Evidence explainerVaginal Health: BV & Yeast

Vaginal Probiotics vs Placebo: What the Trials Show for BV and Yeast Infections

A vaginal Lactobacillus crispatus product cut BV recurrence in a 2020 trial, but it is not on the market. For yeast infections, probiotics added to antifungals helped short term in low-quality trials, and the CDC does not recommend them as treatment.

By Kymata Health editorial teamPublished October 10, 2026Last verified October 10, 2026

Medical review pending. Written by our editorial team from the studies and documents cited below; a credentialed clinician has not reviewed it yet. Educational only, not medical advice.

Key takeaways

  • In a 228-woman trial, Lactin-V after metronidazole gel cut BV recurrence at 12 weeks to 30% vs 45% with placebo [1].
  • The CDC says Lactin-V is not yet FDA cleared or commercially available, and that no studies support probiotics as add-on or replacement BV treatment [2].
  • A 2023 meta-analysis found lower BV recurrence when vaginal probiotics were added to antibiotics, but that result came from only 2 studies [3].
  • For yeast infections, probiotics plus antifungals improved short-term cure in low to very low quality trials, with no clear long-term benefit [4][5].

Lactin-V: the strongest trial

Lactin-V is a vaginal Lactobacillus crispatus strain (CTV-05). Women who had finished vaginal metronidazole gel were randomized to Lactin-V or placebo for 11 weeks; recurrence by week 12 was 30% vs 45% (risk ratio 0.66), and the strain was detected in 79% of users at week 12 [1]. Adverse events were similar between groups [1].

It is not something you can buy: the CDC says it is not yet FDA cleared or commercially available [2].

Other probiotics for BV

A 2023 meta-analysis of trials combining antibiotics with vaginal probiotics reported lower recurrence at 12 to 16 weeks (relative risk 0.62), but the recurrence estimate rests on 2 studies [3].

The CDC's 2021 guidelines say that, overall, no studies support Lactobacillus or other probiotic products as add-on or replacement treatment for BV [2]. See our BV recurrence guide for options with stronger evidence.

Probiotics for yeast infections

A 2017 Cochrane review of 10 trials (1,656 women) found probiotics added to antifungals improved short-term clinical cure (risk ratio 1.14) and lowered relapse at 1 month, but the evidence was low or very low quality and the benefit did not carry into long-term cure [4].

A 2026 meta-analysis reached a similar conclusion: combination therapy helped short term with no sustained effect, and probiotics alone did worse than antifungals for long-term cure [5]. The CDC says no substantial evidence supports probiotics for treating yeast infections [6].

Reading a probiotic label

Trial results apply to the strain tested, not to every product with Lactobacillus on the label. Our guide to CFU counts and strain names explains what to look for, and the probiotics monograph covers the wider evidence.

Quick answers

Should I take a probiotic instead of antibiotics for BV?

No. The CDC's recommended BV treatments are metronidazole or clindamycin, and it says no studies support probiotics as a replacement [2].

More in Vaginal Health: BV & Yeast

References

  1. [1]Randomized Trial of Lactin-V to Prevent Recurrence of Bacterial Vaginosis. N Engl J Med, 2020. PMID 32402161
  2. [2]Bacterial Vaginosis: Sexually Transmitted Infections Treatment Guidelines, 2021. Centers for Disease Control and Prevention, 2021.
  3. [3]Antibiotics therapy combined with probiotics administered intravaginally for the treatment of bacterial vaginosis: A systematic review and meta-analysis. Open Med (Wars), 2023. PMID 37724125
  4. [4]Probiotics for vulvovaginal candidiasis in non-pregnant women. Cochrane Database Syst Rev, 2017. PMID 29168557
  5. [5]Probiotics for the treatment of vulvovaginal candidiasis in nonpregnant women: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol, 2026. PMID 41547378
  6. [6]Vulvovaginal Candidiasis (VVC): Sexually Transmitted Infections Treatment Guidelines, 2021. Centers for Disease Control and Prevention, 2021.

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