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Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article Jun-

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Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections inpostmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarianhormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), whichact beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogenpromotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginalhealth by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increasedvaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positivelyeffects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginalmicrobiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections(e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article,we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness ofprobiotics in the treatment and prevention of BV and VVC. (J Menopausal Med 2017;23:139-145)

Abstract

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections inpostmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarianhormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), whichact beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogenpromotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginalhealth by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increasedvaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positivelyeffects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginalmicrobiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections(e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article,we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness ofprobiotics in the treatment and prevention of BV and VVC. (J Menopausal Med 2017;23:139-145)

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