Can I stop Vagifem now my microbiome is healthy?

Author: Aunt Vadge
Qualified Naturopath | BHSc(N)

Last reviewed: July 7, 2026

Hello Aunt Vadge,

I’m using Vagifem because I had BV for a long time. I also used vaginal probiotics and lactoferrin. My recent microbiome test showed 98.5% Lactobacillus gasseri. I’ve stopped the probiotics – should I also stop the Vagifem?

Sincerely,
D
Age 41, Canada

Hey there D,

Congratulations – 98.5% Lactobacillus is a lovely, protective result, and a real turnaround from long-term BV. Well done. The most important point, though, and the bit that’s easy to miss: your great result may be partly because of the Vagifem, not a sign you no longer need it.

Vagifem is local (vaginal) oestrogen, and oestrogen keeps the vaginal walls plump and full of glycogen – exactly what your protective lactobacilli feed on. So if low oestrogen was part of why your BV kept coming back, the Vagifem may be the thing holding your lovely new microbiome in place. And stopping it suddenly could let things slip back.

So should you stop? That’s a conversation for the doctor who prescribed it, not a decision to make alone, since it’s a hormonal medication – ask them directly whether, given your history and this result, they want you to continue, taper, or trial stopping.

If you do trial stopping with their okay, keep an eye on symptoms, and you can always restart if things wobble.

The bigger question worth answering is why your BV was so persistent in the first place: if low oestrogen is the underlying driver, that’s really useful to know and to support properly. And that whole-body, root-cause piece is exactly what we work on with people alongside their medical care – it’s the heart of what we do clinically.

If the BV returns once you stop, that’s your cue to dig deeper, and you can book an appointment with one of our practitioners to look at what else might be contributing, including checking your oestrogen. You’ve done a brilliant job getting here – keep listening to your body.

Lots of love,
Aunt Vadge

This is general information based on current research and our clinical experience, not a substitute for personalised medical advice. Don’t stop a prescribed medication without your prescriber’s guidance.