Maintaining the balance of vaginal flora for vaginal health

This article was sponsored by Church & Dwight Co., Inc.

The human vaginal microbiota consists of a balance of both beneficial microbes and opportunistic pathogens, including bacteria and yeast.1 In a healthy vagina, the microbiota exists in an interdependent relationship with the body.2

Both internal and external factors can upset the balance of the vaginal microbiome. An imbalance in the vaginal microflora is called vaginal dysbiosis. A feature of vaginal dysbiosis is increased vaginal pH, which can be caused by decreased lactic acid concentrations.2lactobacilli Species commonly found in the female reproductive tract are believed to play important roles in the vaginal microbiome due to their production of lactic acid, which helps maintain vaginal pH.2.3

The composition of the vaginal microbiome is constantly changing. Hormonal fluctuations during a woman’s reproductive life (eg, menstruation and pregnancy), medications (eg, antibiotics and hormonal contraceptives), sex, and vaginal douching are factors that can disrupt normal flora.4,5,6,7

To maintain the balance of the vaginal flora, women can benefit from a daily probiotic formulation that contains lactobacilli Strains to keep microflora within a normal range and support vaginal health.

lactobacilli are the dominant type of bacteria found in a healthy and balanced vagina.2 This type of bacteria thrives in an anaerobic environment like the vagina and produces byproducts like lactic acid, hydrogen peroxide, and bacteriocins. As the main source of lactic acid production in the vagina, lactobacilli Species help keep the pH of the vagina below 4.5.1

The International Scientific Association for Probiotics and Prebiotics defines probiotics as “live microorganisms which, when administered in appropriate amounts, confer a health benefit on the host”.8th Two main sources of probiotics are foods with natural or added probiotics (e.g. yogurt and infant formula) and dietary supplements.8th Health benefits vary depending on the probiotic strains offered in the supplement. Some probiotic supplements support digestive or immune system health, while others have other health benefits.*9

There are some supplements that are specifically formulated to support vaginal health. One such example is RepHresh Pro-B Probiotic Feminine Supplement, an OTC option formulated with specific strains, lactobacilli reuteri RC-14 (formerly classified as L. Fermentum RC-14) and lactobacilli rhamnosus GR-1 that support vaginal health. Both strains of bacteria have been studied and shown to positively influence the composition of the vaginal microbiota.*9

RepHresh Pro-B Capsules are taken once daily and contain 5 billion colony forming units from 2 clinically proven beneficial probiotic strains. lactobacilli rhamnosus GR-1 and lactobacilli reuteri RC-14. A clinical study has shown that RepHresh Pro-B Probiotic Feminine Supplement starts working in just 7 days. It provides 24/7 protection with daily use and helps maintain the balance of yeast and bacterial flora, which in turn supports a healthy vagina.*9 This dietary supplement is dairy, egg, fish, peanut, gluten and soy free and has a shelf life of 90 days after opening.9

lactobacilli Strains are probiotic strains that have a long history of safe use in humans.10 Women should talk to their doctor before starting any supplement or if they suspect a vaginal infection, develop an unusual discharge, pain, or any worrisome symptoms.9

Pharmacists can be a helpful resource to answer any questions about effective and safe probiotic options available at the pharmacy. When asked for a product recommendation, pharmacists can provide information on the differences between each probiotic formulation (e.g., digestive health formulations, yogurts with added probiotics, vaginal health formulations) and the benefits associated with the different strains.8th

Pharmacists have the opportunity to help women who come to the pharmacy and want information about a product that supports vaginal health and to keep their vaginal pH in a normal range. Pharmacists can share information about the RepHresh Pro-B female probiotic dietary supplement, including its 2 clinically proven probiotic strains to help maintain flora important to overall vaginal health, balance yeast and bacteria to maintain female health .*9

*These statements have not been evaluated by the US Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.


1. Chen X, Lu Y, Chen T, Li R. The female vaginal microbiome in health and bacterial vaginosis. Front Cell Infect Microbiol. 2021;11:631972. doi:10.3389/fcimb.2021.631972

2. Ma B, Forney LJ, Ravel J. Vaginal microbiome: rethinking health and disease. Annu Rev Microbiol. 2012;66(1):371-389. doi:10.1146/annurev-micro-092611-150157

3. Ceccarani C, Foschi C, Parolin C, et al. Diversity of the vaginal microbiome and metabolome in genital infections. Scientific Rep. 2019;9(1):14095. doi:10.1038/s41598-019-50410-x

4. Lin YP, Chen WC, Cheng CM, Shen CJ. Vaginal pH for the clinical diagnosis and treatment of common vaginitis. diagnosis (Basel). 2021;11(11):1996. doi:10.3390/diagnostics11111996

5. Spinillo A, Capuzzo E, Nicola S, Baltaro F, Ferrari A, Monaco A. The effect of oral contraception on vulvovaginal candidiasis. contraception. 1995;51(5):293-297. doi:10.1016/0010-7824(95)00079-p

6. Cribby S, Taylor M, Reid G. Vaginal microbiota and the use of probiotics. Interdisciplinary Perspective Infect Dis. 2008;2008:256490. doi:10.1155/2008/256490

7. Amabebe E, Anumba DOC. The vaginal microenvironment: The physiological role of lactobacilli. front med (Lausanne). 2018;5:181. doi:10.3389/fmed.2018.00181

8. Hill C, Guarner F, Reid G, et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014(11): 506-514. doi:10.1038/nrgastro.2014.66

9. RepHresh PRO-B Female Probiotic Dietary Supplement. leaflet. Church and Dwight Co., Inc. 2022.

10. Probiotics and prebiotics. World Gastroenterology Organization. Published February 2017. Accessed May 24, 2022.

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