Dr. Jen Gunter

So yeast can be in the skin and you can have symptoms and have a negative culture and think what else it could be as well.

So that would be the thing, but there's no diet, wearing white cotton underwear, all that kind of stuff make any difference.

Yeah, so yeast has nothing to do with...

lactobacilli and other things like that.

Even though there's pH changes that can... No, so yeast actually grows at a normal pH of 4.5.

It's rare to see.

I mean, you can sometimes see it when the pH is elevated, but it doesn't grow well.

So the standard pH should be like between 3.8 and 4.5 or something with the yeast infection.

And we think this is the, we've got several issues going on.

So first of all, there may be sort of an increase in virulence strains with yeast.

What that's related to, we don't really know.

temperature climate don't know um microplastics who knows something to do so yeast is becoming you know more virulent so meaning it's sticking better causing problems um so that's one reason but also there's subtle immune things that we just don't understand low iron is another one that um you know i've

probably 50% of the people I see with yeast infections have low iron.

And so we don't actually understand why.

So if we don't understand why, then obviously, you know, another specific therapy, we don't have data to support it, but we don't really think that there's any reason for that, for a probiotic to help.

The idea, I suppose, behind oral probiotics is you colonize your gut and some of that gut bacteria is going to get into the vagina.

The data for probiotics with bacterial vaginosis is actually really, really low quality.

The best data was published in the New England Journal, I can't remember how long ago, and it was a specific strain, I think, called Lactin-V, which had, I think it had rhamnosus and ruderi, but I can't remember off the top of my head.

And that was a vaginal insert.

And it did reduce the risk of recurrence, but it didn't, you know, so it was statistically significant, unsure if it would be clinically significant,