Disturbance in vaginal microbiota equilibrium can stimulate infectious clinical syndromes. Vaginal discharge or odor, irritation, pruritus, and vulvar burning are few of the frustrating symptoms. Even though identifying and eliminating the pathogen that is involved has been the standard of care generally but restoration of regional microbiota with probiotics is gaining momentum in recent years.

The present study had the objective to evaluate the efficacy of topical Bacillus coagulans treatment for patients presenting with vaginal discomfort symptoms. A clinical trial was conducted regarding the use of a topical B. coagulans treatment in reproductive-age women (n=70) with vaginal discomfort symptoms. Their symptoms were assessed using a questionnaire, vaginal pH were measured and vaginal swabs for microscopy and cultivation were performed.

For next four days, patients received B. coagulans vaginal douches and suppositories with suitable antibiotic treatment that was added on the 4th day based on the results of vaginal swab. Sixteen days later, patients came to fill out the questionnaire again. The Wilcoxon signed-ranked test was used to evaluate differences in symptomatology and pH between appointments. A decrease in vaginal pH was reported by few women between the first and second visit (P<0.001). The probiotic treatment schedule had a favorable effect in all vaginal manifestations such as vulvovaginal itching, burning sensation, vaginal irritation, and vaginal discharge (P<0.001 for all symptoms).

Moreover, 3 out of the 4 symptoms were improved to a larger extent during the first 4 days of exclusive probiotic use than in the second phase. The collected sample delivered significant results regarding the benefits of B. coagulans for vaginal discomfort. It was also postulated that the highest symptom improvement was achieved in the first 4 days of exclusive probiotic use, even before the addition of antibiotics.

Source: Tsimaris P, Giannouli A, Tzouma C, Athanasopoulos N, Creatsas G, Deligeoroglou E. Alleviation of vulvovaginitis symptoms: can probiotics lead the treatment plan? Benef Microbes. 2019; 10(8):867‐872. doi:10.3920/BM2019.0048