Women’s health is a growth area in Asia-Pacific. Facing an evolving set of needs across life stages, women are seeking out clinically validated products that can help them naturally meet their health and wellness goals.
The demand is creating opportunities for customized blends of probiotic strains that are tailored to the needs of women at every life stage from adolescence to post-menopause. In recent years, probiotics have moved beyond gut health to target metabolic conditions, skin disorders, and much more.
The scientific progress has shown the specific strains that can benefit women at each life stage. Women in Asia-Pacific are particularly interested in incorporating probiotics into their wellness regimes.
A Euromonitor survey found 37% of women in China choose natural or traditional remedies for women’s health issues, compared to 27% of their counterparts in Europe.1 Similarly, a higher proportion of women seek alternative medicines in India (29%) than in Europe (12%). Widespread interest in women’s health dietary supplements is driving strong sales, with the market in Asia-Pacific growing 10% in 2023.
Yet, women in Asia-Pacific continue to have unmet health and wellness needs. Here, we look at areas of ongoing unmet need and how companies can use clinically validated strains to create products that meet the demands.
Why nutrition is an opportunity
In India, 53% of women of reproductive age have anemia, indicating iron deficiency.2 More than half of the cases of anemia are moderate or severe. Iron deficiency is a major issue in South Korea and Japan too, with respectively 13.5% and 19% of women of reproductive age in the countries having anemia. Iron deficiency is a particular concern in pregnant women in South Korea and Japan.3 Almost one-quarter of pregnant women in Japan have anemia.
Calcium deficiency is another widespread problem.4 Intake of the mineral is below the internationally recommended level in nearly all Asian countries. In Malaysia, the Philippines, and India people consume less than half the recommended amount of calcium, on average.
The consequences of calcium deficiency vary by life stage, with the increased risk of preeclampsia and maternal morbidity affecting people of reproductive age and the negative effects on bone health being more relevant for older women.5 Calcium deficiency in seniors is becoming a public health problem as societies age, with studies suggesting Asia will account for half of all osteoporotic hip fractures by 2050.
Studies have linked probiotics to mineral absorption.6 If probiotics can optimize mineral absorption, the use of the supplements could mitigate the health consequences of deficiencies even if dietary intake of nutrients such as calcium and iron stays the same.
Improved mineral status in healthy women: Clinical evidence
Researchers studied the effect of two probiotic strains – Bifidobacterium lactis BS01 and Lactobacillus acidophilus LA02 – on mineral balance in a randomized clinical trial.7 The study randomized 53 healthy young women to receive placebo or the probiotic strains for six weeks.
The concentration of calcium and iron in hair samples increased in women taking the strains, validating their effect on mineral balance. At baseline, 31% of women in the supplement cohort had calcium levels below the reference value. The figure fell to 6% over the course of the trial. Similarly, the proportion of women with iron levels above the reference value rose from 25% to 63%.
Limosilactobacillus reuteri Lb26 and Bifidobacterium animalis subsp. lactis Bb1 internalize high levels of selenium and zinc, respectively, making these sources more bioavailable compared to other sources commonly used in the formulation of supplements dedicated to women.8
How strains affect mood
Psychiatric disorders such as depression and schizophrenia, as well as stress and anxiety, are associated with decreased abundance of Lactobacillus, Faecalibacterium and Bifidobacterium.9 Other studies have linked increases in types of bacteria, such as Escherichia coli, that make lipopolysaccharide (LPS) to the neuroinflammation that is associated with mood disorders.
Anxiety disorders are more prevalent and more disabling in women than in men.10,11 Anxiety disorders are twice as prevalent in women as in men, reflecting biological, psychological, and social factors. Women are more likely to report insomnia and other sleep disturbances and are twice as likely to experience depression.
Women suffer from mood fluctuations and depressive symptoms at different stages of life, linked to hormonal changes associated with menstrual cycles, pregnancy, postpartum period, and menopause. Premenstrual syndrome and premenstrual dysphoric disorder are examples where mood swings can be particularly pronounced.
When used as part of a blend, probiotics could address the decreased abundance of bacteria such as Lactobacillus, impaired intestinal permeability and the rises in LPS-producing bacteria seen in people with mood disorders.
Lacticaseibacillus rhamnosus LR06 and Lactiplantibacillus plantarum LP01 have been studied with Limosilactobacillus fermentum LF16 and Bifidobacterium longum 04 in a multi-strain probiotic. The blend positively affected epithelial intestinal barrier, ROS production, and cell viability in different cellular axis models. The mix has proven more effective than single strains.
Potential mechanisms of action for the activity of the blend on the gut-microbiota-brain axis include the production of the neurotransmitters serotonin and GABA, counteraction of oxidative stress and inflammation, antipathogenic activity, as and the restoration of membrane integrity. Evidence that the blend may be able to improve mood, anxiety, depressive symptoms, and sleep disorders in women has led researchers to test the blend of strains in humans.
The blend: Clinical evidence
Investigators have confirmed the effect of the blend on mental health in four different randomized placebo-controlled clinical trials, which are supported by seven preclinical studies that compared the activity of the blend to the single strains.
Compared to placebo in different clinical settings, the blend significantly enhanced overall sleep quality and reduced the time it took to fall asleep, improved mood and measures of subclinical/occasional depression, enhanced resilience against mood fluctuations, and notably decreased state and trait anxiety scores. The significant improvements persisted at the six-week analysis and the final post-dosing assessment, with no significant changes seen in the placebo group.
The preclinical and clinical studies showed the blend significantly impacts neurotransmitter production and modulates the immune system, oxidative stress, and low-grade systemic inflammation, with significant changes in the metabolic profiles and gut microbiota in patients who received the probiotic formulation.12–16
Unmet needs in gynecological health
Maintenance of a healthy vaginal microbiome throughout the lifespan has important effects on a woman's life and fertility, notably because the microbial community is the first line of defense against infections in a part of the body involved in 175 million cases of disease a year.17
Bacterial vaginosis, which happens when the vaginal microbiome is disrupted, has a prevalence of 24% in East Asia and Pacific and 29% in South Asia.18 The figures make bacterial vaginosis the most common cause of vaginal discharge in women of reproductive age.19 Vulvovaginal candidiasis, a yeast infection, is the second most common cause.20 Most women will have at least one vulvovaginal candidiasis episode.
Topical and oral treatments are available for the bacterial and yeast conditions but there remains a need for interventions that provide durable relief. Research showing certain strains lower intravaginal pH, creating a barrier against yeast, and restore normal vaginal flora suggests probiotics may be an attractive alternative.
BV, VVC and UTIs: Clinical evidence
Investigators randomized women with bacterial vaginosis to take placebo or Lactobacillus fermentum LF15 and L. plantarum LP01, formulated in slow-release vaginal tablets.21 Scores on a bacterial vaginosis test fell below the threshold level in 92% of the women in the probiotic arm. Almost 60% of the women had a score that suggested the restoration of physiological vaginal microbiota after taking the strains.
Another trial assessed the effect of Lactobacillus fermentum LF10 and Lactobacillus acidophilus LA02 on vulvovaginal candidiasis, the second most common cause of vaginitis after bacterial vaginosis.22 The subjects applied vaginal tablets. After 28 days, the strains significantly solved Candida yeast symptoms in most of the women. Assessments after two months showed the long-term barrier effect of the product.
A third trial assessed a blend of L. plantarum LP01, L. paracasei LPC09, S. thermophilus ST10, tara gum, cranberry, and D-mannose in women affected by cystitis.23 Typical symptoms of cystitis, including pain when urinating, were significantly improved.
Partnering to seize the opportunities in women’s health
The potential of Probiotical’s custom blends extend beyond nutrition, mood, and gynecological health. Some strains can address leaky gut syndrome, a cause of increased intestinal permeability that is linked to women’s health conditions such as endometriosis, polycystic ovary syndrome, and premenstrual symptoms.24–26
Other strains cut levels of heavy metals, which affect reproductive health, or act on the gut-skin axis to address acne and beauty from within.27,28 Postbiotic heat-treated bacteria used for the formulation of cosmetic and personal care products targeting hydration, redness, pathogenic overgrowth and inflammation in the intimate provide further opportunities to manage vaginal symptoms.29
The wide range of conditions linked to gut and vaginal microbiota, plus the fact that women’s health concerns vary by life stage, creates opportunities for a variety of blends capable of addressing different needs from adolescence, through the reproductive years, and into menopause and beyond.
Probiotical enables its partners to meet diverse health needs by developing products that are tailored to the specific requirements of women in different age groups. The products are based on Probiotical strains that produce vitamins, counteract high cholesterol, target increased intestinal permeability and inflammatory processes, provide gender-specific antioxidant activity, detoxify from heavy metals, and target symptoms in the intimate area.30–35
The company can customize the strains and finished product to give customers a formulation that is ready to market. As well as developing products, Probiotical supports its partners with regulatory affairs, market insights, clinical protocol support, and more.
Companies that want to learn more about the women’s health market and Probiotical’s capabilities can visit the company at booth F28 at Vitafoods Asia in Bangkok in September 2024.
References
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