Probiotic‐based strategies in vulvovaginal candidiasis management: A comprehensive review of mechanisms and future directions

Abstract Vulvovaginal candidiasis (VVC), a common mucosal infection caused by Candida spp., affects approximately 75% of reproductive‐aged women worldwide. Nevertheless, this significant health concern remains understudied. Consequently, novel therapeutic interventions are urgently required. Probiotics have emerged as a viable alternative for VVC management owing to their favorable safety profile and proven efficacy. However, evidence supporting their antifungal properties remains inconclusive, necessitating further elucidation of the underlying mechanisms. Numerous studies have demonstrated that probiotics and their derivatives can effectively counteract Candida by reducing Candida ’s virulence factors, modulating immune responses, promoting vaginal barrier, remodeling the metabolic environment and restoring microbiota homeostasis. Providing an updated summary of VVC pathogenesis and its relationship with vaginal microbiota, this review aims to comprehensively elucidate the roles and mechanisms of probiotics and their derivatives in VVC. Additionally, it discusses the existing evidence for probiotic‐based strategies, including probiotics, probiotics derivatives and vaginal microbiome transplants, and provides a better theoretical foundation for interventions targeting VVC based on probiotics.