Probiotics and Usage in Bacterial Vaginosis

Abstract

Bacterial vaginosis (BV) is one of the most common causes of genital discomfort in women. It results from an imbalance in the microbiota of the vagina and can cause many complications including pelvic inflammatory disease and tubal factor infertility. BV is usually treated by metronidazole and clindamycin. However, this protocol doesn't prevent its recurrence, which is a main complaint of the patients. Probiotics have been documented to be beneficial in curing BV as well as reducing its recurrence and have been administered both orally and vaginally. Probiotics consumed orally are believed to ascend to the vaginal tract after they are excreted from the rectum. Mechanisms through which probiotics play a role in BV treatment include: (1) occupation of specific adhesion sites at the epithelial surface of the urinary tract; (2) maintenance of a low pH and production of antimicrobial substances like acids, hydrogen peroxide, and bacteriocins; (3) degradation of polyamines; and (4) the production of surfactants with antiadhesive properties. Based on literature, receiving Lactobacillus acidophilus, Lactobacillus rhamnosus GR-1, and Lactobacillus fermentum RC-14 at a dose of at least 108CFU/day for 2 months has had the most desired effects expected. Probiotics have been shown to exert the beneficial effect both in foods and supplements; however, foods may be preferred by patients since BV is not considered a disease by the public and the affected women may not want to be prescribed supplements. é 2016 Elsevier Inc.