Probiotics with estriol in the treatment of acute and recurrent vaginal and vulvar infections in women Review article
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Published:
Dec 31, 2021
Keywords:
vaginal microflora, microbiome, menopause, probiotics, hormone therapy, antibiotic therapy
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Abstract
The microbiome undergoes qualitative and quantitative changes at different times in a woman’s life, and their nature is due to many factors such as age, sexual activity, comorbidities, etc. As a result, vaginal dryness and inflammation can occur in the vagina. This problem is most important during the menopausal period, when estrogen secretion decreases – this induces a cascade of unfavorable biological effects. We can prevent them by adding probiotics to the standard menopausal hormonotherapy. Adding probiotics restore and maintain the proper microbiological condition of the vagina. The use of probiotics reduces the risk of developing ailments that require antibiotic therapy, which is also detrimental to the vaginal microbiome.
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How to Cite
Tomaszewski, J. (2021). Probiotics with estriol in the treatment of acute and recurrent vaginal and vulvar infections in women. Medycyna Faktow (J EBM), 14(4(53), 393-399. https://doi.org/10.24292/01.MF.0421.Y
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References
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29. Kanda N, Watanabe S. Regulatory roles of sex hormones in cutaneous biology and immunology. J Dermatol Sci. 2005; 38: 1-7.
30. Fujimoto J, Hori M, Ichigo S et al. Ovarian steroids regulate the expression of basic fibroblast growth factor and its mRNA in fibroblasts derived from uterine endometrium. Ann Clin Biochem. 1997; 34: 91-6.
31. Kovacs EJ, Duffner LA, Plackett TP. Immunosuppression after injury in aged mice is associated with a TH1-TH2 shift, which can be restored by estrogen treatment. Mech Ageing Dev. 2004; 125: 121-3.
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34. Rechberger T, Adamiak A, Skorupski P et al. Collagen metabolism in women suffering from stress urinary incontinence. Polish J Gynecol Invest. 1999; 2: 21-4.
35. Rechberger T, Postawski K, Jakowicki JA et al. Role of fascial collagen in stress urinary incontinence. Am J Obstet Gynecol. 1998; 179: 1511-4.
36. Falconer C, Ekman G, Malmstrom A et al. Decreased collagen synthesis in stress-incontinent women. Obstet Gynecol. 1994; 84: 583-6.
37. Jackson S, James M, Abrams P. The effect of oestradiol on vaginal collagen metabolism in postmenopausal women with genuine stress incontinence. BJOG. 2002; 109: 339-44.
38. Jackson S, Shepherd A, Brookes S et al. The effect of oestrogen supplementation on post-menopausal urinary stress incontinence: a double-blind, placebo-controlled trial. Br J Obstet Gynaecol. 1999; 106: 711-8.
39. Moalli PA, Klingensmith WL, Meyn LA et al. Regulation of matrix metalloproteinase expression by estrogen in fibroblasts that are derived from the pelvic floor. Am J Obstet Gynecol. 2002; 187: 72-9.
40. Shackelford DP, Lalikos JF. Estrogen replacement therapy and the surgeon. Am J Surg. 2000; 179: 333-6.
41. Jaisamram U, Triratanachat S, Chaikittsilpa S et al. Ultra-low-dose estriol and lactobacilli in the local treatment of postmenopausal vaginal atrophy: a double-blind randomized trial followed by open-label maintenance therapy. Climacteric. 2013; 16: 347-55.
42. Gaspar C, Donders GG, Palmeira-de-Oliveira R et al. BActeriocim production of the probiotic Lactobacillus acidophillus KS400. AMB Expr. 2018; 8: 153. http://doi.org/10.1186/s13568-018-0679-z.
43. Donders GG, van Bulck B, van de Walle P et al. Effect of lyophylized lactobacilli and 0.03 mg estriol (Gynoflor) on vaginitis and vaginosis with disrupted vaginal microflora: a multi-centre, randomized, single-blind, active-controlled pilot study. Gynecol Obstet Invest. 2010, 70: 264-72.
44. Unzeitig V, Al Awad H. New options of stabilization of disturbed vaginal environment balance. Prakt Gyn. 2006: 10: 170-3.
45. Ozkinay E, Terek MC, Yayci M et al. The effectiveness of live lactobacilli in combination with low dose oestriol (Gynoflor) to restore the vaginal flora after treatment of vaginal infections. BJOG. 2005; 112: 234-40.
46. Ehrström S, Daroczy K, Rylander E et al. Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis. Microbes Infect. 2010; 12: 691-9.
2. Pines A. Microbiotica in women. Climacteric. 2015; 18: 1-3.
3. Borges S, Silva J, Teixeira P. The role lactobacilli and probiotics in maintaining vaginal health. Arch Gynecol Obstet. 2014; 289: 479-89.
4. Macklaim JM, Clemente JC, Knight R et al. Changes in vaginal microbiota following antimicrobial and probiotic therapy. Microb Ecol Health Dis. 2015; 26: 27799. http://doi.org/10.3402/mehd.v26.27779.
5. O’Hanlon DE, Lanier BR, Moench TR et al. Cervicovaginal fluid and semen block the microbicidal activity of hydrogen peroxide produced by vaginal lactobacilli. BMC Infect Dis. 2010; 10: 1-8.
6. Karaoglu SA, Aydin F, Kilic SS et al. Antimicrobial activity and characteristics of bacteriocins produced by vaginal lactobacilli. Turk J Med Sci. 2002; 33: 7-13.
7. Luthje P, Hirschberg AL, Brauner A. Estrogenic action on innate defense mechanism in the urinary tract. Maturitas. 2014; 77: 32-6.
8. Galhardo CK, Soares JM Jr, Simoes RS et al. Estrogen effects on the vaginal pH, flora nad cytology in late postmenopause after a long period without hormone therapy. Clin Exp Obstet Gynecol. 2006; 33: 85-9.
9. Brotman RM, Shardell MD, Gajer P et al. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. 2014; 21: 450-8.
10. Hummelen R, Macklaim JM, Bisanz JE et al. Vaginal microbiome and epithelial gene array in post-menopasusal women with moderate to severe dryness. PLoS One. 2011; 6: e26602.
11. Reid G, Bruce AW. Selection of Lactobacillus strains for urogenital probiotic applications. J Infect Dis. 2001; 183: 77-80.
12. Reid G, Beuerman D, Heinemann C et al. Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora. FEMS Immunol Med Microbiol. 2001; 32: 37-41.
13. Ngugi BM, Hemmerling A, Bukusi EA et al. Effects of bacterial vaginosis – associated bacteria and sexual intercourse on vaginal colonization with the probiotic Lactobacillus crispatus CTV-05. Sex Transm Dis. 2011; 38: 1020-7.
14. Alvarez-Olmos MI, Barousse MM, Rajan L et al. Vaginal lactobacilli in adolescents: presence and relationship to local and systemic immunity, and to bacterial vaginosis. Sex Transm Dis. 2004; 31: 393-400.
15. Andersson H, Asp NG, Bruce A et al. Health effects of probiotics and prebiotics: a literature review on human studies. Food Nutr Res. 2001; 45: 58-75.
16. Karlsson M, Scherbak N, Khalaf H et al. Substances released from probiotic Lactobacillus rhamnosus GR-1 potentiate NF-κB activity in Escherichia coli-stimulated urinary bladder cells. FEMS Immunol Med Microbiol. 2012; 66(2): 147-56. http://doi.org/10.1111/j.1574-695X.2012.00994.x.
17. Wagner RD, Johnson SJ. Probiotic lactobacillus and estrogen effects on vaginal epithelial gene expression responses to Candida albicans. J Biomed Sci. 2012: 19: 58.
18. Pendharkar S, Brandsborg E, Hammarstrom L et al. Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection. BMC Infect Dis. 2015; 15: 255. http://doi.org/10.1186/212879-015-0971-3.
19. Parent D, Bossens M, Bayot D et al. Therapy of bacterial vaginosis using exogenously-applied Lactobacillus aciophili and a low dose of estriol: a placebo-controlled multicentric clinical trial. Arzneimittelforschung. 1996; 46: 68-73.
20. Gardiner GE, Heinemann C, Baroja ML et al. Oral administration of the probiotic combination Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 for human intestinal applications. Int Dairy J. 2002; 12: 191-6.
21. Donders G, Bellen G, Neven P et al. Effect of ultra-low-dose estriol and lactobacilli vaginal tablets (Gynoflor) on inflammatory and infectious markers of the vaginal ecosystem in postmenopausal women with breast cancer on aromatase inhibitors. Eur J Clin Microbiol Infect Dis. 2015; 34: 2023-8.
22. Ashcroft GS, Ashworth JJ. Potential role of estrogens in wound healing. Am J Clin Dermatol. 2003; 4: 737-43.
23. Ashcroft GS, Dodsworth J, van Boxtel E et al. Estrogen accelerates cutaneous wound healing associated with an increase in TGF-beta 1 levels. Nature Med. 1997; 3: 1209-15.
24. Ashcroft GS, Greenwell-Wild T, Horan MA et al. Topical estrogen accelerates cutaneous wound healing in aged humans associated with an altered inflammatory response. Am J Pathol. 1999; 155: 1137-46.
25. Engeland CG, Sabzehei B, Marucha PT. Sex hormones and mucosal healing. Brain Behav Immun. 2009; 23: 629-35.
26. Archer DF. Postmenopausal skin and estrogen. Gynecol Endocrinol. 2012; 28: 2-6.
27. Sator PG, Schmidt JB, Rabe T et al. Skin aging and sex hormones in women – clinical perspectives for intervention by hormone replacement therapy. Exp Dermatol. 2004; 13: 36-40.
28. Sator PG, Schmidt JB, Sator MO et al. The influence of hormone replacement therapy on skin ageing: a pilot study. Maturitas. 2001; 39: 43-55.
29. Kanda N, Watanabe S. Regulatory roles of sex hormones in cutaneous biology and immunology. J Dermatol Sci. 2005; 38: 1-7.
30. Fujimoto J, Hori M, Ichigo S et al. Ovarian steroids regulate the expression of basic fibroblast growth factor and its mRNA in fibroblasts derived from uterine endometrium. Ann Clin Biochem. 1997; 34: 91-6.
31. Kovacs EJ, Duffner LA, Plackett TP. Immunosuppression after injury in aged mice is associated with a TH1-TH2 shift, which can be restored by estrogen treatment. Mech Ageing Dev. 2004; 125: 121-3.
32. Kovacs EJ, Messingham KA, Gregory MS. Estrogen regulation of immune responses after injury. Mol Cell Endocrinol. 2002; 193: 129-35.
33. Kovacs EJ, Plackett TP, Witte PL. Estrogen replacement, aging, and cell-mediated immunity after injury. J Leukoc Biol. 2004; 76: 36-41.
34. Rechberger T, Adamiak A, Skorupski P et al. Collagen metabolism in women suffering from stress urinary incontinence. Polish J Gynecol Invest. 1999; 2: 21-4.
35. Rechberger T, Postawski K, Jakowicki JA et al. Role of fascial collagen in stress urinary incontinence. Am J Obstet Gynecol. 1998; 179: 1511-4.
36. Falconer C, Ekman G, Malmstrom A et al. Decreased collagen synthesis in stress-incontinent women. Obstet Gynecol. 1994; 84: 583-6.
37. Jackson S, James M, Abrams P. The effect of oestradiol on vaginal collagen metabolism in postmenopausal women with genuine stress incontinence. BJOG. 2002; 109: 339-44.
38. Jackson S, Shepherd A, Brookes S et al. The effect of oestrogen supplementation on post-menopausal urinary stress incontinence: a double-blind, placebo-controlled trial. Br J Obstet Gynaecol. 1999; 106: 711-8.
39. Moalli PA, Klingensmith WL, Meyn LA et al. Regulation of matrix metalloproteinase expression by estrogen in fibroblasts that are derived from the pelvic floor. Am J Obstet Gynecol. 2002; 187: 72-9.
40. Shackelford DP, Lalikos JF. Estrogen replacement therapy and the surgeon. Am J Surg. 2000; 179: 333-6.
41. Jaisamram U, Triratanachat S, Chaikittsilpa S et al. Ultra-low-dose estriol and lactobacilli in the local treatment of postmenopausal vaginal atrophy: a double-blind randomized trial followed by open-label maintenance therapy. Climacteric. 2013; 16: 347-55.
42. Gaspar C, Donders GG, Palmeira-de-Oliveira R et al. BActeriocim production of the probiotic Lactobacillus acidophillus KS400. AMB Expr. 2018; 8: 153. http://doi.org/10.1186/s13568-018-0679-z.
43. Donders GG, van Bulck B, van de Walle P et al. Effect of lyophylized lactobacilli and 0.03 mg estriol (Gynoflor) on vaginitis and vaginosis with disrupted vaginal microflora: a multi-centre, randomized, single-blind, active-controlled pilot study. Gynecol Obstet Invest. 2010, 70: 264-72.
44. Unzeitig V, Al Awad H. New options of stabilization of disturbed vaginal environment balance. Prakt Gyn. 2006: 10: 170-3.
45. Ozkinay E, Terek MC, Yayci M et al. The effectiveness of live lactobacilli in combination with low dose oestriol (Gynoflor) to restore the vaginal flora after treatment of vaginal infections. BJOG. 2005; 112: 234-40.
46. Ehrström S, Daroczy K, Rylander E et al. Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis. Microbes Infect. 2010; 12: 691-9.