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Bacterial Vaginosis (BV)

Bacterial vaginosis is a common condition in which protective Lactobacillus bacteria in the vagina decline and others, like Gardnerella, overgrow, often causing thin gray discharge and a fishy odor. Lactobacillus probiotics have the strongest evidence, with moderate support for vitamin D and vaginal boric acid, and symptoms improved in one calendula trial. That trial had only 80 women, and large trials of L. acidophilus alone are limited.

Sources: PMID 29441319

Supplements studied
4
Graded outcomes
2
Trials
2
People studied
2,450

Evidence by supplement

  • Strong
  • Moderate
  • Limited
  • Very limited

4 supplements

Lactobacillus acidophilus: outcomes studied for Bacterial Vaginosis (BV)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Vaginal Health

L. acidophilus is a natural constituent of vaginal flora and has moderate evidence supporting its use for vaginal health. Studies confirm mother-to-child transmission of L. acidophilus at delivery. Clinical use for bacterial vaginosis prevention is supported by its colonization capacity, though large RCTs specific to L. acidophilus alone are limited.

Improves (the measure goes up)Small effect2 studies
Calendula Officinalis: outcomes studied for Bacterial Vaginosis (BV)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Bacterial Vaginosis Symptoms

Moderate Improvement

Improves (the measure goes down)Moderate effect1 study80 people

Studies that measured bacterial vaginosis symptoms

Probiotics

  • Bacterial Vaginosis Symptoms: improves
Probiotics: outcomes studied for Bacterial Vaginosis (BV)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Bacterial Vaginosis SymptomsImproves (the measure goes down)1 study1,662 people

Studies that measured bacterial vaginosis symptoms

Vitamin C

  • Bacterial Vaginosis Symptoms: improves
Vitamin C: outcomes studied for Bacterial Vaginosis (BV)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Bacterial Vaginosis SymptomsImproves (the measure goes down)1 study277 people

Key findings

  • Vaginal HealthLactobacillus acidophilusImproves (the measure goes up)
  • Bacterial Vaginosis SymptomsCalendula OfficinalisImproves (the measure goes down)

The Bacterial Vaginosis Supportive Care protocol

2 primary supplements · 5 supporting supplements

  • Probiotics (Lactobacillus)10–20 billion CFU Lactobacillus-containing probiotic (L. rhamnosus, L. reuteri, L. crispatus) daily; oral or vaginal
  • Vitamin D2,000–4,000 IU daily (target 40–60 ng/mL)

See the full protocol

Shop the evidence-backed picks

Support alongside medical care. These supplements are not a treatment for Bacterial Vaginosis (BV). If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.

Fullscript collectionWomen's health: evidence-graded picksOpen on Fullscript

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Studies cited

100 studies from PubMed

  1. The effects of probiotic supplementation on cardiometabolic health in patients with prediabetes: a systematic review, meta-analysis, and GRADE assessment.Front Nutr, 2025 · PMID 40959695
  2. Lactococcus lactis strain Plasma activates plasmacytoid dendritic cells and mitigates common cold-like symptoms in healthy adults: a meta-analysis of individual participant data.Front Immunol, 2025 · PMID 41280892
  3. Potential benefits of L. acidophilus in dyslipidemic ratsScientific Reports, 2021 · PMID 33731756
  4. Effect of a Probiotic Supplement Containing Lactobacillus Acidophilus and Bifidobacterium Animalis Lactis on Urine Oxalate in Calcium Stone Formers with Hyperoxaluria: A Randomized, Placebo-controlled, Double-blind and In-vitro TrialUrology Journal, 2021 · PMID 34129232
  5. Preventive Effect of Lactobacillus acidophilus XY27 on DSS-Induced Ulcerative Colitis in MiceDrug Design, Development and Therapy, 2020 · PMID 33376308
  6. Immune enhancing effects of Lactobacillus acidophilus on Newcastle disease vaccination in chickensComparative Immunology, Microbiology and Infectious Diseases, 2020 · PMID 32721773
  7. Lactobacillus acidophilus attenuates toxin production by Vibrio cholerae and shigella dysenteriae following intestinal epithelial cells infectionMicrobial Pathogenesis, 2020 · PMID 33010360
  8. Primary prevention of Clostridium difficile infections with a specific probiotic combining Lactobacillus acidophilus, L. casei, and L. rhamnosus strains: assessing the evidenceThe Journal of Hospital Infection, 2018 · PMID 29702133
  9. Lactobacillus acidophilus Alleviated Salmonella-Induced Goblet Cells Loss and Colitis by Notch PathwayMolecular Nutrition & Food Research, 2018 · PMID 30198100
  10. Lactobacillus acidophilus ameliorates pain and cartilage degradation in experimental osteoarthritisImmunology Letters, 2018 · PMID 30003932
  11. Efficacy of a standardized extract of Matricariae chamomilla L., Melissa officinalis L. and tyndallized Lactobacillus acidophilus (HA122) in infantile colic: An open randomized controlled trialNeurogastroenterology and Motility, 2017 · PMID 28665038
  12. Uromodulin-SlpA binding dictates Lactobacillus acidophilus uptake by intestinal epithelial M cellsInternational Immunology, 2017 · PMID 28992252
  13. Lactobacillus acidophilus Mixture in Treatment of Children Hospitalized With Acute DiarrheaClinical Pediatrics, 2016 · PMID 26581358
  14. Efficacy of prolonged ingestion of Lactobacillus acidophilus L-92 in adult patients with atopic dermatitisJournal of Dairy Science, 2016 · PMID 27108169
  15. Lactobacillus acidophilus attenuates Salmonella-induced intestinal inflammation via TGF-β signalingBMC Microbiology, 2015 · PMID 26446848
  16. The effects of Lactobacillus acidophilus as feed supplement on skin mucosal immune parameters, intestinal microbiota, stress resistance and growth performance of black swordtailFish & Shellfish Immunology, 2015 · PMID 25514375
  17. Lactobacillus acidophilus CP23 with weak immunomodulatory activity lacks anchoring structure for surface layer proteinJournal of Bioscience and Bioengineering, 2015 · PMID 25454604
  18. Lactobacillus acidophilus modulates the virulence of Clostridium difficileJournal of Dairy Science, 2014 · PMID 24856984
  19. Effects of oral administration of Lactobacillus acidophilus L-92 on the symptoms and serum cytokines of atopic dermatitis in Japanese adults: a double-blind, randomized, clinical trialInternational Archives of Allergy and Immunology, 2014 · PMID 25660281
  20. Effects of oral administration of Lactobacillus acidophilus L-92 on the symptoms and serum markers of atopic dermatitis in childrenInternational Archives of Allergy and Immunology, 2011 · PMID 20861645
  21. Probiotic Lactobacillus acidophilus and L. casei mix sensitize colorectal tumoral cells to 5-fluorouracil-induced apoptosisNutrition and Cancer, 2010 · PMID 20358475
  22. Influence of vitamin C supplementation on oxidative and immune changes after an ultramarathonJ Appl Physiol, 1985 · PMID 11960947
  23. Transmission of Lactobacillus jensenii and Lactobacillus acidophilus from mother to child at time of deliveryJournal of Clinical Microbiology, 1975 · PMID 809467
  24. The effect of versus metronidazole on bacterial vaginosis in women: A double-blind randomized controlled trial.J Adv Pharm Technol Res · PMID 29441319
  25. Therapeutic effectiveness of a Calendula officinalis extract in venous leg ulcer healing.J Wound Care · PMID 27974009
  26. Evaluation of Calendula officinalis as an anti-plaque and anti-gingivitis agent.J Indian Soc Periodontol · PMID 24554883
  27. Comparing the effects of Calendula officinalis and clotrimazole on vaginal Candidiasis: A randomized controlled trial.Women Health · PMID 27880086
  28. Treatment of acute wounds in hand with L.: A randomized trial.Tissue Barriers · PMID 34674610
  29. Antioxidant capacity of calendula officinalis flowers extract and prevention of radiation induced oropharyngeal mucositis in patients with head and neck cancers: a randomized controlled clinical study.Daru · PMID 23497687
  30. No differences between Calendula cream and aqueous cream in the prevention of acute radiation skin reactions--results from a randomised blinded trial.Eur J Oncol Nurs · PMID 23245940
  31. Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer.J Clin Oncol · PMID 15084618
  32. Use of calendula ointment after episiotomy: a randomized clinical trial.J Matern Fetal Neonatal Med · PMID 32460565
  33. Low-level laser therapy and Calendula officinalis in repairing diabetic foot ulcers.Rev Esc Enferm USP · PMID 27680049
  34. Calendula extract: effects on mechanical parameters of human skin.Acta Pol Pharm · PMID 21928714
  35. Probiotics for people with cystic fibrosis.Cochrane Database Syst Rev · PMID 31962375
  36. Probiotics for the prevention of gestational diabetes mellitus: A meta-analysis of randomized controlled trials.Biomol Biomed · PMID 38642385
  37. The effects of probiotics supplements on metabolic indices and clinical signs in patients with diabetic retinopathy, a randomized double blind clinical trial.J Diabetes Metab Disord · PMID 38932908
  38. Effect of applying Lactiplantibacillus plantarum subsp. plantarum N793 to the scalps of men and women with thinning hair: a randomized, double-blind, placebo-controlled, parallel-group study.Biosci Microbiota Food Health · PMID 38966052
  39. Randomized Clinical Trial to Evaluate the Effect of Probiotic Intake on Androgenic Alopecia.Nutrients · PMID 39275216
  40. Impact of probiotics on sleep quality and mood states in patients with insomnia: a systematic review and meta-analysis.Front Microbiol · PMID 40740336
  41. Gaba-producing lactobacilli boost cognitive reactivity to negative mood without improving cognitive performance: A human Double-Blind Placebo-Controlled Cross-Over study.Brain Behav Immun · PMID 39163908
  42. The effect of probiotic consumption on lipid profile, glycemic index, inflammatory markers, and liver function in NAFLD patients: A systematic review and meta-analysis of randomized controlled trials.J Diabetes Complications · PMID 38968867
  43. Efficacy of probiotics in the treatment of oral mucositis in head and neck cancer patients: A systematic review and meta-analysis.Microb Pathog · PMID 38971507
  44. The effect of probiotics on severe oral mucositis in cancer patients undergoing chemotherapy and/or radiotherapy: A meta-analysis.J Stomatol Oral Maxillofac Surg · PMID 39187039
  45. Oral probiotic supplementation to alleviate diarrhea induced by fluoropyrimidines or irinotecan-based chemotherapy: A systematic review and meta-analysis.Complement Ther Med · PMID 39993479
  46. The impact of probiotics on core autism symptoms - A systematic review and meta-analysis of randomized clinical trials.Clin Nutr ESPEN · PMID 39173907
  47. Efficacy and safety of Bacteroides fragilis BF839 for pediatric autism spectrum disorder: a randomized clinical trial.Front Nutr · PMID 39290561
  48. Probiotics for autism spectrum disorder: An updated systematic review and meta-analysis of effects on symptoms.J Psychiatr Res · PMID 39265200
  49. The efficacy and safety of probiotics in the adjuvant treatment of psoriasis: a systematic review and meta-analysis of randomized controlled trials.Front Med · PMID 39328313
  50. Effects of probiotic supplementation on testosterone levels in healthy ageing men: A 12-week double-blind, placebo-controlled randomized clinical trial.Contemp Clin Trials Commun · PMID 38770015
  51. A 12-Week, Single-Centre, Randomised, Double-Blind, Placebo-Controlled, Parallel-Design Clinical Trial for the Evaluation of the Efficacy and Safety of Lactiplantibacillus plantarum SKO-001 in Reducing Body Fat.Nutrients · PMID 38674828
  52. Effects of oral supplementation of probiotics on body weight and visceral fat in obese patients: a meta-analysis and systematic review.Sci Rep · PMID 39984625
  53. The effects of probiotics administration during pregnancy on preeclampsia and associated maternal, fetal, and newborn outcomes: a systematic review and meta-analysis.Am J Obstet Gynecol MFM · PMID 38447676
  54. Effects of probiotics supplementation on glycemic profile in adults with type 2 diabetes mellitus: A grade-assessed systematic review and dose-response meta-analysis of randomized controlled trials.Clin Nutr ESPEN · PMID 39349104
  55. The Effect of Probiotics on Obesity with Comorbid Depression: A Systematic Review and Meta-Analysis.Br J Hosp Med · PMID 39347684
  56. A network meta-analysis of probiotics in the treatment of childhood asthma.Front Pediatr · PMID 41098501
  57. Efficacy of probiotics as adjuvant therapy in bronchial asthma: a systematic review and meta-analysis.Allergy Asthma Clin Immunol · PMID 39563347
  58. Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication of Helicobacter pylori: a meta-analysis.Front Cell Infect Microbiol · PMID 40012609
  59. Efficacy of probiotics regimens for Helicobacter pylori eradication: A systematic review, pairwise, and network meta-analysis of randomized controlled trials.Clin Nutr ESPEN · PMID 39642994
  60. Effect of probiotics on C-reactive protein levels in schizophrenia: Evidence from a systematic review and meta-analysis.Complement Ther Med · PMID 39798817
  61. Probiotics Supplementation for Improving Glucolipid Parameters in Individuals with Prediabetes: A Systematic Review and Meta-Analysis of Randomized Trials.Probiotics Antimicrob Proteins · PMID 39806201
  62. Systematic review and meta-analysis on probiotics as treatment for food allergies among pediatric patients: A 2024 update.Pediatr Allergy Immunol · PMID 39803979
  63. Efficacy of Oral Probiotic Supplementation in Preventing Vulvovaginal Infections During Pregnancy: A Randomized and Placebo-Controlled Clinical Trial.Nutrients · PMID 39771026
  64. Clinical effects of probiotics on the treatment of gingivitis and periodontitis: a systematic review and meta-analysis.BMC Oral Health · PMID 40186219
  65. Evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled Trials.BMC Gastroenterol · PMID 40301781
  66. Clinical efficacy of probiotic supplementation in the treatment of knee osteoarthritis: a meta-analysis.Front Microbiol · PMID 40276226
  67. The effect of probiotics on select cognitive domains in mild cognitive impairment and Alzheimer's disease: A systematic review and meta-analysis.J Alzheimers Dis Rep · PMID 40034358
  68. Efficacy of probiotic supplementation in influencing cognitive function in Alzheimer's disease: A systematic review and meta-analysis.J Food Sci · PMID 40709497
  69. Effectiveness of probiotic supplements on cognitive function in mild cognitive impairment and Alzheimer's disease: A meta-analysis of randomized controlled trials.Gen Hosp Psychiatry · PMID 41237466
  70. Probiotics are a good choice for the treatment of bacterial vaginosis: a meta-analysis of randomized controlled trialReprod Health · PMID 35698149
  71. Efficacy and safety of Saccharomyces boulardii CNCM I-745 for the treatment of pediatric acute diarrhea in China: a systematic review and meta-analysis.Front Cell Infect Microbiol · PMID 40535538
  72. Efficacy of probiotics in reducing the duration and severity of acute gastroenteritis in children: A meta-analysis of randomized controlled trials.J Pediatr Gastroenterol Nutr · PMID 40739406
  73. Investigating the effects of probiotics during the menopause transition: A systematic review & meta-analysis.Clin Nutr ESPEN · PMID 40639456
  74. Effects of probiotic supplements on bone mineral density and bone turnover markers in postmenopausal women: A systematic review.Clin Nutr ESPEN · PMID 40716641
  75. Impact of probiotic supplementation on serum levels of brain-derived neurotrophic factor: GRADE-based dose-response meta-analysis.BMC Nutr · PMID 40790243
  76. Probiotic Supplementation and Inflammatory Status in Coronary Artery Disease: A Systematic Review and Meta-Analysis.Microorganisms · PMID 41156763
  77. Ascorbic acid supplementation improves skeletal muscle oxidative stress and insulin sensitivity in people with type 2 diabetes: Findings of a randomized controlled studyFree Radic Biol Med · PMID 26774673
  78. Vitamin C may have similar beneficial effects to Gemfibrozil on serum high-density lipoprotein-cholesterol in type 2 diabetic patientsJ Res Pharm Pract · PMID 25328896
  79. Supplementation of vitamin C reduces blood glucose and improves glycosylated hemoglobin in type 2 diabetes mellitus: a randomized, double-blind studyAdv Pharmacol Sci · PMID 22242019
  80. The effect of vitamin C supplementation on diabetic hyperlipidaemia: a double blind, crossover studyDiabet Med · PMID 2952396
  81. Unchanged renal haemodynamics following high dose ascorbic acid administration in normoalbuminuric IDDM patientsScand J Clin Lab Invest · PMID 7624737
  82. Ascorbic acid supplementation improves postprandial glycaemic control and blood pressure in individuals with type 2 diabetes: Findings of a randomized cross-over trialDiabetes Obes Metab · PMID 30394006
  83. Effects of eicosapentaenoic acid and vitamin C on glycemic indices, blood pressure, and serum lipids in type 2 diabetic Iranian malesJ Res Med Sci · PMID 22247720
  84. Effect of vitamin C on inflammation and metabolic markers in hypertensive and/or diabetic obese adults: a randomized controlled trialDrug Des Devel Ther · PMID 26170625
  85. Does short-term vitamin C reduce cardiovascular risk in type 2 diabetes?Endocr Pract · PMID 23757614
  86. Effects of atorvastatin and vitamin C on forearm hyperaemic blood flow, asymmentrical dimethylarginine levels and the inflammatory process in patients with type 2 diabetes mellitusHeart · PMID 16914485
  87. Effect of vitamin C supplementation on postprandial oxidative stress and lipid profile in type 2 diabetic patientsPak J Biol Sci · PMID 22518934
  88. High-dose oral vitamin C partially replenishes vitamin C levels in patients with Type 2 diabetes and low vitamin C levels but does not improve endothelial dysfunction or insulin resistanceAm J Physiol Heart Circ Physiol · PMID 16126809
  89. Vitamin C and the common cold: a double-blind trialCan Med Assoc J · PMID 5057006
  90. Ascorbic acid and the common coldLancet · PMID 4113614
  91. Preventing the common cold with a vitamin C supplement: a double-blind, placebo-controlled surveyAdv Ther · PMID 12201356
  92. Vitamin C and the common coldJ Soc Occup Med · PMID 162650
  93. Winter illness and vitamin C: the effect of relatively low dosesCan Med Assoc J · PMID 1091343
  94. Ascorbic acid for the common cold. A prophylactic and therapeutic trialJAMA · PMID 163386
  95. Therapeutic effect of vitamin C. A co-twin control studyJAMA · PMID 318715
  96. A randomized controlled trial of the therapeutic effect of vitamin C in the common coldPractitioner · PMID 319446
  97. Vitamin C and the common cold: a second MZ Cotwin control studyActa Genet Med Gemellol · PMID 7048833
  98. Trial of ascorbic acid in prevention of coldsBr Med J · PMID 4290259
  99. Mega-dose vitamin C in treatment of the common cold: a randomised controlled trialMed J Aust · PMID 11700812
  100. A controlled clinical trial of ascorbic acid for the common coldAnn N Y Acad Sci · PMID 1106302