Do men have unique probiotic needs compared to women?
While the beneficial bacteria in probiotic supplements are great for everyone, men do have unique health conditions. While there’s significant research evidence (over 500 studies!) to demonstrate that probiotics play an important role for digestive health and overall health, when it comes to men’s health, the data becomes a bit more sparse. However, lack of data doesn’t mean that probiotics aren’t effective for issues specific to men’s health. Preliminary evidence holds promising news for men’s health.
In this article we’ll explore:
Probiotics for Men’s Sexual Health
There’s very little direct research into the benefits of probiotics for men’s sexual health. However, several studies show a correlation between men’s sexual problems and poor gut health:
A very large study of 17,608 male patients found that men with IBS were 2.92 times more likely to have erectile dysfunction than non-IBS patients. 
A research review found that IBS patients (both men and women) have more sexual health problems compared to control groups. 
In a study of patients with IBD (Inflammatory bowel disease), most men had erectile dysfunction. Of sixty-nine men with Crohn’s disease and ulcerative colitis, 39% had global sexual dysfunction and 94% had erectile dysfunction. 
While much more research is needed, we can make some inferences here. We know that probiotics are helpful for many digestive issues, therefore it’s plausible that probiotics may also be beneficial for sexual problems.
And while I don’t normally put much stock into animal studies, this one is intriguing:
Aging male mice that consumed probiotics had larger testicles and increased testosterone levels when compared with age-matched controls. 
If you suffer from erectile dysfunction or low testosterone, a trial of probiotic supplements may prove to be beneficial.
for Heart Health
Heart disease may be one of the most common men’s health concerns.
Throughout life, men are about twice as likely as women to have a heart attack.  This is the conclusion from a very large study of nearly 34,000 people in Norway. This higher risk for men persisted even after accounting for other risk factors such as high cholesterol, high blood pressure, diabetes, body mass index, and physical activity.
The “gut hypothesis” of cardiac disease suggests that inflammation and other gut-related changes may be the culprit behind many heart conditions. Three recent research reviews (the highest quality of scientific data)    support this hypothesis and found that:
Changes in the composition and diversity of gut microbiome have been observed in patients with heart failure.
Compounds produced by gut bacteria can lead to increased susceptibility to heart disease.
Leaky gut is likely the cause for the low-grade inflammation found in heart disease patients.
Research into the potential benefits of probiotic supplements for heart health is still in its infancy, with only one small human clinical trial to date. In this study , subjects attending a heart failure outpatient clinic were given the probiotic S. Boullardii or a placebo for three months. At the end of the study, the S. Boulardii patient group showed:
Significant reduction in the overall diameter of the left heart artery. This is an exciting finding because swelling of this artery is linked to heart failure and atrial fibrillation.
Small improvements in metabolic lab markers compared to the placebo group. This included a reduction in total cholesterol and uric acid levels.
Additional research into probiotics and markers of metabolic health mostly show modest improvements for weight loss and improving cholesterol, blood pressure, and blood sugar levels.      
Heart disease is the leading cause of death for men in the United States. Preliminary evidence suggests that probiotics may be valuable in an overall plan for heart health that also includes dietary and lifestyle modifications.
for Prostate Health
If you haven’t given much thought to your prostate health,
it’s worth considering.
In the United States, almost 2 million men visit the doctor for prostatitis (inflammation of the prostate gland) every year.  Prostate cancer is the second most common cancer among men in the United States.  Research suggests that prostatitis may be a risk factor for prostate cancer. 
Once again, there’s not a lot of data to go by yet, but what we do have is promising:
One research review found that the gut microbiome can influence prostate inflammation in prostate conditions, including prostate cancer. 
These researchers suggest that dysbiosis (an imbalance of gut bacteria and fungus) may be an underlying, primary cause of chronic prostatitis and that probiotics may provide a therapeutic strategy. 
In one clinical trial, long-term treatment with rifaximin and a probiotic supplement reduced the recurrence rate of chronic prostatitis and prevented the spread of infection to other parts of the reproductive tract. 
Probiotic supplements may be helpful for improving your prostate health.
for Better Sleep
Research suggests that men have poorer sleep quality when compared with women. According to one study, men have shorter sleep times, take longer to fall asleep, and have lower sleep efficiency (the percentage of time you are actually asleep during the night). 
Chronic poor sleep can have negative impacts on your overall health, including your mental health.
Preliminary evidence shows that probiotics can help to improve sleep:
In a clinical trial of medical students, those who took probiotic supplements showed superior sleep quality during times of exam stress. 
In another clinical trial, participants reported that their sleep quality improved after 6 weeks of taking probiotics. 
A study of IBS patients showed sleep improvements for diarrhea-type IBS patients. The same results were not seen for constipation-type mixed-type IBS patients. 
Finally, a study of subjects with depression showed that the group taking probiotic supplements had less sleep disruption than the placebo group. 
If you suffer from poor sleep quality, probiotics may help to improve your sleep.
Probiotics for Digestive Health
Digestive health complaints are not unique to men. However, no matter your gender, your overall health depends on your gut health. The evidence for the value of probiotic supplements for your digestive system is substantial.
Here’s a sampling of some of the best evidence to date:
Two meta-analyses (the highest quality research data) have shown probiotics to be an effective treatment for irritable bowel syndrome (IBS), with no side effects.   Another meta-analysis , involving twenty clinical trials and a total of 1,404 patients, showed that probiotics improved global IBS symptoms when compared to placebo. This includes improvements in:
Constipation, diarrhea, and/or loose stools
Fatigue and Difficulty Sleeping
A meta-analysis summarizing 18 clinical trials concluded that probiotic supplements are an effective treatment for small intestinal bacterial overgrowth (SIBO), both in improving symptoms, such as bloating, and in improving lab values.  One study found probiotics to be more effective than the antibiotic metronidazole (a standard treatment for SIBO). 
Probiotics can help with leaky gut. At least two clinical trials found that probiotics helped to promote repair of the digestive tract in humans.  
Two studies show that probiotic supplements can be more effective than standard antiparasitic drug treatment in Blastocystis hominis and Giardia gut infections.  
One review (a summary of multiple studies) found that probiotics worked as well as the anti-inflammatory drug, mesalamine, in maintaining remission for Crohn’s disease.  Best results were for a combination of probiotics and mesalamine.
Other reviews have found probiotics to be effective for treating ulcerative colitis.   
The prestigious Journal of the American Medical Association published a meta-analysis of 82 randomized control trials. They found that probiotics work to reduce antibiotic-associated diarrhea. 
A large body of evidence shows that probiotic supplements are beneficial for digestive issues such as IBS, IBD, SIBO, and gut infections. Probiotics are also safe with few side effects. By improving the balance of good bacteria and bad bacteria in your gut, probiotics can calm an overzealous immune system and reduce inflammation. Improving your gut health can have profound effects on your overall health.
The Best Probiotics for Men
A quick search on Amazon shows that men’s probiotics are marketed widely. And while it’s true that men’s health concerns are unique, it’s not true that there is a best probiotic supplement for men that’s different from what women need.
Here’s a simple fact: ALL probiotics work synergistically to balance the gut microbiome, modulate the immune system, and reduce inflammation.
Some health professionals may recommend a specific probiotic strain or species for specific health conditions because it was used successfully in a relevant study. And while there’s nothing wrong with that approach, my years of clinical experience has taught me that using a powerful, multi-species protocol is the most effective choice for the vast majority of patients.
This probiotic protocol is fully explained in my Probiotics Starter Guide, but it calls for a combination of one blend of probiotic species from the Lactobacillus and Bifidobacterium category, a Saccharomyces boulardii probiotic, and a third supplement which includes soil-based probiotic species. Taken together, you receive all of the gut-balancing power you need to restore and maintain a healthy gut microbiome.
Each category of probiotic works as one leg of a three-legged stool. Each leg of the stool performs key functions, but it needs the other two legs to hold up the stool.
Here are the three categories of probiotic supplements I recommend. Take all three categories together to optimize the number of different species of healthy bacteria you get from your dietary supplements.
Lacto-Bifido Probiotic Blend: A blend of Lactobacillus and Bifidobacterium species (such as Lactobacillus reuteri, Lactobacillus rhamnosus, Bifidobacterium bifidum or Bifidobacterium longum) is what is most commonly used in research and is widely available to purchase.
Keep in mind that Lacto-Bifido probiotics should be refrigerated for best results. Even refrigerated, these healthy bacteria will lose 10-15% of their potency per month. This loss of potency is faster if they are kept at room temperature. If you are buying Lacto-Bifido blends, ensure that they have been handled and stored properly. It’s very important to check the expiration date for this type of probiotic supplement.
Saccharomyces boulardii Probiotic: Actually a healthy type of fungus. It is the second-most commonly used probiotic supplement in research studies, with a great track record for safety.
S. boullardii is shelf-stable and doesn’t require refrigeration, though storage in the refrigerator may extend the shelf life. Once again, it’s important to check expiration dates before buying.
Soil-Based Probiotic: This third probiotic supplement type is formulated from Bacillus species, which are naturally found in the soil and have a long history of inhabiting the human microbiome.
A lot of articles on the internet warn against taking soil-based probiotics due to safety concerns. While it’s true that some members of the Bacillus family are not safe for human consumption, species like B. subtilis and B. coagulans are very safe. The real problem with some soil-based probiotic supplements is an issue of poor quality control in the supplement industry. If you are buying soil-based probiotics, it’s especially important to buy a product that’s been independently lab tested to ensure that no harmful species have been included in the formula.
Soil-based probiotics are shelf-stable and don’t require refrigeration.
What About Fermented Foods?
Including fermented foods in your diet is a great way to add more healthy bacteria to your digestive system. Most of the healthy bacteria in fermented foods fall into the Lactobacillus family. Typical bacterial species include Lactobacillus acidophilus in Yogurt, Lactobacillus casei in Kefir and Lactobacillus plantarum in sauerkraut.
Keep in mind that unless you eat very large amounts of fermented foods, you won’t be getting a therapeutic dose of probiotics. Also, probiotic supplements can provide a wider range of probiotic species.
Probiotic manufacturing is not highly regulated and some label claims do not stand up to scrutiny. This is why it’s so important to buy a quality probiotic supplement.
As a consumer, it’s important to get your probiotic money’s worth and avoid buying junk products. These criteria can help you choose a high-quality probiotic supplement. Probiotics should:
Have a clearly stated list of species
Have clearly stated number of colony-forming units (CFUs) in the billions
Show the manufacture date and/or expiration date
Are labeled free of common allergens and other substances you may wish to avoid (e.g. gluten-free, non-GMO, vegan)
Show Good Manufacturing Practices (GMP) certification
Lab-verified for probiotic species and potency by third-party analysis (independent lab testing)
Do I Need to Buy a Special Formulation?
Some probiotic supplements are marketed as special formulations that include prebiotic fiber or have been encapsulated to protect the beneficial bacteria from stomach acid.
It’s not necessary to buy special probiotic formulations, especially if they are more expensive. What’s more important is that you are buying a high quality, lab-verified probiotic supplement from a reputable supplier. Almost all of the research conducted on probiotics has been done with simple probiotic products. Based on the benefits demonstrated through research, a simple, high-quality probiotic supplement should be effective for meeting your health needs.
A proper balance of good and bad bacteria in the microbiota is crucial for ideal health – for both men and women. Poor gut health leads to an overactive immune system and inflammation throughout that body. This is a key factor in a litany of modern-day health conditions and has significant implications for your overall health and vitality.
While we don’t currently have a large body of research into the benefits of probiotics for men’s health concerns like sexual health, heart health and prostate health, I do think we’ll learn a lot more in the next few years. Probiotics is a growing area of research in human health. In the meantime, I hope I’ve convinced you that there’s already enough evidence for you to include probiotics as a part of your daily health routine.
I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!
Transform your health
Every product is science-based, validated by real-world use, and personally vetted by Dr. Ruscio, DNM, DC.