Home Ingredients Lactobacillus rhamnosus GR-1 + L. reuteri RC-14 (Femdophilus / Jarro-Dophilus EPS)

Lactobacillus rhamnosus GR-1 + L. reuteri RC-14 (Femdophilus / Jarro-Dophilus EPS)

Lacticaseibacillus rhamnosus GR-1 + Limosilactobacillus reuteri RC-14 (formerly Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14)
Evidence Level
Limited
7 Clinical Trials
7 Documented Benefits
2/5 Evidence Score

Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14 are two probiotic strains taken together by mouth; early papers call RC-14 Lactobacillus fermentum RC-14. Jarrow Formulas sells the pair as Fem-Dophilus, and Chr. Hansen supplied the strains for several trials. In placebo-controlled trials in healthy women, postmenopausal women and women with a diagnosed vaginal infection, more women had a normal, lactobacilli-dominated vaginal flora on the strains than on placebo. These trials read the flora under a microscope, and the one that also asked about symptoms found no difference from placebo. Two trials that added the strains to an antibiotic reported higher cure rates, but a later trial in China and a 6-month trial in women with HIV found no added benefit, and two pregnancy trials found no difference from placebo. In a urinary tract trial in postmenopausal women the strains did not match an antibiotic.

Studied Dose Oral capsules: 1 billion CFU of each strain twice daily (30 days with an antibiotic); 1 billion CFU of the pair twice daily (12 months, urinary trial); 2.5 billion CFU of each strain per capsule, once daily (14 days after menopause; through pregnancy) or twice daily (12 weeks in pregnancy).
Active Compound Live Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14, published earlier as Lactobacillus rhamnosus GR-1 with Lactobacillus fermentum RC-14 and later Lactobacillus reuteri RC-14. Sold as Fem-Dophilus (Jarrow Formulas); a Croatian trial used Lactogyn (JGL).

Benefits

Vaginal flora balance in healthy women

In 64 healthy women taking daily L. rhamnosus GR-1 and L. reuteri RC-14 capsules (then called L. fermentum RC-14) for 60 days, 37% moved from an asymptomatic bacterial vaginosis flora to a normal lactobacilli flora versus 13% on placebo (P=0.02). Cultures showed more lactobacilli and less yeast and coliforms. A symptom questionnaire found no significant difference: 30% versus 12% reported improved vaginal well-being (P=0.17).

Supported by Trial 1

Vaginal flora scores after menopause

In 72 postmenopausal women with intermediate Nugent scores (4 to 6), GR-1 and RC-14 at 2.5 billion CFU each once daily for 14 days lowered the Nugent score by at least two grades in 60% of women versus 16% on placebo (p=0.0001). The Nugent score is a microscope reading of the vaginal flora, not a symptom score.

Supported by Trial 2, Trial 1

Vaginal flora with the strains versus placebo capsules

In 544 women diagnosed with bacterial vaginosis or another vaginal infection, GR-1 and RC-14 capsules (Lactogyn) taken daily for 6 weeks gave a balanced vaginal flora in 61.5% versus 26.9% on placebo (p<0.001), and 51.1% versus 20.8% six weeks later. No antibiotic is described in the abstract. The flora was read by a cytologist; no symptom scores are reported.

Supported by Trial 2, Trial 1

Use alongside a prescription antibiotic

Two placebo-controlled trials gave GR-1 and RC-14 with an antibiotic to women diagnosed with bacterial vaginosis: cure was 88% on the strains versus 40% on placebo with oral metronidazole, and 87.5% versus 50.0% with single-dose tinidazole. Every woman took the drug, so these trials do not test the strains alone, and the strains are not a replacement for prescribed treatment.

Supported by Trial 4, Trial 3

Later trials that paired the strains with an antibiotic

Two later trials found no added benefit from GR-1 and RC-14. In 99 Chinese women using metronidazole suppositories, 30-day cure was 57.69% versus 59.57% without the strains, and 90-day cure 36.54% versus 48.94%. In 65 women with HIV over 6 months, cure with metronidazole did not improve, though vaginal pH improved in women with intermediate flora.

Supported by Trial 6, Trial 1

Vaginal flora during pregnancy

Two placebo-controlled pregnancy trials of GR-1 and RC-14 found no difference from placebo. In 238 UK women dosed from early pregnancy, bacterial vaginosis rates at 18 to 20 weeks were 15% versus 9%, a nonsignificant gap. In 66 Canadian women given the strains for 12 weeks, the Nugent score returned to normal in 30% of both groups.

Supported by Trial 1, Trial 4

Urinary tract health after menopause

In 252 postmenopausal women with recurrent urinary tract infections, capsules with 1 billion CFU of GR-1 and RC-14 twice daily for 12 months did not meet the noninferiority margin against the antibiotic trimethoprim-sulfamethoxazole (3.3 versus 2.9 infections a year). There was no placebo group. E. coli antibiotic resistance rose on the antibiotic but not on the strains.

Supported by Trial 2, Trial 3

Mechanism of action

1

More vaginal lactobacilli during dosing

In the healthy-women trial, cultures found more vaginal lactobacilli on the strains at days 28 and 60. In the metronidazole trial, lactobacilli above 100,000 CFU per ml were recovered from 96% of women on the strains versus 53% on placebo at day 30.

2

Low detection of the swallowed strains

Not every trial found the strains in the vagina. In the Chinese trial the probiotic species were rarely detected in vaginal or fecal samples, and in the UK pregnancy trial the share of women colonized with the probiotic strains did not differ from placebo.

3

Vaginal pH

In the 6-month trial in women with HIV, women with intermediate flora on the strains were more likely to have a beneficial vaginal pH at follow-up (odds ratio 3.8, P=0.02).

4

Cytokines and chemokines in pregnancy

The Canadian pregnancy trial measured vaginal cytokines and chemokines. Interleukin-10 rose slightly at 28 weeks in both the probiotic and placebo groups and was not different from 13-week levels at 35 weeks, so no immune effect specific to the strains was shown.

Clinical trials

1
GR-1 and RC-14 Capsules and Vaginal Flora in Healthy Women (60 Days)
PubMed

Randomized, placebo-controlled trial; daily oral capsules of L. rhamnosus GR-1 and L. fermentum RC-14 (now L. reuteri RC-14), made by Chr Hansen, for 60 days; vaginal flora scored by microscopy and culture, plus a well-being questionnaire; funded by Procter and Gamble, NSERC and the Kidney Foundation of Canada, with four authors from Procter and Gamble Healthcare Research (Reid et al. 2003, FEMS Immunol Med Microbiol)

64 healthy adult volunteers.

Flora moved from an asymptomatic bacterial vaginosis pattern to normal lactobacilli in 37% on the strains versus 13% on placebo (P=0.02). Cultures showed more lactobacilli at days 28 and 60, less yeast at day 28 and fewer coliforms at days 28, 60 and 90. No side effects were reported. On the questionnaire, 30% on the strains versus 12% on placebo reported improved vaginal well-being (P=0.17), with no difference in itchiness or odor.

2
GR-1 and RC-14 Capsules Alone in Adults with Vaginal Infections (6 Weeks)
PubMed

Multicenter, double-blind, randomized, placebo-controlled trial in Croatia; Lactogyn capsules (L. rhamnosus GR-1 and L. reuteri RC-14, JGL) or identical placebo capsules daily for 6 weeks (no antibiotic described in the abstract); swabs read by a clinical cytologist at 6 and 12 weeks; funding is not stated in the abstract (Vujic et al. 2013, Eur J Obstet Gynecol Reprod Biol)

544 adults diagnosed with bacterial vaginosis or another vaginal infection (395 probiotic, 149 placebo).

Balanced vaginal microbiota at about 6 weeks in 61.5% on the strains versus 26.9% on placebo (p<0.001); 6 weeks later, 51.1% versus 20.8% (p<0.001). The outcome was a microscope reading of the flora; the abstract reports no symptom scores.

3
GR-1 and RC-14 Added to Oral Metronidazole (30 Days)
PubMed

Randomized, double-blind, placebo-controlled trial in Nigeria; all participants took oral metronidazole 500 mg twice daily on days 1 to 7, plus L. rhamnosus GR-1 and L. reuteri RC-14 (1 billion CFU each) or placebo twice daily on days 1 to 30 (Anukam et al. 2006, Microbes Infect)

125 premenopausal adults diagnosed with bacterial vaginosis; 106 returned at day 30.

Cure at day 30 (normal Nugent score, negative sialidase test and no signs or symptoms) was 88% with the strains versus 40% with placebo (p<0.001). Lactobacilli above 100,000 CFU per ml were recovered from 96% versus 53%. Everyone took the antibiotic, so the strains were not tested alone.

4
GR-1 and RC-14 Added to Single-Dose Tinidazole (4 Weeks)
PubMed

Randomized, double-blind, placebo-controlled multicenter trial in Brazil; a single 2 g dose of tinidazole, then 2 capsules of L. rhamnosus GR-1 and L. reuteri RC-14 or 2 placebo capsules every morning for 4 weeks (Martinez et al. 2009, Can J Microbiol)

64 Brazilian adults diagnosed with bacterial vaginosis.

At day 28 the cure rate was 87.5% with the strains versus 50.0% with placebo (p=0.001), and a normal Nugent score was seen in 75.0% versus 34.4% (p=0.011). Everyone took the antibiotic, so the strains were not tested alone.

5
GR-1 and RC-14 for 6 Months in Adults Living with HIV
PubMed

Randomized, double-blind, placebo-controlled trial (NCT00536848); L. rhamnosus GR-1 and L. reuteri RC-14 or placebo daily for 6 months, with metronidazole 400 mg twice daily for 10 days for those with a Nugent score of 7 to 10 (Hummelen et al. 2010, Int J Gynaecol Obstet)

65 adults with HIV and a Nugent score of 4 to 10.

Null primary result: the strains did not raise the cure rate with metronidazole. In the intermediate-flora subgroup a beneficial pH was more likely on the strains (odds ratio 3.8, P=0.02); a normal flora was not significantly more likely (odds ratio 2.4, P=0.1).

6
GR-1 and RC-14 Added to Metronidazole Suppositories in China
PubMed

Prospective, parallel-group, randomized, controlled trial without a placebo; metronidazole vaginal suppositories for 7 days alone or with oral L. rhamnosus GR-1 and L. reuteri RC-14 for 30 days; funded by Shenzhen government research grants, and one author was employed by BGI-Shenzhen (Zhang et al. 2021, Front Cell Infect Microbiol)

126 Chinese adults with bacterial vaginosis; 52 and 47 in the analysis.

Null result: total cure at 30 days was 57.69% with the strains versus 59.57% with metronidazole alone, and at 90 days 36.54% versus 48.94% (p=0.213). Vaginal and fecal microbiota did not differ, and the probiotic species were rarely detected. No serious adverse effects were reported.

7
GR-1 and RC-14 from Early Gestation to Delivery (UK)
PubMed

Randomized, double-blind, placebo-controlled trial at four UK maternity units; L. rhamnosus GR-1 and L. reuteri RC-14 at 2.5 billion CFU each once daily from 9 to 14 weeks' gestation to the end of gestation; funded by Barts Charity; placebo capsules came from Chr. Hansen, which reviewed the final report before submission (Husain et al. 2020, BJOG)

304 consenting adults recruited at 9 to 14 weeks' gestation; 238 in the primary analysis.

Null result: bacterial vaginosis at 18 to 20 weeks was 15% (19/123) on the strains versus 9% (10/115) on placebo (adjusted odds ratio 1.82, 95% CI 0.64 to 5.19). Colonization with the probiotic strains, E. coli, group B streptococci and other microbes did not differ.

Side effects and drug interactions

Common Potential side effects

Safety reports in the cited trials: no side effects reported over 60 days in 64 healthy women, no serious adverse effects in the Chinese trial, and no serious adverse events related to the study products in the UK pregnancy trial.
Pregnancy: in 66 low-risk pregnant women taking the strains for 12 weeks, the investigators reported no adverse issues, and in the UK trial of 238 analyzed women dosed through pregnancy no serious adverse events were related to the capsules. Ask your obstetrician before use.
Weakened immunity or serious illness: NCCIH notes that the risk of harmful effects from probiotics is greater in people with severe illnesses or compromised immune systems. Use only with medical advice in these situations.
Vaginal symptoms such as discharge, odor or itching call for a clinician's evaluation; in the cure trials cited here the strains were added to prescribed treatment, not used in place of it.

Important Drug interactions

Antibiotics: in the vaginal cure trials the strains were taken together with metronidazole or tinidazole, and two of four such trials reported an added benefit while two did not. In a 12-month urinary tract trial in postmenopausal women, the strains did not match the antibiotic trimethoprim-sulfamethoxazole.
Immunosuppressants and chemotherapy: NCCIH notes a greater risk of harmful effects from probiotics in people with compromised immune systems; ask the prescribing clinician first.

Frequently asked questions about Lactobacillus rhamnosus GR-1 + L. reuteri RC-14 (Femdophilus / Jarro-Dophilus EPS)

What is Lactobacillus rhamnosus GR-1 + L. reuteri RC-14 used for?

The pair is taken by mouth to support a lactobacilli-dominated vaginal flora. Placebo-controlled trials in healthy women, postmenopausal women and women with a diagnosed vaginal infection found more women with a normal flora on the strains, measured under a microscope. Results alongside antibiotics were positive in two trials and null in two, two pregnancy trials were null, and a urinary tract trial did not match an antibiotic.

What is the recommended dosage of Lactobacillus rhamnosus GR-1 + L. reuteri RC-14?

There is no official dose. Trials used 1 billion CFU of each strain twice daily, or 2.5 billion CFU of each strain once or twice daily, for 14 days to 12 months. Follow the product label.

Is Lactobacillus rhamnosus GR-1 + L. reuteri RC-14 safe, and does it have side effects?

In the cited trials, adverse effects were few, and pregnancy trials reported no serious adverse events related to the capsules. NCCIH notes that people with severe illnesses or compromised immune systems face a greater risk of harm from probiotics, so they should ask a doctor first.

Can these strains replace an antibiotic a doctor has prescribed?

No trial cited here compared the strains with an antibiotic for a vaginal infection. The two positive cure trials gave the strains on top of metronidazole or tinidazole and two later trials found no added benefit. In a urinary tract trial that did compare them with an antibiotic, the strains did not match it.

Do the strains reach the vagina after being swallowed?

Sometimes. One trial recovered high lactobacilli counts from 96% of women on the strains versus 53% on placebo, but a Chinese trial rarely detected the probiotic species and a UK pregnancy trial found no difference in colonization with them.

What is Lactobacillus rhamnosus GR-1 + L. reuteri RC-14?

Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14 are two probiotic strains taken together by mouth; early papers call RC-14 Lactobacillus fermentum RC-14. Jarrow Formulas sells the pair as Fem-Dophilus, and Chr. Hansen supplied the strains for several trials.

Does Lactobacillus rhamnosus GR-1 + L. reuteri RC-14 interact with any medications?

Possible interactions include: Antibiotics: in the vaginal cure trials the strains were taken together with metronidazole or tinidazole, and two of four such trials reported an added benefit while two did not. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Lactobacillus rhamnosus GR-1 + L. reuteri RC-14?

NutraSmarts rates the evidence for Lactobacillus rhamnosus GR-1 + L. reuteri RC-14 as Limited (2 out of 5). It is backed by 7 study summaries and 12 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(12 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Reid G, Charbonneau D, Erb J, Kochanowski B, Beuerman D, Poehner R, Bruce AW. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS Immunol Med Microbiol. 2003;35(2):131-4. doi: 10.1016/S0928-8244(02)00465-0.PubMedUsed to support: Randomized, placebo-controlled trial in 64 healthy women: daily oral GR-1 and RC-14 (published as L. fermentum RC-14) for 60 days restored a normal lactobacilli flora in 37% versus 13% on placebo (P=0.02), with more vaginal lactobacilli and less yeast and coliforms in culture. A well-being questionnaire showed no significant difference (30% versus 12% reported improvement, P=0.17; no difference in itchiness or odor), and no side effects were reported. Funded by Procter and Gamble (four co-authors), NSERC and the Kidney Foundation of Canada; strains made by Chr Hansen (full text).
  2. Petricevic L, Unger FM, Viernstein H, Kiss H. Randomized, double-blind, placebo-controlled study of oral lactobacilli to improve the vaginal flora of postmenopausal women. Eur J Obstet Gynecol Reprod Biol. 2008;141(1):54-7. doi: 10.1016/j.ejogrb.2008.06.003.PubMedUsed to support: Randomized, double-blind, placebo-controlled trial in 72 postmenopausal women with Nugent scores of 4 to 6: 2.5 billion CFU each of GR-1 and RC-14 once daily for 14 days lowered the Nugent score by at least two grades in 60% versus 16% on placebo (p=0.0001).
  3. Vujic G, Jajac Knez A, Despot Stefanovic V, Kuzmic Vrbanovic V. Efficacy of orally applied probiotic capsules for bacterial vaginosis and other vaginal infections: a double-blind, randomized, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol. 2013;168(1):75-9. doi: 10.1016/j.ejogrb.2012.12.031.PubMedUsed to support: Multicenter, double-blind, randomized, placebo-controlled trial in 544 women diagnosed with vaginal infection: oral GR-1 and RC-14 for 6 weeks without an antibiotic gave a balanced vaginal microbiota in 61.5% versus 26.9% on placebo, and 51.1% versus 20.8% six weeks later (both p<0.001).
  4. Anukam K, Osazuwa E, Ahonkhai I, Ngwu M, Osemene G, Bruce AW, Reid G. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes Infect. 2006;8(6):1450-4. doi: 10.1016/j.micinf.2006.01.003.PubMedUsed to support: Randomized, double-blind, placebo-controlled trial in 125 premenopausal women with bacterial vaginosis, all taking oral metronidazole: adding GR-1 and RC-14 (1 billion CFU each twice daily for 30 days) gave a day-30 cure rate of 88% versus 40% on placebo (p<0.001). The strains were not tested without the antibiotic.
  5. Martinez RC, Franceschini SA, Patta MC, Quintana SM, Gomes BC, De Martinis EC, Reid G. Improved cure of bacterial vaginosis with single dose of tinidazole (2 g), Lactobacillus rhamnosus GR-1, and Lactobacillus reuteri RC-14: a randomized, double-blind, placebo-controlled trial. Can J Microbiol. 2009;55(2):133-8. doi: 10.1139/w08-102.PubMedUsed to support: Randomized, double-blind, placebo-controlled trial in 64 Brazilian women with bacterial vaginosis given a single 2 g dose of tinidazole: adding GR-1 and RC-14 for 4 weeks gave a cure rate of 87.5% versus 50.0% (p=0.001) and a normal Nugent score in 75.0% versus 34.4% (p=0.011). The strains were not tested without the antibiotic.
  6. Hummelen R, Changalucha J, Butamanya NL, Cook A, Habbema JD, Reid G. Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 to prevent or cure bacterial vaginosis among women with HIV. Int J Gynaecol Obstet. 2010;111(3):245-8. doi: 10.1016/j.ijgo.2010.07.008.PubMedUsed to support: Randomized, double-blind, placebo-controlled trial in 65 women with HIV over 6 months: the strains did not raise the cure rate of metronidazole; in women with intermediate flora they increased the chance of a beneficial vaginal pH (odds ratio 3.8, P=0.02).
  7. Zhang Y, Lyu J, Ge L, Huang L, Peng Z, Liang Y, Zhang X, Fan S. Probiotic Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14 as an Adjunctive Treatment for Bacterial Vaginosis Do Not Increase the Cure Rate in a Chinese Cohort: A Prospective, Parallel-Group, Randomized, Controlled Study. Front Cell Infect Microbiol. 2021;11:669901. doi: 10.3389/fcimb.2021.669901.PubMedUsed to support: Randomized, controlled trial in 126 Chinese women with bacterial vaginosis: oral GR-1 and RC-14 for 30 days added to metronidazole suppositories did not raise the cure rate (57.69% versus 59.57% at 30 days; 36.54% versus 48.94% at 90 days, p=0.213), and the probiotic species were rarely detected.
  8. Husain S, Allotey J, Drymoussi Z, Wilks M, Fernandez-Felix BM, Whiley A, Dodds J, Thangaratinam S, McCourt C, Prosdocimi EM, Wade WG, de Tejada BM, Zamora J, Khan K, Millar M. Effects of oral probiotic supplements on vaginal microbiota during pregnancy: a randomised, double-blind, placebo-controlled trial with microbiome analysis. BJOG. 2020;127(2):275-284. doi: 10.1111/1471-0528.15675.PubMedUsed to support: Randomized, double-blind, placebo-controlled trial in pregnant women in the UK (238 analyzed): GR-1 and RC-14 at 2.5 billion CFU each daily from early pregnancy did not change bacterial vaginosis rates at 18 to 20 weeks (15% versus 9%) or the vaginal microbiota. Funded by Barts Charity; Chr. Hansen supplied the placebo capsules and reviewed the final report (full text).
  9. Yang S, Reid G, Challis JRG, Gloor GB, Asztalos E, Money D, Seney S, Bocking AD. Effect of Oral Probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 on the Vaginal Microbiota, Cytokines and Chemokines in Pregnant Women. Nutrients. 2020;12(2):368. doi: 10.3390/nu12020368.PubMedUsed to support: Randomized, double-blind, placebo-controlled trial in 86 low-risk pregnant women (66 completed): GR-1 and RC-14 for 12 weeks did not differ from placebo, with the Nugent score returning to normal in 30% of both groups; the authors reported no adverse issues. Strains and placebo were provided by Chr. Hansen (full text).
  10. Beerepoot MA, ter Riet G, Nys S, van der Wal WM, de Borgie CA, de Reijke TM, Prins JM, Koeijers J, Verbon A, Stobberingh E, Geerlings SE. Lactobacilli vs antibiotics to prevent urinary tract infections: a randomized, double-blind, noninferiority trial in postmenopausal women. Arch Intern Med. 2012;172(9):704-12. doi: 10.1001/archinternmed.2012.777.PubMedUsed to support: Randomized, double-blind noninferiority trial in 252 postmenopausal women with recurrent urinary tract infections: capsules with 1 billion CFU of GR-1 and RC-14 twice daily for 12 months did not meet noninferiority versus trimethoprim-sulfamethoxazole (3.3 versus 2.9 infections a year); E. coli resistance did not rise on the strains.
  11. Jarrow Formulas. Fem-Dophilus 1 Billion CFU product page. Jarrow Formulas (manufacturer website). 2026;Accessed 2026-10-31..SourceUsed to support: Not PubMed-indexed; manufacturer product page (accessed 2026-10-31). Lists Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14 at 1 billion CFU per capsule, one capsule daily. Cited only for the commercial product name; Jarrow's Jarro-Dophilus EPS products list other strains.
  12. National Center for Complementary and Integrative Health, National Institutes of Health. Probiotics: What You Need To Know. NCCIH (NIH). 2019;Online fact sheet, last updated August 2019; accessed 2026-10-31..SourceUsed to support: Not PubMed-indexed; US government fact sheet. States that the risk of harmful effects from probiotics is greater in people with severe illnesses or compromised immune systems, and that severe or fatal infections have been reported in premature infants given probiotics.