Addition of pre & probiotics linked to better clinical outcomes in women suffering from recurrent vaginitis: Study
Vaginitis is a common condition involving inflammation or infection of the vagina, often resulting in discomfort, abnormal discharge, itching, or irritation. It can affect women of all ages but is most frequently seen during the reproductive years. Common types of vaginitis include bacterial vaginitis (BV), yeast vaginitis (YV), and trichomoniasis, each with distinct causes. Bacterial vaginitis occurs when there is an imbalance in the normal bacterial flora of the vagina, leading to an overgrowth of harmful bacteria such as Gardnerella spp., Prevotella spp., Mobilincus spp., Megaspahera spp., Sneathea spp. and Mycoplasma hominis. Yeast infections are usually caused by an overgrowth of Candida albicans. Trichomoniasis is a sexually transmitted infection caused by a parasite, Trichomonas vaginalis.
Probiotics are beneficial live microbes that improve the host's microbial balance, promoting overall well-being. Probiotics play a crucial role in maintaining gut health by regulating the gut microbiota. They enhance the gut barrier and produce antimicrobial substances to prevent pathogen invasion. The clinical applications of probiotics are diverse, encompassing cardiovascular health, metabolic regulation, weight management, and mental well-being, with emerging research on their benefits for women's health. The most common probiotic bacteria include Lactobacillus spp., Bifidobacterium spp. and Saccharomyces boulardii.
Prebiotics are substrates that serve as food for beneficial microorganisms, supporting their function and conferring health benefits. Generally, substances like FOS (Fructooligosaccharides), Inulin and Lactitol are used as prebiotics. However, certain bacterial species when ingested produce nutrients which help in the proliferation of beneficial bacteria, thus qualifies the usage as prebiotic. For instance, Bacillus mesentericus TO-A helps in the production of a nutrient named 3,3-dihydroxyazetidine, which in turn helps in the proliferation of beneficial bacteria such as Bifidobacterium spp.
Probiotics have multiple mode of action in alleviating the symptoms of recurrent vaginitis which can be summarized as under: (a) Probiotics helps to restore the lactobacillus dominance in the vagina. (b) It inhibits the adhesion of pathogenic microorganisms. (c) It produces short-chain fatty acids such as lactic acid which helps to maintain the acidic pH. (d) Probiotics helps to enhance the local immunity, thus facilitating the body to clear urogenital tract infections more effectively. In addition, when used alongside antibiotics such as metronidazole or clindamycin, probiotics reduce recurrence rates and side effects, thus enhancing antibiotic therapy. With growing concerns about antibiotic resistance, probiotics offer a safe, non-pharmacological alternative for prevention.
There is growing evidence suggesting that certain probiotic strains may play a role in preventing and treating urogenital tract infections. However, the effectiveness of prebiotics and probiotics in the treatment of vaginitis has not been sufficiently studied in Indian women. Hence, authors assessed the clinical benefits of administering prebiotics and probiotics in Indian women suffering from recurrent vaginitis.
100 women with recurrent vaginitis were randomized into two groups. Study group received pre & probiotics capsule (Bifilac capsule) twice daily for 8 weeks along with standard therapy. Control group received standard therapy alone. The standard therapy comprised of antibiotics & antifungals. Duration of the study was 24 weeks with 8 weeks of Intervention and 16 weeks of follow up. Reduction in symptoms and recurrence rate were the primary end points. Causative organisms and the restoration of vaginal pH were evaluated
At 8 weeks, vaginitis symptoms were reduced in 76% of subjects in study group as compared to 48% in control group (P = 0.003). After 24 weeks, there was a significant reduction in the recurrence rate observed in the study group as compared to control group (86% vs 62%, P = 0.006). Candida species accounted for 64% cases of vaginitis. A higher proportion of women in the study group (98%) achieved restoration of acidic pH in the vagina as compared to the control group (74%) (P < 0.001).
In women with recurrent vaginitis, administration of prebiotic and probiotic capsule (Streptococcus faecalis T-110 - 30 million, Clostridium butyricum TO-A - 2 million, Bacillus mesentericus TO-A - 1 million and Lactobacillus sporogenes - 50 million) twice daily, along with standard therapy, yielded notable improvements. Specifically, this treatment approach led to a significant reduction in vaginitis symptoms and a decrease in recurrence rates. Furthermore, greater number of subjects achieved restoration of a normal vaginal pH, emphasizing the potential benefits of incorporating prebiotics and probiotics into the management of recurrent vaginitis
Source: Poovithaa et al. / Indian Journal of Obstetrics and Gynecology Research 2026;13(1):32–37
