Urogenital infections in women and probiotics.
Urogenital infections are an extremely common reason for women to seek medical care. These infections, specifically yeast vaginitis, bacterial vaginosis and urinary tract infections (UTI’s) remain a major medical problem in terms of the number of women affected each year.1 And although treatment with antibiotics and anti-fungal medication is usually effective, there is a high risk of the infection recurring, with the woman’s quality of life being affected and many becoming frustrated by having to take repeated courses of medication and suffering their side effects.1,3
There is now evidence to show that the urogenital flora (the bacteria that live in the vagina and bladder) play a role in our health.1 And probiotics or “good bacteria” are receiving recognition for helping to maintain and restore healthy normal flora.1
BACTERIAL VAGINOSIS
Bacterial vaginosis (BV) is the most common cause of vaginal infection, and affects women usually between the ages of 17 – 30 years, as well as older women.1,2
BV is the name of the condition where the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain “bad” or “harmful” bacteria.2
What are the symptoms? There may be no symptoms at all, or there may be a thin, white or grey vaginal discharge with an unpleasant, “fish-like” odour. There may also be burning during urination or itching.2
It is not fully understood how BV is caused, but it occurs when there is an imbalance in the bacteria that are normally found in the vagina.2 Douching, having a new sex partner or having multiple sex partners may increase the risk of developing BV.2
BV is treated with antibiotics, such as metronidazole or clindamycin.2 However, it may recur after treatment2 and the following steps may be required to prevent upsetting the natural balance of bacteria in the vagina:
- Abstinence or limit the number of sex partners
- Do not douche
- Use all of the medicine prescribed to treat BV (finish your course of antibiotics)
- Consider using a probiotic that will help restore and maintain a healthy vaginal flora1,3
CANDIDIASIS
Yeast vaginitis or candidiasis is a fungal infection that occurs when there is an overgrowth of the fungus, Candida albicans. Candida is usually present in the body in small amounts. However, when an imbalance in the normal flora occurs, Candida can multiply and the symptoms of candidiasis appear.4
What are the symptoms? There may be a “cottage cheese-like” discharge, with genital itching and burning as well as pain during sexual intercourse.4, ⁵
The overgrowth of Candida, that causes the symptoms of an infection, may be caused by a weakened immune system, or occur during pregnancy, when using medication such as corticosteroids or broad-spectrum antibiotics, or in someone with another illness such as diabetes mellitus.4
Candidiasis is treated with antifungal creams or medication, such as fluconazole.4 However, like BV, it may recur after treatment.4
In terms of probiotics, very few are actually able to kill or inhibit adhesion of the yeast to vaginal cells, although the strains L. rhamnosus GR-1 and L. fermentum RC-14 do have some such activity.1 There is little evidence that probiotics can effectively cure a symptomatic yeast vaginitis, but a reliable probiotic product might be a worthwhile addition to drug therapy (antifungal medicines) as a means to help reduce the risk of recurrence.1
Brought to you by Acacia Healthcare in the interest of continued education.
References available on request
References:
1) Reid G, Bruce AW. Urogenital infections in women: can probiotics help? Postgrad Med J 2003;79:428–432
2) CDC Fact Sheet. Bacterial Vaginosis. 2007 [updated 2007 Dec; cited 2011 April 21]. Available from: http://www.cdc.gov/std/bv/STDFact-Bacterial-Vaginosis.htm.
3) Reid G, Charbonneau D, Erb J, Kochanowski B, Beuerman D, Poehner R, Bruce AW. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora : randomized, placebo-controlled trial in 64 healthy women. FEMS Immunology and Medical Microbiology 2003; 35:131-134.
4) CDC.Candidiasis: General Information. 2010.[page last updated/reviewed 2010 Jul 6; cited 2011 April 20].Available from:http://www.cdc.gov/nczved/divisions/dfbmd/diseases/candidiasis/#whatvvc on 19/04/2011. Centers for Disease Control and Prevention (http://www.cdc.gov).
5) Vaginal yeast infection: MedicinePlus Medical Encyclopedia.2009 [updated 2009 Jan 01; cited 2011 May 03]. Available from http://www.nlm.nih.gov/medlineplus/ency/article/001511.htm
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