 women) had cured their BV by day 30. They remained BV-free until the end of the study at 60 days, as well.

This is in contrast to the placebo group (remember, they still got the conventional treatment — 7 days of metronidazole). In this group, only 31% (5 women) were free of BV by the end of the study and almost 70% of the women who only received metronidazole treatment still had BV. (6)

Study 2

In another study (double-blind, placebo-controlled, randomized) on these two strains, women who had received these probiotics in addition to conventional metronidazole treatment for BV were cured at a much higher rate than those who only received metronidazole treatment.

125 women were split into two groups, and of those on the combination of probiotics and metronidazole, 88% were cured at the 30-day follow up. Only 40% of women who received metronidazole treatment alone were cured. (7)

Study 3

Another very similar study in 2017 showed, again, that women who took these probiotic strains in addition to metronidazole antibiotic treatment were much more likely to cure their BV. 83% of those who took the combination of probiotics and antibiotics for BV had cured their BV by the end of the 30-day study, while only 37% of women who only received antibiotics had cleared their BV by the end of the study. (8)

You may have also heard milk-based drinks with Lactobacillus cultures like Yakult for BV, or Actimel for BV. They do not contain the same strains of Lactobacillus as mentioned above, and thus may not be as effective for BV. That said, I’m always open to seeing more research so if you want to share any, please do so in the comments section!

Best Probiotic for BV that Includes Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14

Clearly, these two probiotics strains have some promising results for those with BV. If you’re looking for a BV treatment over the counter to help improve the efficacy of your medical treatment, probiotics are a wonderful choice. It’s an easy remedy that you can administer at home!

Fem-Dophilus from Jarrow Formulas is a great option if you’re looking for a probiotic supplement that contains these two strains.

You can also find these same strains in RepHresh Pro B probiotic capsules.

Ideally, I would love these companies to share the exact CFU counts for each individual strain, but none of them do (opting to list it as a “proprietary blend” instead). Both of these options contain 5 billion total CFUs, but they don’t specify how much of those 5 billion is coming from each of the strains. If you know of a brand that tells you how much of each strain their supplement contains, I’d love to hear about it in the comments!

Other BV Treatments Over the Counter & Home Remedies for BV

In addition to probiotics for BV, there are some other over the counter treatments for BV that you might want to consider.

Garlic for BV

In a study of 120 women with BV, 60 women were given 500 mg capsules of garlic and 60 women were given the standard treatment of metronidazole. 63% of women who received the garlic were successful in their treatment, while 48% were successful in the metronidazole group. (9)

This shows that garlic may be a better treatment for BV than antibiotics. Perhaps combined with the probiotics listed above, we’d see even higher rates of clearance!

If you’re looking for a quality garlic supplement, Allimax is a good choice.

Boric Acid Suppositories for BV

Boric acid suppositories have long been used for vaginal infections, including BV and yeast infections. It is regarded as a simple, safe home remedy for vaginal infections. It is thought that boric acid may affect the biofilms of BV-causing bacterial. (2)

One study showed that treatment with nitroimidazole followed by 21 days of intravaginal boric acid suppositories (600 mg) and then, if in remission, metronidazole gel twice weekly for 16 weeks. BV cure rates at 12, 16, 28, and 36 weeks were 87%, 78%, 65%, and 50%, respectively. (10)

Though the BV cure was not permanent for 50% of women in the trial, this study indicates that boric acid (along with other maintenance therapies), may be useful in delaying recurrence of BV. More studies are needed to determine if ongoing use of boric acid may be helpful for BV prevention, especially for those with recurring BV.

Please note: Oral use of boric acid is toxic — vaginal use only. Pregnant women should not use boric acid.

You can purchase boric acid suppositories online quite easily. As always, it is best to discuss any of these remedies with your doctor before use.

Other home remedies for BV that are less studied include: herbal suppositories (such as this one from Dr. Aviva Romm), tea tree oil for BV, and hydrogen peroxide for BV.

If you are considering any BV treatment over the counter or home remedies for BV, talk to your doctor.

The Bottom Line:

Bacterial vaginosis is the most common vaginal infection and affects almost 1 in 3 women. It causes symptoms such as thin, white or grey discharge with a strong fishy odor, and can cause itchiness or pain in or around the vagina.

Probiotics can be a great way to improve your chances of clearing BV. The best probiotics for BV are products that include both Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 strains. These can be found in both the Fem-Dophilus from Jarrow Formulas and RepHresh Pro B probiotic supplements. Taken orally, these probiotics can help rebalance the bacteria and lower the pH of the vagina and may help prevent and treat BV.

sunfiber partially hydrolyzed guar gum PHGG

Sunfiber (partially hydrolyzed guar gum or PHGG) is one of the most well-tolerated prebiotics on the market and is especially useful for those dealing with symptoms like bloating, gas, constipation, and diarrhea. Learn more about how Sunfiber might be helpful for you in this article.

As someone who works almost exclusively with clients with digestive problems, I get really excited about prebiotics (a substance that feeds healthy gut bacteria) that are well-tolerated even by those with issues like bloating, gas, diarrhea, and constipation.

I’m a huge fan of pretty much all prebiotics as they can all be useful for those with imbalanced gut bacteria — much like probiotics being strain-specific in their effects, each prebiotic has a slightly different effect on the beneficial bacteria colonies that live in your gut.

But the problem with many prebiotics is that they’re not particularly well-tolerated by those with digestive problems…and as you can imagine, these are often the people that need them most!

Some prebiotics cause digestive problems, especially when taken in high doses right away. The most common digestive side effect when taking prebiotics is bloating.

The Well-Tolerated Prebiotic Fiber

Sunfiber is very unique in that sense; unlike most other prebiotic fibers, it is actually very well-tolerated by most people with digestive issues. 

It’s a prebiotic I’ve used for years in my practice with much success because of how well it’s tolerated.

In fact, it’s my go-to prebiotic choice because of this — I know that it’s very unlikely that a client won’t respond well to it. Sadly, this isn’t the case with many other prebiotic choices on the market.

So let’s dig into why Sunfiber is an excellent choice for a prebiotic and how it is especially helpful for those dealing with digestive complaints.

The Scientific Evidence

Now, just because a prebiotic is well-tolerated by those with digestive issues doesn’t necessarily mean that it’s effective. That’s where looking at the research comes in handy — we want to see that taking Sunfiber provides a benefit, of course!

Partially hydrolyzed guar gum (PHGG) is very unique in that the scientific evidence supports its use in a range of digestive issues, including reducing constipation, diarrhea, abdominal pain, and more.

Sunfiber Reduces Constipation

Sunfiber (partially hydrolyzed guar gum) has been used in many studies to reduce constipation and increase bowel movement frequency. In addition to this, research shows that PHGG consumption improves stool consistency, changing it from hard to normal.

Consuming Sunfiber also seems to reduce the need for the use of laxatives and enemas, taking their use from 2 to <0.1 and 7-8 to 1-3, respectively.

Partially hydrolyzed guar gum at 5g/day increases colonic transit time (essentially the speed at which your digestive system moves food through it) by about 12 hours in constipated patients, and by about 22 hours in those with slow transit time. 

Interestingly, these benefits occurred when using a wide range of dosages of Sunfiber within these studies. Dosages from 5g/day to 36g/day were used, all with significant benefits to constipation.

This means that even at dosages as low as 5g/day, you may notice improvements in bowel movement frequency, abdominal pain related to constipation, and stool consistency.

Sunfiber Reduces Diarrhea

Acute instances of diarrhea can be disruptive and sometimes dangerous.

Sunfiber significantly reduces the incidence of diarrhea as well as the frequency of diarrhea in those with health issues that make them more prone to this condition.

In a study of healthy adults made to have diarrhea (by giving them a hefty dose of sugar alcohols), 10g of Sunfiber strongly reduced the incidence of diarrhea by a cumulative 82%.

It seems that a higher relative dose of partially hydrolyzed guar gum is beneficial for diarrhea — these studies used doses from 5g all the way up to 28g/day with good effect. 

Given the evidence, I suggest around 10g/day for those dealing with diarrhea.

Sunfiber Improves IBS Symptoms

Irritable Bowel Syndrome (IBS) is a condition that can lower your quality of life significantly. It also happens to be where Sunfiber really shines.

Sunfiber (partially hydrolyzed guar gum) has been shown to significantly improve a host of IBS symptoms, including:

  • Bloating
  • Abdominal Pain
  • Bowel habits
  • Flatulence (gas)
  • Abdominal spasm
  • Quality of life

In addition to this, Sunfiber decreases the concentration of methane in stool. This may be particularly helpful for those dealing with methane dominant SIBO.

The dosages used in these studies ranged from 5-10g/day, but even at the lower dosage partially hydrolyzed guar gum was highly effective in reducing IBS symptoms.

Therefore, if you suffer from IBS, just taking 5g/day of Sunfiber may help improve your symptoms.

Many of these studies had participants taking Sunfiber for at least 3 weeks, so make sure to give it some time to start working! You’ll need to take Sunfiber daily for at least this amount of time to start noticing a difference.

Sunfiber is Prebiotic

Partially hydrolyzed guar gum (Sunfiber) is a prebiotic, meaning that it increases the number of healthy bacteria in your gut microbiome.

Research shows that Sunfiber increases counts of Bifidobacteria and Lactobacillus species — two of the main beneficial bacteria present in your gut.

In addition to this, Sunfiber is highly fermentable. This means that your bacteria can “eat” Sunfiber, and when they do, they produce highly beneficial compounds called short-chain fatty acids (SCFAs).

Short-chain fatty acids fuel the cells of your digestive tract, keeping your gut (and your body as a whole) healthy.

I recommend taking at least 6g of Sunfiber per day if you’re specifically looking for prebiotic effects.

Taking Partially Hydrolyzed Guar Gum (PHGG)

As you can see, Sunfiber may be a great choice for you if you suffer from digestive issues and want help reducing your symptoms.

The dosage you may want to take ranges a bit, but in general I would recommend at least 6g/day because that is the point at which Sunfiber becomes prebiotic (meaning that we see significant increases in the counts of beneficial bacteria in the gut microbiome).

From there, we see dosages go up to 36g/day in some of these studies — clearly, you can take quite a lot of it and notice benefits!

However, it is clear from this research that a high dosage like that may not be necessary for symptom improvement.

In general, I recommend keeping your intake anywhere from 6g to 20g/day.

As mentioned above, it’s also important to be consistent with taking partially hydrolyzed guar gum in order to notice the benefits. I typically tell my clients to expect to notice symptom improvement within a few weeks of taking Sunfiber daily.

Gut Power: An Easy Source of Sunfiber

Sunfiber is one of my favorite prebiotic fibers out there, so when I wanted to create a prebiotic & probiotic drink mix, I knew I wanted to include Sunfiber in it.

Gut Power Matcha is a blend of prebiotics (Sunfiber partially hydrolyzed guar gum), probiotics (Bacillus coagulans GBI-30 6086), and organic matcha green tea from Japan.

In just one scoop, you get not only a delicious cup of matcha but also 6g of Sunfiber and 1 billion CFUs of our probiotic strain.

It’s truly the easiest, tastiest way to support your gut health!

Want to try it for yourself? Click here to order.

The Bottom Line:

Sunfiber is a well-tolerated prebiotic fiber with a lot of evidence supporting its use in those with digestive complaints. Partially hydrolyzed guar gum has been shown to significantly improve symptoms such as constipation, diarrhea, bloating, flatulence (gas), abdominal pain, and more.

For an easy way to incorporate Sunfiber on a daily basis, try Gut Power Matcha, which includes 6g of Sunfiber per serving.


This article is a summary of an excellent review article: 

Rao, Theertham Pradyumna, and Giuseppina Quartarone. “Role of guar fiber in improving digestive health and function.” Nutrition (2018). Link to article.