The Benefits of Lactobacillus in Treating Vaginitis

July 22, 2012
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Vaginitis is one of the most common reasons for women to seek medical attention. It affects all age groups and has a variety of causes. But alone or in combination with other vaginal or oral therapies, selected combination species and strains of a probiotic called lactobacillus can provide the key to establishing normal vaginal microflora, preventing recurring infections, and treating acute candida and bacterial infections of the vagina.

An initial bout of vaginitis may be easily diagnosed by a qualified health care practitioner, but recurrent vaginitis can be among the most troublesome and challenging conditions for both practitioners and patients. Proper diagnosis is important due to the fact that there could be undetected co-infections and potential consequences of an incorrect diagnosis and treatment. Vaginitis is commonly classified in four ways: as being caused by yeast, as bacterial vaginosis (BV), as Trichomonas vaginalis or as atrophic vaginitis.

Much like your gastrointestinal tract, the vaginal “ecosystem” is contingent on a delicately balanced relationship between normal microflora, metabolic products of that microflora and the host, estrogen and the pH level.

The normal microflora of the vagina, dominated by different species of lactobacillus, is capable of inhibiting the adhesion and growth of pathogens (infection-causing organisms), depletes nutrients available to pathogens, and modulates the host immune response and vaginal environment. Lactobacilli perform their role via at least three mechanisms: First, they help to produce lactic acid and other acids, promoting a normal vaginal acidic environment of 3.5-4.5. Many disease-causing microbes cannot survive or flourish in this pH level. Next, many species of lactobacilli produce hydrogen peroxide, which also inhibits microbial growth. Finally, the lactobacilli are competitive with the pathogenic microorganisms for adherence to the vaginal epithelial cells.

Around seven species have substantial data published on their properties and antipathogen abilities. These Lactobacillus species are L. rhamnosus, L. acidophilus, L. casei Shirota, L. reuteri , L. casei ,  L. plantarum and L. salivarius.  A number of studies have supported the use of lactobacillus in preventing and treating both candida (yeast) vaginitis and bacterial vaginosis (BV).  These have included using the lactobacillus as suppositories and/or oral delivery.

For simple acute yeast vaginitis or BV, one might consider a lactobacillus suppository (including one or more of the above species), twice daily for seven days, and an oral capsule once daily.  Oral capsules should always include a minimum of L. reuteri and/or L. rhamnosis and L. acidophilus).

For chronic or recurring infections, the suppository regimen may need to extend to once weekly for several weeks and the oral for 2 to 6 months to ensure recolonization of normal vaginal ecology.

Speak with a Pharmaca practitioner about selected combination species and strains of lactobacillus that can help prevent and treat recurring vaginal infections.