​​​​​​Lactobacilli dominate a healthy vaginal microbiota. Menstrual cycles, sexual activity, diet, certain medications, hygiene, and other factors can occasionally disrupt the vaginal microbiome. AZO Feminine Balance Daily Probiotic has been clinically demonstrated to contribute to the colonization of these important lactobacilli in the vagina.* The result: restoring the natural balance of good bacteria and yeast to maintain vaginal health.*

​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Researchers that formulated the blend started by selecting species that are dominant in the healthy vaginal microbiota. Then they further refined the formula by selecting strains of probiotics that flourish in the vagina. The blend is clinically proven to help protect vaginal/feminine health.*

Unless you have a perfect gut and are already eating lots of fermented foods—which is rare, although you can work up to this point—it’s difficult to get all the probiotics you need from diet alone. Most of us don’t have perfect guts—everything from antibiotics to high-carbohydrate diets to being born via a C-section can compromise the balance of bacteria in our microbiome. Supplementing with a probiotic can help to restore imbalances, and it’s also just a great preventative health measure, helping to keep your microbiome in balance and your immune system healthy to ward off illnesses.
What about prebiotics vs probiotics? Prebiotics are the food fibers that go through the gut unchanged and are then used by good colon bacteria as a food source for their own growth. Everyone already has most of these good bacteria present, but often in small quantities. Prebiotics are used to stimulate their growth. Simply stated, you already grow your own probiotics within your colon. You do not rely on them to make the passage through the stomach acid — acid that can destroy many probiotic bacteria. That’s why taking a probiotic supplement or adding probiotic foods to your diet does not always help your digestive system. You can eat as many probiotic bacteria as you want, but if they don’t survive the trip to the colon, your effort will be fruitless.
Made from fermented cabbage and other vegetables, sauerkraut is not diverse in probiotics but is high in organic acids (what gives food its sour taste) that support the growth of good bacteria. Sauerkraut is extremely popular in Germany today. It is high in vitamin C and digestive enzymes. It’s also a good source of natural lactic acid bacteria, such as lactobacillus.
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."
Undaunted, researchers looked into whether probiotics might be beneficial in a host of disorders, even when the connection to gut health and the microbiome was tenuous. Reviews show that there is insufficient evidence to recommend their use to treat or prevent eczema, preterm labor, gestational diabetes, bacterial vaginosis, allergic diseases or urinary tract infections.
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.
However, these quality of life improvements are varied, and some improvements are quite mild. Sample group, types of allergies, symptoms, and results are across a broad spectrum. For example, numerous studies have shown that allergic rhinitis responses to the household dust mite decrease significantly in adults and children when probiotics were used. However, people allergic to birch pollen saw neither a decrease in general allergic responses to birch pollen or to apple food.
Before buying this, I didn't realize that some strains of bacteria used in probiotics produce histamines. When I discovered this, I looked up which ones do, and all three I discovered are used in this one. If you're sensitive to histamines or have leaky gut (which makes you sensitive to histamines), then this is not for you. According to an article on bullet proof, an overload of histamines "leads to increased inflammation and many other symptoms including: skin irritation, hives, throat tightening, increased heart rate, nasal congestion, migraines, fatigue, heartburn, reflux, and weight gain." I'm sure this can work for some people, but probably only despite the histamine-producing bacteria.
If you want to supercharge your probiotic friends, you may want to feed them with prebiotics. That’s P-R-E-biotics. They nourish the good bacteria in your gut in order to keep them healthy against the bad bacteria. They should go hand-in-hand with probiotics. Prebiotics are found in many foods, including bananas, whole grains, honey, garlic and onions. Try to get two to four servings of these prebiotic-rich foods a day.
Rachel Allen is a writer at Hyperbiotics who's absolutely obsessed with learning about how our bodies work. She's fascinated by the latest research on bacteria and the role they play in health, and loves to help others learn about how probiotics can help the body get back in balance. For more ideas on how you can benefit from the power of probiotics and live healthier days, be sure to subscribe to our newsletter. To learn more about how a healthy microbiome can enrich your life, subscribe to our newsletter.

With Prebiotin, you can easily add prebiotic fiber to your diet without worrying about eating huge amounts of troublesome foods or hunting down hard-to-find ingredients. You also won’t have to worry about loading up on high-calorie foods that can negatively affect any effort to lose weight. Combining Prebiotin prebiotic fiber with a diet enriched with probiotic foods can only help your effort to positively influence the bacterial balance in your lower gut.


Unfortunately, the U.S. has no federal standards for probiotic supplements. Therefore, you run the risk of purchasing a product without any guarantee that it contains its advertised probiotic strains, that the strains are alive, or that the product is free from unhealthy ingredients. Therefore, it may be best to choose a brand-name probiotic that has research backing their effectiveness. Here are some examples:
Many Lactobacillus and Bifidobacterium species are naturals at protecting and improving gut health. Additionally, research in animals and humans has shown that probiotics decrease scores on depression assessments, thereby alleviating depression. As a matter of fact, there is a new term, psychobiotics, for these microbes that influence mental health conditions like depression.
Niv Zmora, Gili Zilberman-Schapira, Jotham Suez, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Eran Kotler, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Yotam Cohen, Raquel Linevsky, Daphna Rothschild, Andreas E. Moor, Shani Ben-Moshe, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Hagit Shapiro, Meirav Pevsner-Fischer, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. Personalized Gut Mucosal Colonization Resistance to Empiric Probiotics Is Associated with Unique Host and Microbiome Features. Cell, 2018; 174 (6): 1388 DOI: 10.1016/j.cell.2018.08.041

EDITOR’S CHOICE: As the only probiotic formula we reviewed backed by a New York Times Bestselling author and expert in the human biome, the Garden of Life Dr. Formulated Once Daily Women’s Probiotic is our top choice for overall digestive and women’s health. With 50 billion cultures and 16 probiotic strains, this probiotic helps to promote women’s digestive, immune and vaginal health.


One review of probiotics benefits for necrotizing enterocolitis was bold enough to say, “The results confirm the significant benefits of probiotic supplements in reducing death and disease in preterm neonates. The … evidence indicate that additional placebo-controlled trials are unnecessary if a suitable probiotic product is available.” Regarding sepsis in developing countries (where it is overwhelmingly more common), a 2017 randomized, controlled trial claims that a large number of these cases “could be effectively prevented” if mothers are given a synbiotic (probiotic and prebiotic together) that contains the probiotic strain L. plantarum.
Probiotics may also be of use in maintaining urogenital health. Like the intestinal tract, the vagina is a finely balanced ecosystem. The dominant Lactobacilli strains normally make it too acidic for harmful microorganisms to survive. But the system can be thrown out of balance by a number of factors, including antibiotics, spermicides, and birth control pills. Probiotic treatment that restores the balance of microflora may be helpful for such common female urogenital problems as bacterial vaginosis, yeast infection, and urinary tract infection.

Similar to yogurt, this fermented dairy product is a unique combination of milk and fermented kefir grains. Kefir has been consumed for well over 3,000 years, and the term kefir was started in Russia and Turkey and means “feeling good.” It is created by the fermentation of milk by the bacteria, and yeasts in kefir starter break down lactose in the milk — that’s why kefir may be suitable for those who are otherwise lactose-intolerant.
Rachel Allen is a writer at Hyperbiotics who's absolutely obsessed with learning about how our bodies work. She's fascinated by the latest research on bacteria and the role they play in health, and loves to help others learn about how probiotics can help the body get back in balance. For more ideas on how you can benefit from the power of probiotics and live healthier days, be sure to subscribe to our newsletter. To learn more about how a healthy microbiome can enrich your life, subscribe to our newsletter.
Every day, we’re exposed to toxins and inflammation-causing molecules from food and the environment that negatively impact digestion through pathways, such as leaky gut, known in the medical field as intestinal hyperpermeability. In leaky gut, the tight junctions that are supposed to keep disease-contributing compounds from leaving the digestive system are disrupted, allowing a lot of things through into the bloodstream that don’t belong there.
The high quality supplement comes in veggie capsule form, and no refrigeration is necessary. This probiotic is made in an FDA registered facility (in the US), and it meets GMP standards. It’s an all natural supplement, that’s free of lactose, soy and gluten. It also contains no artificial coloring. DNA Shift probiotic also offers prebiotic fiber for an extra healthy brain and gut.

If you don’t have a specific health goal in mind and want to bolster the number of good bacteria floating around your system, Perlmutter recommends starting with a minimum of eight to 10 different bacterial species. He included a core five (L. Plantarum, L. Acidophilus, L. Brevis, B. Lactis, and B. Longum) and we added five more highly researched and universally beneficial strains for a general health pick. Vita Miracle, formerly Islands Miracle, has nine of those 10, plus 30 billion CFUs per serving.


The takeaway: Certain strains were found useful in preventing diarrhea among children being prescribed antibiotics. A 2013 review showed that after antibiotic use, probiotics help prevent Clostridium difficile-associated diarrhea. A review focused on acute infectious diarrhea found a benefit, again for certain strains of bacteria at controlled doses. There’s also evidence that they may help prevent necrotizing enterocolitis (a serious gastrointestinal condition) and death in preterm infants.
A number of probiotic products are on the market, including yogurts containing probiotics, as well as supplements and skin creams, and an estimated 3.9 million Americans use such products. Some studies suggest that probiotics may help with diarrhea or symptoms of irritable bowel syndrome (IBS), but strong evidence to support their use for most health conditions is lacking, according to the National Center for Complementary and Integrative Health.

In 2019, dietary restrictions have become so mainstream that it is virtually impossible to step into a restaurant without spotting a specialized menu for dairy, gluten, vegan, and vegetarian eaters. The supplement industry is no exception and the majority of high-quality probiotics available on the market today include vegan or vegetarian capsules. Many brands are also gluten-free these days as well, and several are dedicated to keeping their formulas free of dairy, soy, and many other common allergens.
Probiotics have direct and indirect effects on your immune system. They can help tip an imbalance in an immune response, such as in seasonal allergies, to a more balanced state. Probiotics benefits have direct and indirect effects on your nervous and endocrine systems, too, and are part of your enteric nervous system. They can influence every system in your body. The amount of probiotic pills and supplements shown to be beneficial in research for various conditions differs based on the population and condition studied, so no blanket recommendations can be made.
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.
Digestive tract conditions. Probiotic supplements may be useful in treating and preventing inflammatory conditions, such as pouchitis (which affects people who have their colons removed), inflammatory bowel diseases (such as ulcerative colitis and Crohn's disease), and chronic stomach inflammation and ulcers caused by Helicobacter pylori bacterium. They may also be helpful in treating constipation, irritable bowel syndrome, acid reflux, spastic colon; shortening the duration of infectious diarrhea; and reducing the recurrence of bladder and colorectal cancer. Some studies suggest that yogurt is helpful in preventing diarrhea - a common side effect of treatment with antibiotics. It has also been shown to prevent or treat urinary tract infections and vaginal yeast infections in women.
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.
Whether a brand of probiotics works really depends on its quality and your body's own gut. Everyone has a different set of gut flora so try several to see what works for you. Using a brand of at least 40 billion CFU is best. There seems to be some debate as to whether one should use refrigerated or unrefrigerated probiotics. I went with the side that claims unrefrigerated are sturdier and less prone to die off.

If you’ve ever clicked on the 6:00 news or scrolled through the latest headlines on your smartphone, you probably know that supplements and vitamins are not typically backed by governmental entities like the FDA or the World Health Organization. This fact can leave supplement newbies a bit wary, which is exactly why we love the Garden of Life Dr. Formulated Once Daily Women’s Probiotic so much.
"The name itself is derived from the Latin 'pro-' meaning 'for' and the Greek '-biotic' meaning 'life,'" explains Jeannel Astarita, skincare expert and founder of Just Ageless NYC Wellness and Medspa. "Probiotics are the helpful bacteria that live primarily in your gut and play a crucial role in your overall health by fighting pathogens and yeast that lead to a weakened immune system."
Since the bulk of your natural flora exists in your gut, it makes sense that this is the part of your body that feels it most when bacteria become imbalanced. Women, in particular, can experience all kinds of digestive problems, particularly during hormone fluctuations. These are just some of the digestive symptoms a high-quality probiotic can help reduce and even treat:
Probiotics may also be of use in maintaining urogenital health. Like the intestinal tract, the vagina is a finely balanced ecosystem. The dominant Lactobacilli strains normally make it too acidic for harmful microorganisms to survive. But the system can be thrown out of balance by a number of factors, including antibiotics, spermicides, and birth control pills. Probiotic treatment that restores the balance of microflora may be helpful for such common female urogenital problems as bacterial vaginosis, yeast infection, and urinary tract infection.
Similar to yogurt, this fermented dairy product is a unique combination of milk and fermented kefir grains. Kefir has been consumed for well over 3,000 years, and the term kefir was started in Russia and Turkey and means “feeling good.” It is created by the fermentation of milk by the bacteria, and yeasts in kefir starter break down lactose in the milk — that’s why kefir may be suitable for those who are otherwise lactose-intolerant.
If you have an immune system problem or another serious health condition, you may have a greater chance of issues. Some reports have linked probiotics to serious infections and other side effects. The people most likely to have trouble are those with immune system problems, people who've had surgery, and others who are critically ill. Don't take probiotics if you have any of those issues.
According to Bonnie Taub-Dix, MA, RD, CDN, founder of Better Than Dieting and author of Read It Before You Eat It, “We have more bacterial cells in our body than actual tissue, so you want as much “good” bacteria to be on your side. But not all probiotics are alike, and how your body reacts to them will not be the same as someone else who takes them.”

Probiotic bacteria actually compete against unfriendly flora for bacterial binding sites on the inside lining of your intestines, further protecting you from these harmful pathogens. One way to repopulate your gut with probiotics to restore harmony and get all their many benefits is with the right foods, which can support the growth and proliferation of good bacteria that crowd out the bad ones.
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.”
Probiotics are a big and rapidly growing business and are now among the most popular dietary supplements. The term probiotic refers to dietary supplements (tablets, capsules, powders, lozenges and gums) and foods (such as yogurt and other fermented products) that contain “beneficial” or “friendly” bacteria. The organisms themselves are also called probiotics.
"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."
In addition to its powerful probiotic strands, the Vitamin Bounty Women’s Pro-Daily Probiotic also features a proprietary women’s health formula. This blend includes many of the minerals and plant extracts that have been found to be the most beneficial to women’s health, making it ideal for any women that have experienced feminine health problems. Specifically, this Vitamin Bounty formula includes Ashwagandha Root Powder, Cranberry Fruit Powder and Black Cohosh Root Powder.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.
However, this particular probiotic does not contain any additional vitamins, minerals, or plant extracts like some of the other brands we have reviewed. The Probiotic Pearls are a great option for women looking for an introductory probiotic or one with less fuss, but likely won’t pack the same punch as probiotics that include mineral blends and added vitamins in their formulas. This probiotic was also not designed to treat or prevent urinary tract problems, and may not be as suitable as other brands for women with recurrent urinary tract infections.

Undaunted, researchers looked into whether probiotics might be beneficial in a host of disorders, even when the connection to gut health and the microbiome was tenuous. Reviews show that there is insufficient evidence to recommend their use to treat or prevent eczema, preterm labor, gestational diabetes, bacterial vaginosis, allergic diseases or urinary tract infections.

Coming in at a close second, our runner-up as the best probiotic for women is the Culturelle Women’s Healthy Balance Probiotic. As the #1 recommended brand by pharmacists, it is easy to see why so many women are turning to Culturelle for their digestive health. Featuring the LGG culture and a laundry list of other healthy bacteria, this probiotic offers a wonderful balance between digestive and feminine health. The Culturelle Women’s Healthy Balance Probiotic is also taken in an easy, chewable tablet and can even be taken during pregnancy, making it one of the most versatile formulas we reviewed!

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