J Menopausal Med.  2017 Dec;23(3):139-145. 10.6118/jmm.2017.23.3.139.

Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article

Affiliations
  • 1Department of Urology, Soonchunhyang University College of Medicine, Bucheon, Korea. urojun@schmc.ac.kr
  • 2Department of Interdisciplinary Program in Biomedical Science, Soonchunhyang University, Asan, Korea.

Abstract

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.

Keyword

Candidiasis, vulvovaginal; Postmenopause; Probiotics; Vaginal diseases; Vaginosis, bacterial

MeSH Terms

Candida
Candidiasis, Vulvovaginal
Colon
Enterobacter
Escherichia coli
Estrogens
Female
Glycogen
Humans
Hydrogen-Ion Concentration
Lactic Acid
Lactobacillus
Microbiota
Odors
Postmenopause
Premenopause
Probiotics*
Progesterone
Vagina
Vaginal Discharge
Vaginal Diseases
Vaginosis, Bacterial
Estrogens
Glycogen
Lactic Acid
Progesterone
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