What Do Probiotics Do For Men? Evidence-Based Insights

According to the 2012 National Health Interview Survey (NHIS), the use of probiotic and prebiotic supplements has boomed, quadrupling between 2007 and 2012, making these supplements the third most commonly used dietary supplement other than vitamins and minerals (42). This trend has not slowed down, with probiotics accounting for 9% of all dietary supplement sales in the United States in 2023.

Our growing appreciation of the role of the microbiome in human health has undoubtedly contributed to this surge in popularity. For men, these beneficial bacteria not only support digestive health but can also enhance immune function, metabolism, prostate health, and mood. 

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Understanding Probiotics

Probiotics are live microorganisms that provide some sort of health benefit when consumed in adequate amounts. To be a successful probiotic, bacteria must be ingested in an active form, must be able to reproduce in the gut, and must be able to attach and adhere to the lining of the gastrointestinal tract. (45) 

In general, supplemental probiotics can be grouped into three main categories: 

1. Blends containing Lactobacillus and Bifidobacterium bacterial species
2. Spore-forming probiotics (most commonly containing Bacillus bacterial species)
3. Saccharomyces boulardii, a beneficial and non-pathogenic yeast 

Probiotics can restore and maintain a healthy balance in the microbiome, the community of microorganisms living in and on the body. They work by colonizing the intestines, outcompeting harmful bacteria, and producing antimicrobial substances to prevent infection. Research is also exposing the microbiome's roles in aiding digestion, nutrient absorption, immune system functioning, and the synthesis of a variety of compounds (e.g., vitamins, neurotransmitters, and short-chain fatty acids) that have further desirable effects on human health. (1, 36) 

Health Benefits of Probiotics for Men

As our understanding of the human microbiome deepens, the range of applications for supplemental probiotics in men's health continues to expand.

Digestive Health

Probiotics support digestion in several ways. They help maintain the integrity of the intestinal barrier, preventing hyperpermeability ("leaky gut") that allows harmful substances to enter the bloodstream. Probiotics also enhance digestion and nutrient absorption by aiding food breakdown and increasing nutrient bioavailability. They can directly and indirectly promote intestinal motility, facilitating smoother and more regular bowel movements. (36)

Dysbiosis is a common feature of gastrointestinal conditions, including:

• Constipation
• Irritable bowel syndrome (IBS) 
• Inflammatory bowel disease (IBD)
• Gastroesophageal reflux disease (GERD)
• Celiac disease

Probiotics have been shown to alleviate various digestive issues by correcting dysbiosis, reducing intestinal inflammation, and improving overall gut function.

• Antibiotic-Associated Diarrhea (AAD): Diarrhea is one of the most common side effects of antibiotics. Probiotic strains of Lactobacillus spp., Bifidobacterium spp., Bacillus spp., and Saccharomyces spp. are effective complementary therapies in preventing and treating AAD. (7) 
• Constipation: A 2010 systematic review concluded that Bifidobacterium lactis DN-173 010, Lactobacillus casei Shirota, and Escherichia coli Nissle 1917 were effective in relieving constipation, both in terms of bowel movement frequency and stool consistency. 
• Celiac Disease: Despite adhering to a gluten-free diet, about 30% of patients with celiac disease will continue to experience digestive symptoms. Probiotics can modulate the gut microbiota, reduce gluten toxicity, and prevent gluten-induced epithelial damage. Probiotic supplementation has been deemed a successful treatment strategy for celiac disease, as observed by improvements in symptom scores and microbiota composition in patients taking them. (22) 
• IBS: According to the International Foundation for Gastrointestinal Disorders, 35-40% of IBS sufferers are male. In a systematic review of 19 randomized controlled trials (including 1,650 patients), probiotic supplements were statistically significantly better than placebo at reducing symptoms of IBS. 

Immune System Support

70-80% of the immune system is located in the gut. A healthy microbiome supports immune function by enhancing the body's ability to respond to infections and maintain immune tolerance. The gut microbiome interfaces with the immune system by interacting with gut-associated lymphoid tissue (GALT), where it helps train immune cells to differentiate between harmful pathogens and benign substances. 

Results of clinical studies suggest that probiotics have the potential to enhance immune function and prevent disease: 

• A randomized controlled study demonstrated that Lactobacillus GG can act as an adjuvant to enhance the efficacy of the live-attenuated influenza vaccine in healthy adults. Specifically, a higher percentage of adults who took Lactobacillus GG for 28 days following their vaccination achieved protective antibody titer levels compared to those who received a placebo. (20) 
• Probiotics can reduce seasonal allergy symptoms by downregulating the pro-inflammatory immune mediators associated with allergic reactions. 
• Incorporating probiotics into your cold-and-flu prevention toolbox can lower the likelihood of contracting viral respiratory infections. A randomized controlled study found that participants taking a probiotic formula containing Lactobacillus plantarum HEAL 9 and Lactobacillus paracasei 8700 over 12 weeks experienced fewer occurrences of the common cold. Those who did become ill experienced less severe symptoms and shorter durations of illness. (4) 

Mental Health and Mood

The gut-brain axis is the complex bidirectional communication network between the gastrointestinal and central nervous systems. The gut microbiome influences nervous system functioning by producing neurotransmitters, short-chain fatty acids, and proteins called neurotrophic factors that support the health of nerve cells, mood, and cognition. Individuals with mental health conditions often exhibit altered gut microbiota compositions compared to healthy individuals, suggesting that the state of the gut microbiome can significantly impact mental health. This emerging understanding underscores the potential of targeting the gut microbiome as a therapeutic approach for mental health disorders. (18) 

The abundance of Firmicutes, Lactobacillus, Bifidobacterium, and Faecalibacterium bacteria is significantly lowered in the gastrointestinal tracts of patients with major depressive disorder. Probiotics, especially those containing Lactobacillus and Bifidobacterium species, have been extensively studied and found beneficial for replenishing these bacteria within the microbiota and improving depressive symptoms in those affected (38).

Similar findings apply to anxiety disorders. Patients with anxiety taking probiotic supplements report improvements in their physical and emotional symptoms. 

Metabolic Health

Human studies have found that the majority of microbiomes of obese people have a higher Firmicutes-to-Bacteroidetes bacterial ratio and overall less bacterial diversity than those of moderate-weight people.

Dysbiosis can negatively impact energy and lipid metabolism, nutrient absorption, and inflammation, contributing to metabolic syndrome (which includes high blood pressure, high blood sugar, central adiposity, and dyslipidemia). (5, 6) 

Probiotics appear to optimize metabolism and fight obesity through various mechanisms:

• Regulating appetite by producing short-chain fatty acids and modulating the release of hormones like GLP-1
• Decreasing fat storage
• Reducing systemic inflammation
• Improving insulin sensitivity and glycemic control

Prostate Health

The gut-prostate axis is an emerging concept highlighting the interaction between the gut microbiome and prostate health. Functional alterations in the gut microbiome, combined with increased intestinal epithelial permeability, are associated with prostate diseases such as benign prostatic hyperplasia (BPH) and prostate cancer. Patients with prostate diseases often exhibit distinct gut microbiome profiles compared to healthy individuals, indicating a link between gut microbial composition and prostate pathology. (23) 

Early research on probiotics and prostate disease has shown promising results, but more research is needed to fully understand the mechanisms behind these effects. Some studies suggest that certain probiotic strains may help reduce inflammation, modulate immune function, and strengthen the body's natural defenses against prostatic cancer cells. Another study of men with chronic prostatitis and IBS found that taking a probiotic with antibiotic treatment reduced the risk of recurrent infection. 

Lab Testing for the Gut Microbiome

A comprehensive stool test evaluates various parameters of gastrointestinal health, including the diversity and abundance of beneficial gut bacteria, the presence of pathogens, levels of inflammation, markers of digestion and absorption, and microbial metabolites (like short-chain fatty acids). 

These tests can help healthcare practitioners tailor probiotic treatments to individual needs by providing a detailed snapshot of the gut microbiome. For instance, identifying specific deficiencies or imbalances in gut bacteria can guide the selection of probiotic strains most likely to restore microbial equilibrium and produce desired clinical outcomes. 

Ongoing monitoring through regular lab tests allows for the adjustment of probiotic regimens, ensuring that the interventions remain effective and responsive to changes in the gut environment. This personalized approach optimizes the benefits of probiotics, enhancing overall gut health and supporting related bodily functions.

Choosing the Right Probiotics

Choosing the right probiotics involves considering several factors to ensure maximum efficacy and health benefits. 

Many people start taking probiotics to address a specific health concern. Probiotics are strain- and disease-specific, meaning different strains offer unique health benefits. Just as with any medication or supplement, you want to select a probiotic with strains tailored to the particular health condition you are targeting. This guide is an excellent resource to help you make that decision.

A product must contain live and active bacterial cultures to be a probiotic. The product should indicate this on its packaging by listing the colony-forming units (CFU). The CFU is the number of bacteria per dose. CFU will decline over time, so store probiotics appropriately to extend their shelf-life. (28) 

As with any dietary supplement, you want to make sure you buy a quality probiotic. Look for products manufactured to cGMP standards and third-party tested for purity and potency. (11) 

Some people prefer a dietary-based approach to supporting their microbiome over probiotic supplements. To do so, you'll want to incorporate probiotic and prebiotic foods into your diet. 

• Probiotic foods contain healthy bacteria. Examples include yogurt, kefir, kombucha, sauerkraut, kimchi, and miso.
• Prebiotics are fermentable fibers that act as food sources for probiotics. Prebiotic foods include beans, garlic, onions, and green bananas. 

Safety and Side Effects

While probiotics are generally considered safe for healthy individuals, potential risks and side effects do exist, particularly for those with compromised immune systems. This risk arises from the possibility that a probiotic product might be contaminated with harmful microbes. While a healthy immune system can typically eliminate these unwanted microbes, they can cause serious infections in individuals with weakened immune defenses. (42) 

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Key Takeaways

• The benefits of probiotics for men are extensive. Probiotics can be a valuable component of a comprehensive health strategy.
• Consulting with a healthcare professional before starting probiotic supplements can help tailor the choice of strains and dosages to individual needs, ensuring both safety and efficacy. 
• By making evidence-based, informed decisions and seeking professional guidance, men can effectively incorporate probiotics into their health regimen and reap their full benefits.