There’s good and bad bacteria in there (fascinating fact: an estimated 100 trillion bacteria live inside your digestive tract): When the good outweighs the bad, your immune health soars; when the bad overpowers good, you get sick. You have diarrhea. Your immune system tanks. Your IBS, lactose intolerance, and other gut problems are exacerbated. It throws your entire system out of whack.
Kefir: This could be the most ideal probiotic dairy product because it contains both bacteria and yeast working together to provide the numerous health benefits. In a recent eight-week study, people with diabetes were given kefir milk containing Lactobacillus casei, Lactobacillus acidophilus, and bifidobacteria vs. conventional fermented milk. The hemoglobin A1C levels were significantly lower in the group consuming the kefir.

We are clearly getting to the strain level by going beyond “Saccharomyces boulardii” and to “Saccharomyces boulardii CNCM I-745”. They did a great job by actually putting it on the label so you don’t even have to contact the company to see exactly what strain you’re getting. (P.S. this is a well-researched strain that I highly recommend, especially for preventing antibiotic-associated diarrhea.)


Even if some of the bacteria in a probiotic managed to survive and propagate in the intestine, there would likely be far too few of them to dramatically alter the overall composition of one's internal ecosystem. Whereas the human gut contains tens of trillions of bacteria, there are only between 100 million and a few hundred billion bacteria in a typical serving of yogurt or a microbe-filled pill. Last year a team of scientists at the University of Copenhagen published a review of seven randomized, placebo-controlled trials (the most scientifically rigorous types of studies researchers know how to conduct) investigating whether probiotic supplements—including biscuits, milk-based drinks and capsules—change the diversity of bacteria in fecal samples. Only one study—of 34 healthy volunteers—found a statistically significant change, and there was no indication that it provided a clinical benefit. “A probiotic is still just a drop in a bucket,” says Shira Doron, an infectious disease expert at Tufts Medical Center. “The gut always has orders of magnitude more microbes.”
Let’s start at the very beginning: probiotics are bacteria. We know what you’re thinking, bacteria cause infections and are just generally kind of gross. Well, in some aspects, you’re absolutely right. But when it comes to your digestive and feminine health, some bacteria are teeny tiny miracle workers that can make all the difference in the way you feel!
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. "Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT." Cell (First published: September 6, 2018)  DOI: 10.1016/j.cell.2018.08.047

Experts agree that this is the most important factor to consider in choosing a probiotic. "You should absolutely choose a probiotic based on what you are looking to address," says Chang. "Because strain specificity will impact outcomes, it is important to consider that one strain that works for one condition will not necessarily be effective for other conditions."
Lacto-bacillus plantarum: If you’ve ever heard of the beneficial effects of fermented foods (pickles, sauerkraut, kimchi, etc.), then you’ve heard of this powerful probiotic, which may help improve the symptoms of IBS, gluten intolerance, soy allergies, and Crohn’s disease. This is also one of the most antibiotic-resistant probiotics, which is especially important if you have taken antibiotics recently.
In a food sensitivity, the immune reaction is delayed, usually several hours to days after the exposure. Food sensitivities are the most difficult to determine since there is not an immediate reaction. These kinds of issues with foods can cause a wide range of physical and mental problems. An elimination diet followed by reintroduction is one of the best ways to determine a food sensitivity.

Probiotic supplements are not drugs (in the United States), although super potent forms may be obtained through prescription. As such, they are not intended to treat or cure any diseases, mental or physical. Probiotics benefit and complement a healthy way of life filled with nutritious food, adequate exercise, restorative sleep, beneficial social engagements, reduced exposure to toxins, and hydration with clean water.
"Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse side effect of probiotic use with antibiotics that might even bring long-term consequences," Elinav says. "In contrast, replenishing the gut with one's own microbes is a personalized mother-nature-designed treatment that led to a full reversal of the antibiotics' effects."
Safety Warning In rare cases, some people may experience stomach upset due to Probiotics Cleansing Effect. This is positive sign as high potency probiotics removing waste or toxic substances from body. To avoid reaction, it's recommended to start with less dosage and slowly increase. Do not exceed recommended dose. Pregnant or nursing mothers, children under the age of 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement. May adversely affect existing medical conditions, including but not limited to: IBS (Irritable Bowel Syndrome), Gastritis, G.E.R.D. Please note: Probiotics may temporarily cause bloating, gas or gassy, stomach pain, hurt stomach or cramps (cramped, cramping), vomiting, nausea, diarrhea, constipation, changes in digestion, allergic reactions, heartburn, jitters, rashes, skin irritation, breakouts, headache, fatigue, changes in appetite, joints hurt, spike blood glucose, bad pains, terrible symptoms, tiredness, passed out or sick feeling or sickness. These possible side effects are rare and will vary from one person to another in occurrence and severity. This product does not contain Milk, Eggs, Soy, Wheat, Peanuts, Tree Nuts, Seafood, Fish. The Lactobacillus strain contained is grown on a dairy medium, but the dairy is removed in processing. People with severe allergies to dairy and those that are lactose intolerant should consult a medical professional before taking this product, as adverse reactions can occur. If for any reason you experience any adverse effects, immediately discontinue use of the product and consult with your doctor. Do not use if seal is missing or broken. Keep Out Of Reach of Children and Pets. KEEP OUT OF REACH OF CHILDREN. DO NOT USE IF SAFETY SEAL IS DAMAGED OR MISSING. STORE IN A COOL, DRY PLACE. Do not exceed recommended dose. Pregnant or nursing mothers, children under the age of 18 and individual with a known medical condition should consult a physician before using this or any other dietary supplement. Do not take this supplement if you are allergic to any of the listed ingredients. May adversely affect existing medical conditions, including but not limited to: G.E.R.D., IBS, Stomach Ulcer(s), asthma. Please note: Probiotics 60 Billion CFU may temporarily cause heartburn, gas, upset stomach, stomach cramps, stomach pain (hurt stomach), irritated stomach, burning stomach, acid reflux, bloating, constipation, increased chest congestion/mucus, insomnia, inflammation, fatigue, make your brain not feel right, nose bleeds, agitation, headaches, nausea, diarrhea (liquid stools, burning bowel movements, runs), intestinal issues, dry mouth, rash, itching, hives, dizziness, swollen tongue, vomiting, heart palpitations, fast heartbeat, unexpected issues or sickness. These possible side effects are rare and will vary from one person to another in occurrence and severity. If for any reason you experience any adverse effects, immediately discontinue use of the product and consult with your doctor. Do not use if seal is missing or broken. Keep Out Of Reach of Children and Pets. Caution: As with any dietary supplement, consult your healthcare practicioner before using this product, especially if you are pregnant, nursing, anticipate surgery, take medication on a regular basis or are otherwise under medical supervision. Keep out of reach of children. Do not use if safety seal is broken or missing. Contains no carriers, fillers, artificial colors . This product is labelled to United States standards and may differ from similar products sold elsewhere in its ingredients, labeling and allergen warnings
The good news keeps stacking up for probiotics, the good-for-you bacteria that keep your GI system functioning in tip-top shape. "Research is finding that a healthy microbiome may play a role in reducing inflammation, a risk factor involved in illnesses ranging from colds to cancer, heart disease, arthritis, and cognitive decline," says Katherine Tallmadge, RD, author of Diet Simple. In addition, the bacteria may help burn body fat and reduce insulin resistance, she says. So to stay slim and healthy, consider adding more probiotic foods to your diet. Start with these truly yummy 13.

Remember that dietary supplements are not tested by the U.S. Food and Drug Administration like medications. And the probiotic strains in the supplements may not be specific for the condition you're looking to treat. You may want to consult with a practitioner, like a registered dietitian, who is familiar with probiotics. Always tell your physician what you are doing that may affect your health.
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell, 2018; 174 (6): 1406 DOI: 10.1016/j.cell.2018.08.047
Flu is short for influenza, an upper respiratory viral infection. The main problem for you, and the main advantage for the survival of influenza viruses, is that there are many variations that can cause illness. Flu shots are based on virus strains that are anticipated to be widespread. Sometimes those assumptions are correct and other times they are not. This section will show you one overlooked way to fortify your body to best avoid becoming sick with the flu at all, or how to recover if you do succumb.
In the new study, the researchers analyzed information from 15 healthy volunteers who took either a probiotic product containing 11 strains of bacteria, or a placebo, for four weeks. The participants also underwent colonoscopies and upper endoscopies before they took the probiotics or the placebo, and again after the four-week treatment period. (An upper endoscopy looks at the upper part of the digestive tract.) During these procedures, the researchers took samples from inside participants' guts.
Most probiotics are like what is already in a person's digestive system. Some probiotics have been used for a very long time throughout history, such as in fermented foods and cultured milk products. These don't appear to cause illness. But more study is needed on the safety of probiotics in young children, the elderly, and people who have weak immune systems.
Known as the most clinically proven effective probiotic strain, Lactobacillus rhamnosus GG (otherwise known as “LGG”) has been clinically proven to maintain healthy numbers of bacteria and yeast for optimal digestive health. This powerful probiotic is also paired with some of the best probiotic strains for feminine health, making it an ideal choice for any woman that is looking for complete care from her probiotic.

The bottom line: Stick to trusted whole food sources of probiotics if you don’t know a probiotic supplement brand you trust. “Kimchi, pickled beets, Greek yogurt and sauerkraut are great sources of probiotics. If you don’t like them, throw them into a food you do like, like a smoothie, and add your favorite fruit to help mask the flavor,” Taub-Dix says.
One overlooked mechanism that supports your innate immunity is gut health, specifically the role probiotics play. Good probiotics benefit your health by keeping your gut microbiota, inflammation, and immune system balanced preventively, as well as acutely when you are sick, so that no matter which flu strain comes along, your immune system is ready.
After suffering from liquid nighttime but painless diarrhea for over a year (which I semi-controlled with one Imodium/day), I had a colonoscopy that gave a diagnosis of microcolitis. After the colonoscopy, I developed for the first time excrutiatingly painful gas pain in the LLQ. Usually this pain started during aerobic activity such as walking, but not always. Sometimes I woke up with it. CT scan revealed nothing. Will a probiotic help and if so, which would be best? There are so many it is hard to choose.

Even for those without an urgent problem, probiotics can help with overall digestive management. Challa argues in his book, Probiotics For Dummies, that good bacteria help "crowd out" bad bacteria. That's because the intestine is lined with adherence sites where bacteria latches on. If the sites are populated with good-for-you microbes, there's no place for a harmful bacterium to latch on.
By eating probiotic-rich foods and maintaining good intestinal flora, a person can also help to maintain a healthy immune system. And that has real world effects: for example, in one small study of students, those who were given a fermented dairy drink (instead of milk) displayed increased production from lymphocytes -- a marker of immune response.
In these cases, IBS is essentially just TMI. “For the colon to be functioning properly, it needs to be contracting and relaxing in a way that is conducive to regular bowel movements that occur at predictable times and don’t occur too frequently or too rarely," Lebwohl says. "And the bowel needs to be giving infrequent feedback to the brain. People should not be getting updates from their bowel in terms of cramps or the feeling of having to have a bowel movement too often. Yet, people with IBS get very frequent unsolicited ‘progress reports’ from the bowel.”
Renew Life Ultimate Flora offers 30 billion CFUs with 10 scientifically studied strains of Bifidobacterium and Lactobacillus, which according to current scientific research, are the two most prevalent good bacteria found in a healthy gut. In other words, you might choose these if you’re seeking a careful balance designed to re-establish proper immune health and digestive equilibrium.
Here’s a startling fact: For every one human cell we have, there are ten bacteria cells in our body to match it. That means that the majority of DNA in our body isn’t even human; it’s from the 500 bacteria species that call us home.1 Thinking about that much bacteria might have your skin crawling, but the relationship between human and bacteria is really a perfect synergy: we give bacteria room and board, and in return, they work hard to protect our intestinal health, which ultimately protects the health of our immune system and overall well-being. But if we have that much bacteria already living in our gut, you might be thinking to yourself, what are probiotics’ benefits?

The research also showed that while probiotics colonised the gastrointestinal tract of some people, the gut microbiome of others just expelled them. There was no way of telling from their stool sample which category people fell into. “Some people accept probiotics in their gut, while others just pass them from one end to the other,” says Elinav. They found that the probiotic colonisation patterns were highly dependent on the individual. That tells us that the concept that everyone can benefit from a universal probiotic bought from the supermarket is empirically wrong, he says.
Taking a probiotic every day is a good way to help prevent getting sick and having to go on antibiotics in the first place. Preventative measures, of course, are preferred. Another that is believed to help is upping your vitamin D intake when your immune system needs a boost. Diet is also huge in terms of preventing sickness. Studies show that you can change your microbiome within hours of adjusting your diet. If you’re not into sauerkraut, even just cutting back on sugar and eating more whole foods can make a difference.
This makes it harder for your immune system to work properly and leaves you open to feeling under the weather unnecessarily. The good news is that taking probiotics can help replenish your gut microbiome, and since 80% of your immune system is in your gut, this inevitably has a very supportive effect on your immunity. Probiotics also specifically support your mucosal immune systems, found in your ear, nose, and throat area and your lungs, helping you to maintain respiratory health.4

In the United States, most probiotics are sold as dietary supplements, which do not undergo the testing and approval process that drugs do. Manufacturers are responsible for making sure they're safe before they're marketed and that any claims made on the label are true. But there's no guarantee that the types of bacteria listed on a label are effective for the condition you're taking them for. Health benefits are strain-specific, and not all strains are necessarily useful, so you may want to consult a practitioner familiar with probiotics to discuss your options. As always, let your primary care provider know what you're doing.
"Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," says Segal. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."
If you’re most interested in taking a probiotic supplement for overall gut health, I suggest starting with 30 to 50 billion CFUs. Take probiotics on an empty stomach once or twice a day for at least three months. After that time, reassess and decide if the benefits warrant continuing a maintenance dose of the probiotic supplement. However, if you have SIBO, beware of starting a probiotic too soon after your treatment. In this case, it’s best to work with a health practitioner on which probiotic is right for each stage of the treatment.
Garden of Life RAW Probiotics are some of the most popular out there – and for good reason. Let’s start with the basics: You’ll get 85 billion CFUs and 31 to 33 probiotic strains out of your daily, whole-food, gluten-free, soy-free probiotic, which helps support the immune system, a healthy thyroid, nutrient absorption, digestive function, and a healthy microbial balance.

Do you strain with infrequent bowel movements? Do the feces look like separate hard lumps or like bunches of hard lumps stuck together, or are they pencil-thin? You may have constipation. The Bristol stool chart (BSC) was developed by two doctors as a way to differentiate between states of constipation, normal elimination, a state of lacking fiber, and states of inflammation. Stools are supposed to be long and sausage-like, with few or no cracks in the surface.


Lebwohl says IBS isn’t just about intestinal distress. For many IBS sufferers, it’s about the way our brain receives messages about pain. He describes the human colon as “almost reptilian” in the way that it contracts and relaxes throughout the day, but says these contractions are usually happening way below our threshold of consciousness, so we don’t even notice. In people with IBS, the neurotransmitters in our gut (yes, we have them in there too) may be sending severe distress signals to the brain about benign contractions happening in digestive tract.
Even if some of the bacteria in a probiotic managed to survive and propagate in the intestine, there would likely be far too few of them to dramatically alter the overall composition of one's internal ecosystem. Whereas the human gut contains tens of trillions of bacteria, there are only between 100 million and a few hundred billion bacteria in a typical serving of yogurt or a microbe-filled pill. Last year a team of scientists at the University of Copenhagen published a review of seven randomized, placebo-controlled trials (the most scientifically rigorous types of studies researchers know how to conduct) investigating whether probiotic supplements—including biscuits, milk-based drinks and capsules—change the diversity of bacteria in fecal samples. Only one study—of 34 healthy volunteers—found a statistically significant change, and there was no indication that it provided a clinical benefit. “A probiotic is still just a drop in a bucket,” says Shira Doron, an infectious disease expert at Tufts Medical Center. “The gut always has orders of magnitude more microbes.”
While taking a daily probiotic supplement may seem like an easy answer to cure common gut ailments, it’s always best to try for a food first approach, since you can get probiotics from the foods you eat. Probiotics can be found in foods such as yogurt, cheese, miso, sauerkraut, and kimchi. But, adding a supplement into the mix if you haven’t achieved the desired effect through diet alone can be effective.
Immunity and colds/flu.There’s a close connection between the bacteria in your colon and the immune system. Several studies, including one in 2012 in the British Journal of Nutrition, have found that certain probiotic strains boost measures of immune response—but whether this translates into any clinical benefits is uncertain. Studies have been inconsistent, for example, as to whether probiotics will actually curb colds and other upper respiratory infections. In 2014 a review in the British Journal of Nutrition, which looked at 20 clinical trials, linked probiotics to shorter duration of colds, but not necessarily reduced incidence or severity. Similarly, a 2015 Cochrane review of 12 clinical trials concluded that certain probiotics may help prevent or shorten such infections, though the quality of the studies was poor.
The popular frenzy surrounding probiotics is fueled in large part by surging scientific and public interest in the human microbiome: the overlapping ecosystems of bacteria and other microorganisms found throughout the body. The human gastrointestinal system contains about 39 trillion bacteria, according to the latest estimate, most of which reside in the large intestine. In the past 15 years researchers have established that many of these commensal microbes are essential for health. Collectively, they crowd out harmful microbial invaders, break down fibrous foods into more digestible components and produce vitamins such as K and B12.
“I’d probably stay away from store brands and pay a little extra for the name brand that’s been studied,” Dr. Cresci adds. “Ideally, look for a product that’s been tested for whatever you’re looking to address. It might say it helps with IBS, but you wouldn’t take that same product if you were taking antibiotics. You would want a product that helps with immunity. That’s where a lot of people get confused.”
As a world-renowned neurologist and nutritionist, Dr. David Perlmutter has become somewhat of a household name when it comes to the linkage between what we eat and how we feel. He is known as “The Empowering Neurologist” and has been featured on the Doctor Oz Show, CNN, and NPR as well as in prominent publications like The New York Times, Forbes, Time Magazine, and the Wall Street Journal. If that wasn’t enough to spark your interest, Dr. Perlmutter is also the award-winning author of the Grain Brain Whole Life Plan, Brain Maker, and Grain Brain, all of which have become international bestsellers.
This mildly sour, chewy bread is made with a lactic acid starter that contains strains of lactobacillus, a friendly type of bacteria that adds good microbes into the bakery staple. Sourdough may be the healthiest bread choice if diabetes is a concern for you: one 2008 study found that people with pre-diabetes who ate sourdough bread had less of a blood sugar spike compared to when they ate bread made with baker's yeast. (Experts also say fiber-rich whole grain bread can also reduce a post-meal blood sugar spike.) The researchers credit the lactic acid for the favorable effect.
Prebiotics and supplementary ingredients — For probiotic bacteria to grow, they also need prebiotics. High-quality probiotic supplements have both prebiotics and other ingredients designed to support digestion and immunity. Examples of these ingredients are (preferably fermented) flaxseed, chia seed, cañihua seed, astragalus, ashwagandha, hemp seed, pumpkin seed, milk thistle, peas, ginger, mung bean and turmeric.
Most people with diverticulosis have few if any symptoms at all. When people do experience signs and symptoms of diverticulosis (diverticular disease) they may include abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon. Treatment methods for diverticulitis includes prescription medications, and in some cases, diverticulitis surgery.
What's more, there's still a lot more to learn about the microbiome and probiotics, in general. "Truth be told, the research area of probiotics and health is still pretty much in its infancy," says registered dietitian Kate Scarlata. Research is growing in the area of gut microbiome daily—but it is much more complicated than first thought." With all these options and major gaps in the available information, where are you supposed to start? Here, gut experts narrow it down to three simple tips for picking the right probiotic for you.
Colic is crying or fussing that begins suddenly, lasting for a total of three hours a day and happening more than three days a week for about three weeks. Symptoms include the baby's face turning red, the belly is distended, the feet may be cold, the hands clenched, and the legs may alternate between being flexed or extended. Treatment may involve ruling out other causes of the fussing and the doctor prescribing anti-gas bubbly medicine.

​​​​​​Every woman’s microbiota is different and so results will vary. However clinical studies using the blend of probiotic strains in AZO Complete Feminine BalanceTM demonstrated benefits in as little as 7 days. We suggest continuing with use of the product for a minimum of 30 days. Also, keep in mind that for regular maintenance, you may not SEE results but the product is still helping to protect and maintain a healthy vaginal flora.*
As you progress with increasing dosages of probiotics internally, you may experience increased abdominal gas, upset digestion with diarrhea, headache, fever, muscle pain, brain fog, and/or anxiety. If the symptoms become too uncomfortable, decrease the dosage for a few days and try again. These symptoms are your body’s way of telling you that things—such as a die-off of pathogens or an awakened intestinal reflex—are changing.
Most probiotics are like what is already in a person's digestive system. Some probiotics have been used for a very long time throughout history, such as in fermented foods and cultured milk products. These don't appear to cause illness. But more study is needed on the safety of probiotics in young children, the elderly, and people who have weak immune systems.
You may have heard some questions over whether SBOs are safe: The NIH has a presumed case report, which hasn’t been 100 percent verified, of someone with Lymphoma getting septicemia from taking a SBO (the organism B. subtilis). Some say that if you have leaky gut, you should heal it before supplementing with SBOs. If you are immunocompromised or have cancer, you can consult with a physician first to be safe.
This smooth, slightly tangy, and sippable yogurt contains a dozen different types of live active cultures. It's also 99% lactose-free, making it easier to digest for those with intolerant tummies. "If you have lactose intolerance, start slowly on kefir as a test. If you have no symptoms, go ahead and slowly increase your intake," advises Tallmadge. Plus, with 8 to 11 grams of protein per cup (depending on the brand), it can help fill you up for around 100 calories.
What's nice about supplement company Care/of is that it allows you to design personalized daily vitamin and supplement packs containing everything you need, including probiotics. Its vegan, gluten-free probiotic formula has one billion lactobacillus acidophilus and four billion bifidobacterium lactis per dose, popular strains thought to help promote digestive and immune health.
Candida albicans is the most common species that causes yeast infections, but there are others. It is a normal inhabitant of the gastrointestinal tract and is often found in the female vaginal tract. Candida infections on the skin cause red, itchy rashes that often weep moisture, and in the vagina there is often a cottage-cheese-like discharge in addition to the skin symptoms.
Probiotics and raw fermented foods and drinks, such as sauerkraut and kefir that contain probiotic-like microbes, are very helpful for digestion. They help to keep your gastrointestinal tract at the proper pH for optimal digestion and help to break down foods. They also regulate the motion of your intestines so that food moves through at the proper pace.

Candida albicans is the most common species that causes yeast infections, but there are others. It is a normal inhabitant of the gastrointestinal tract and is often found in the female vaginal tract. Candida infections on the skin cause red, itchy rashes that often weep moisture, and in the vagina there is often a cottage-cheese-like discharge in addition to the skin symptoms.
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