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Background  Probiotics are widely used to improve gastrointestinal (GI) health, but they may also be useful to prevent or treat gynaecological disorders, including bacterial vaginosis (BV) and candidiasis. BV prevalence is high in South Africa and is associated with increased HIV risk and pregnancy complications. We aimed to assess the availability of probiotics for vaginal health in retail stores (pharmacies, supermarkets and health stores) in two major cities in South Africa.    Methods  A two-stage cluster sampling strategy was used in the Durban and Cape Town metropoles. Instructions for use, microbial composition, dose, storage and manufacturers’ details were recorded.    Results  A total of 104 unique probiotics were identified in Cape Town and Durban (66.4% manufactured locally). Cape Town had more products than Durban (94 versus 59 probiotics), although 47% were common between cities (49/104). Only four products were explicitly for vaginal health. The remainder were for GI health in adults (51.0%) or infants (17.3%). The predominant species seen overall included  Lactobacillus acidophilus  (53.5%),  L. rhamnosus  (37.6%),  Bifidobacterium longum ssp. longum  (35.6%) and  B. animalis ssp. lactis  (33.7%). Products for vaginal health contained only common GI probiotic species, with a combination of  L. acidophilus/B. longum ssp. longum/B. bifidum ,  L. rhamnosus/L. reuteri  or  L. rhamnosus  alone, despite  L. crispatus ,  L. gasseri,  and  L. jensenii  being the most common commensals found in the lower female reproductive tract.    Conclusion  This survey highlights the paucity of vaginal probiotics available in South Africa, where vaginal dysbiosis is common. Most vaginal products contained organisms other than female genital tract commensals.    Electronic supplementary material  The online version of this article (doi:10.1186/s12905-017-0362-6) contains supplementary material, which is available to authorized users.

Probiotics for vaginal health in South Africa: what is on retailers’ shelves?