'A Practitioner’s Guide to Menopause and How Probiotics May Support'
sponsored by OptiBac

Please note, this is a transcript of the questions received and have been reproduced verbatim in relation to any grammatical errors.

How long after periods stop would it be considered post-menopausal bleeding, e.g. would 13 months after the last period be considered post-menopausal bleeding?
This would need to be assessed and determined by a medical professional.
Post-menopausal bleeding is defined as any form of bleeding from the vagina (e.g. spotting or heavier period-like bleeding) that happens after menopause.
If any bleeding from the vagina occurs more than a year since a woman’s last menstrual period, it must be checked by a GP / medical doctor.

Is there a better time of day that is recommended to take probiotics?
We generally recommend taking our range of probiotics with breakfast when stomach acid tends to be lower than later in the day. There are a few exceptions to this, including Saccharomyces boulardii which is very robust and can be taken at any time of day, with or without food. The same applies to one of our daily probiotics, Adult Gummies because these contain the spore-forming bacterium, Bacillus coagulans Unique IS-2. (Spore-forming bacteria are able to create a protective coating around their DNA, helping them to survive until they reach the favourable conditions of the intestinal environment, where they will then remove their protective spore and behave as a probiotic). Also, our Bifido & Fibre product contains 4g FOS fibres which may initially induce some gas and bloating, so it may be preferable to take this product in the evening to encourage a bowel movement the following morning.

Is it ok to take probiotics long term or is it better to take for 6/52 and then take a break?
It is safe to take probiotics on a long-term basis without causing dependency or addiction. The adult body does not produce its own probiotics – rather, we form our gut bacteria at a very young age – and hence cannot become dependent on probiotic supplementation. Many people, (especially those of older generations), like to top up the body’s good bacteria with a reliable probiotic supplement to promote the balance of gut bacteria in favour of species considered to be more beneficial.

When using single-strain or multiple strain probiotics for different health goals, how long should the intervention continue for – is it until symptoms improve and then stop, or can it continue longer-term?
This depends on the symptom and the probiotic supplement being used. For example, Saccharomyces boulardii could be used for traveller’s diarrhoea, but once the diarrhoea has resolved, there may no longer be a need to take it. However, to balance the gut bacteria after a bout of diarrhoea and maintain healthy gut bacteria, a daily probiotic such as Every Day EXTRA could then be used as a follow-on for the longer term.
It is also possible to take more than one Optibac product at the same time and it is extremely difficult, if not impossible, to overdose on friendly bacteria. An example of this would be to take a daily probiotic for general health, digestive and immune support (e.g. Every Day EXTRA) and a probiotic to help maintain intimate flora for vaginal health (e.g. For Women).

For vaginal health would a pessary be better than a tablet?
It is a matter of personal choice, however if you choose an oral probiotic supplement containing strains proven to reach the vagina alive, such as those used in For Women, then there should be no need to use a pessary. Also, if a woman is experiencing discomfort in the vaginal area, it may be preferable to take a capsule.

Can ROI practitioners set up accounts?
If you are based in the Republic of Ireland, you can set up an account with Pure and Natural Supplies who offer practitioner accounts with a 33% trade discount off all Optibac Probiotics products. Here is the link to their website if you wish to register for an account: https://pureandnatural.ie/register

 Which probiotic in the range would be best for menopause in general?
This very much depends on the symptoms being experienced in menopause. If vaginal disorders are present – such as thrush, bacterial vaginosis and UTI’s – For Women may help, as the strains in this product been extensively trialled for use with these conditions. It can also be used on an ongoing basis to help maintain healthy intimate flora.
For constipation, we would suggest Bifido and Fibre which contains 4g of FOS per sachet and 25 billion Bifidobacterium lactis BB-12. There are numerous clinical trials demonstrating that this strain promotes a natural rhythm of bowel movements but does not cause diarrhoea or induce dependency. If a client can’t tolerate FOS, they may wish to try Every Day MAX instead. This product does not contain FOS but does include the strain, Bifidobacterium lactis HNO19® that has been shown to help with constipation.
Every Day Extra can be used to support overall gastrointestinal health and one of the key strains this product contains, Lactobacillus acidophilus NCFM® has demonstrated in multiple studies to help relieve the symptoms of gastrointestinal discomfort, such as bloating and abdominal pain.
Likewise, Bacillus coagulans Unique-IS2 has been researched for use in addressing a range of digestive symptoms, including those associated with IBS. This strain can be found in Adult Gummies and can be particularly useful for clients who dislike taking supplements in capsule form.

What about calcium and magnesium for bone health?
These are both very important nutrients for bone health, as are vitamin D to aid calcium absorption and vitamin K to regulate calcium use in the body and limit osteoclast function.  You may find the following studies of interest:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313472/

https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02728-4

Is the Practitioner account available in Ireland?
If you are based in the Republic of Ireland, you can set up an account with Pure and Natural Supplies who offer practitioner accounts with a 33% trade discount off all Optibac Probiotics products. Here is the link to their website if you wish to register for an account: https://pureandnatural.ie/register

Can Intimate Flora for Women help resolve a thrush infection?
For Women can be used when thrush is present and has been clinically trialled for this purpose. We would recommend taking 2 capsules daily whilst symptoms are present and then 1 capsule thereafter for ongoing support and maintenance of healthy intimate flora. For Women can be taken at the same time as anti-fungals but should be taken 2 hours apart from antibiotics.

How do you know if a patient has IBS or something more serious? Would you recommend any tests to diagnose IBS or just a symptom checker?
We would always recommend that a client consults their medical doctor / GP in the first instance if they have any unusual or persistent gastrointestinal symptoms, so that a thorough medical assessment and diagnosis can be made.