Probiotics, particularly strains of Lactobacillus, have shown promising efficacy as microbiome-targeted interventions (MBTIs) in the management of vulvovaginal candidiasis (VVC). By restoring Lactobacillus dominance and suppressing pathogenic Candida species, probiotics address both the microbial dysbiosis and host inflammatory pathways underlying VVC. Recent randomized controlled trials and meta-analyses indicate that adjunctive probiotic therapy enhances cure rates, reduces recurrence, and leads to sustained improvements in vaginal microbiome composition.
Probiotics as microbiome-targeted intervention for Vulvovaginal Candidiasis (VVC)
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Divine Aleru
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Divine Aleru
Read MoreI am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
Probiotics have emerged as a promising microbiome-targeted intervention (BTI) for vulvovaginal candidiasis (VC), addressing both microbial imbalances and the host’s immunological and inflammatory mechanisms. By restoring a healthy Lactobacillus-dominated vaginal microbiota, probiotics directly counteract dysbiosis linked to VC, while their bioactive metabolites such as lactic acid and bacteriocins suppress Candida overgrowth and modulate local immune […]
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Divine Aleru
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Researched by:
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Divine Aleru
ID
Divine Aleru
Read More
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Divine Aleru
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References Overview
Probiotics have emerged as a promising microbiome-targeted intervention (MBTI) for vulvovaginal candidiasis (VVC), addressing both microbial imbalances and the host’s immunological and inflammatory mechanisms. By restoring a healthy Lactobacillus-dominated vaginal microbiota, probiotics directly counteract dysbiosis linked to VVC, while their bioactive metabolites such as lactic acid and bacteriocins suppress Candida overgrowth and modulate local immune responses.[1] Clinical and meta-analytic evidence suggests that probiotics not only reduce recurrence rates and improve clinical outcomes but also reinforce the specificity and accuracy of the VVC microbiome signature by targeting key depleted and enriched taxa.[2]
Validation of Probiotics as an MBTI
Mechanistically, probiotics, especially strains of Lactobacillus rhamnosus, L. crispatus, L. gasseri, and L. jensenii, exert several molecular actions: (1) they acidify the vaginal microenvironment via lactic acid production, inhibiting Candida adherence and hyphal growth; (2) they produce hydrogen peroxide and bacteriocins, further restricting pathogenic colonization; (3) they competitively exclude Candida at adhesion sites and (4) modulate host cytokine profiles, enhancing anti-inflammatory responses and mucosal immunity.[3][4] Recent randomized controlled trials and meta-analyses have shown that adjunctive probiotic therapy alongside antifungals leads to greater clinical and mycological cure rates, with significant reductions in recurrence risk compared to antifungal treatment alone.[5]
Microbial Effects Summary Table
| Microbial Effect of Probiotics | VVC Microbiome Signature |
|---|---|
| Lactobacillus spp. | Corrects depletion of Lactobacillus seen in VVC |
| Candida spp. (especially C. albicans) | Targets overgrowth of Candida in VVC |
| Gardnerella, Prevotella, Ruminococcus | Aligns with reduced dysbiotic/anaerobic taxa |
| Restoration of acidic pH (lactic acid) | Reverses elevated vaginal pH in dysbiosis |
| Pro-inflammatory cytokines | Matches shift away from inflammatory milieu |
Validation of the Microbiome Signature of VVC
The microbiome signature of VVC is characterized by a marked depletion of Lactobacillus species (notably L. crispatus and L. gasseri) and an overgrowth of Candida albicans and, at times, anaerobes such as Gardnerella and Prevotella. Clinical and molecular studies demonstrate that probiotic interventions restore Lactobacillus dominance while suppressing pathogenic fungi and bacteria, thereby confirming that these taxa serve as robust biomarkers for VVC dysbiosis.[6][7] The observed increase in Lactobacillus and decrease in Candida abundance following probiotic therapy directly support the validity and specificity of the VVC microbiome signature.
Dual Validation
The use of probiotics as an MBTI in vulvovaginal candidiasis is substantiated by both clinical and microbiological evidence: targeted shifts in microbial taxa (increase in Lactobacillus, decrease in Candida, and dysbiotic anaerobes) are tightly aligned with symptomatic and mycological improvement. These dual outcomes validate both the intervention and the microbiome signature of VVC, confirming the value of probiotics in precision-guided therapy and reinforcing the microbiome-based classification of vulvovaginal candidiasis.
Research Feed
Vaginal microbiota: Potential targets for vulvovaginal candidiasis infection
March 2, 2024
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Vulvovaginal Candidiasis (VVC) •
Vulvovaginal Candidiasis (VVC)
Did you know?
Antibiotics can increase the risk of VVC. Antibiotics can disrupt the balance of the vaginal microbiome by reducing Lactobacillus levels, allowing Candida to overgrow and cause infection. This is why VVC is often a side effect of antibiotic treatment.
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
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Dual Mechanisms of Action: Anti-Candida and Anti-Inflammatory Potential of Lactobacillus Fermentation Broth in Treating Vulvovaginal Candidiasis
December 30, 2024
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Vulvovaginal Candidiasis (VVC) •
Vulvovaginal Candidiasis (VVC)
Did you know?
Antibiotics can increase the risk of VVC. Antibiotics can disrupt the balance of the vaginal microbiome by reducing Lactobacillus levels, allowing Candida to overgrow and cause infection. This is why VVC is often a side effect of antibiotic treatment.
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
Create a free account to unlock this study summary.
Microbiome Insiders can read two study summaries for any topic on Microbiome.
Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review
January 28, 2020
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Bacterial Vaginosis •
Bacterial Vaginosis
Did you know?
Bacterial vaginosis (BV) increases the risk of acquiring HIV by up to 60% in women due to the disruption of the protective vaginal microbiome and the resulting inflammation that facilitates the virus’s entry.
Vulvovaginal Candidiasis (VVC) •
Vulvovaginal Candidiasis (VVC)
Did you know?
Antibiotics can increase the risk of VVC. Antibiotics can disrupt the balance of the vaginal microbiome by reducing Lactobacillus levels, allowing Candida to overgrow and cause infection. This is why VVC is often a side effect of antibiotic treatment.
Alias iure reprehenderit aut accusantium. Molestiae dolore suscipit. Necessitatibus eum quaerat. Repudiandae suscipit quo necessitatibus. Voluptatibus ullam nulla temporibus nobis. Atque eaque sed totam est assumenda. Porro modi soluta consequuntur veritatis excepturi minus delectus reprehenderit est. Eveniet labore ut quas minima aliquid quibusdam. Vitae possimus fuga praesentium eveniet debitis exercitationem deleniti.
Create a free account to unlock this study summary.
Microbiome Insiders can read two study summaries for any topic on Microbiome.
Probiotics
Probiotics are live microorganisms that offer significant health benefits when administered in adequate amounts. They primarily work by modulating the gut microbiome, supporting a balanced microbial ecosystem. Probiotics have been shown to improve gut health, modulate immune responses, and even influence metabolic and mental health disorders. With growing evidence supporting their therapeutic potential, probiotics are increasingly recognized for their role in treating conditions like irritable bowel syndrome (IBS), antibiotic-associated diarrhea (AAD), and even mental health conditions like depression and anxiety through their impact on the gut-brain axis.
Microbiome-Targeted Interventions (MBTIs)
Microbiome Targeted Interventions (MBTIs) are cutting-edge treatments that utilize information from Microbiome Signatures to modulate the microbiome, revolutionizing medicine with unparalleled precision and impact.
Vulvovaginal Candidiasis (VVC)
Vulvovaginal candidiasis (VVC) is a common fungal infection caused by Candida albicans. Disruptions in the vaginal microbiome and immune responses contribute to its development. Effective treatment involves both antifungal therapy and strategies to restore microbiome balance, preventing recurrent infections and addressing emerging antifungal resistance.
References
- The Role of Probiotics in the Treatment of Vulvovaginal Candidiasis: A Systematic Review and Meta-Analysis. Zahedifard T, Khadivzadeh T, Rakhshkhorshid M.. (Ethiop J Health Sci. 2023 Sep;33(5):881-890)
- The Role of Probiotics as Adjunct Treatment in the Prevention and Management of Gynecological Infections: An Updated Meta-analysis of 35 RCT Studies. Abavisani, Mohammad, Saeed Sahebi, Farhad Dadgar, Farzaneh Peikfalak, and Masoud Keikha. (Taiwanese Journal of Obstetrics and Gynecology 63, no. 3 (2024): 357-368. Accessed June 6, 2025.)
- Probiotics in the Management of Vulvovaginal Candidosis. Akinosoglou K, Schinas G, Polyzou E, Tsiakalos A, Donders GGG.. (Journal of Clinical Medicine. 2024; 13(17):5163.)
- The Role of Probiotics in Women's Health: An Update Narrative Review.. Wu, Ling, Tsai Yang, Yu Ou, and Hao Lin.. (Taiwanese Journal of Obstetrics and Gynecology 63, no. 1 (2023): 29-36. Accessed June 6, 2025.)
- The Role of Probiotics in the Treatment of Vulvovaginal Candidiasis: A Systematic Review and Meta-Analysis. Zahedifard T, Khadivzadeh T, Rakhshkhorshid M.. (Ethiop J Health Sci. 2023 Sep;33(5):881-890)
- Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review. Kalia, N., Singh, J. & Kaur, M.. (Ann Clin Microbiol Antimicrob 19, 5 (2020))
- The Role of Probiotics in Women's Health: An Update Narrative Review.. Wu, Ling, Tsai Yang, Yu Ou, and Hao Lin.. (Taiwanese Journal of Obstetrics and Gynecology 63, no. 1 (2023): 29-36. Accessed June 6, 2025.)
Zahedifard T, Khadivzadeh T, Rakhshkhorshid M.
The Role of Probiotics in the Treatment of Vulvovaginal Candidiasis: A Systematic Review and Meta-AnalysisEthiop J Health Sci. 2023 Sep;33(5):881-890
Abavisani, Mohammad, Saeed Sahebi, Farhad Dadgar, Farzaneh Peikfalak, and Masoud Keikha
The Role of Probiotics as Adjunct Treatment in the Prevention and Management of Gynecological Infections: An Updated Meta-analysis of 35 RCT StudiesTaiwanese Journal of Obstetrics and Gynecology 63, no. 3 (2024): 357-368. Accessed June 6, 2025.
Akinosoglou K, Schinas G, Polyzou E, Tsiakalos A, Donders GGG.
Probiotics in the Management of Vulvovaginal CandidosisJournal of Clinical Medicine. 2024; 13(17):5163.
Wu, Ling, Tsai Yang, Yu Ou, and Hao Lin.
The Role of Probiotics in Women's Health: An Update Narrative Review.Taiwanese Journal of Obstetrics and Gynecology 63, no. 1 (2023): 29-36. Accessed June 6, 2025.
Zahedifard T, Khadivzadeh T, Rakhshkhorshid M.
The Role of Probiotics in the Treatment of Vulvovaginal Candidiasis: A Systematic Review and Meta-AnalysisEthiop J Health Sci. 2023 Sep;33(5):881-890
Kalia, N., Singh, J. & Kaur, M.
Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical reviewAnn Clin Microbiol Antimicrob 19, 5 (2020)
Read ReviewWu, Ling, Tsai Yang, Yu Ou, and Hao Lin.
The Role of Probiotics in Women's Health: An Update Narrative Review.Taiwanese Journal of Obstetrics and Gynecology 63, no. 1 (2023): 29-36. Accessed June 6, 2025.