Probiotics in the practice of a gynecologist: a new chapter in the treatment of vaginal infections and dysbiosis

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Vaginal infections and dysbiosis, including bacterial vaginosis (BV), candidal vulvovaginitis (CVV), aerobic vaginitis (AV) and other forms, are a pressing issue in gynecological practice. These diseases affect a large number of women of reproductive age and lead to the development of many clinical symptoms, such as abnormal discharge, itching, pain and discomfort in the vulvar area. In addition, infections can contribute to an increased risk of complications, such as PID, infertility and premature birth. High relapse rate after standard antibiotic therapy is a significant problem in clinical practice. Relapses occur in 50% of cases 6 months after treatment, indicating the insufficient effectiveness of traditional treatments aimed at destroying pathogenic microorganisms, but not restoring normal vaginal microbiota.

Disruption of the vaginal microbiome, primarily a decrease in the number of lactobacilli and the predominance of opportunistic flora, plays a key role in the pathogenesis of infections. A systematic literature review performed using PubMed, Scopus, and Cochrane Library databases for the period 2015–2025 allowed to summarize current data on the use of probiotics based on Lactobacillus spp. as an element of restorative therapy. The analysis showed that probiotics can help reduce relapses, modulate the inflammatory response, and increase the effectiveness of standard therapy, especially in patients with chronic or recurrent infections.

This article is aimed to the analysis of the role of probiotics in restoring vaginal microflora after treatment of bacterial vaginal infections and evaluation of their effectiveness in reducing the frequency of relapses. Using the analysis of existing data, the role of probiotics as an additional method of therapy aimed at restoring the balance of vaginal microbiota and preventing relapses is considered.

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作者简介

Inna Apolikhina

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: apolikhina@inbox.ru
ORCID iD: 0000-0002-4581-6295

Dr. Sci. (Med.), Professor, Head of the Department of Aesthetic Gynecology and Rehabilitation, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov; Professor, Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University (Sechenov University)

俄罗斯联邦, Moscow; Moscow

Liana Tarnaeva

National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov

编辑信件的主要联系方式.
Email: li.tarnaeva@ya.ru
ORCID iD: 0009-0006-7500-7516

Obstetrician-Gynecologist, Postgraduate Student

俄罗斯联邦, Moscow

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