The role of probiotics in the vaginal microbiome

Probiotics, according to the WHO are live
microorganisms which when administered in adequate
amounts confer a health benefit on the host. They are
successfully used as an adjunct to traditional antibiotic
therapy for bacterial vaginosis, to improve the cure rate,
and to prevent the recurrence of the disease through their
ability to supplement the reduced concentration of
lactobacilli strains (Vujic et al., 2013).
Exogenously applied lactobacilli have been shown to
persist on the mucosal surface and aid in the establishment
of a normal microbiome in bacterial vaginosis (MartínezPeña et al., 2013; Ravel and Brotman, 2016). Daily intake
of probiotics with food means the use of fermented
products, while the intake of probiotic supplements means
the use of pharmaceutical products with probiotics and
prebiotics as dietary supplements. Oral intake of
lactobacilli may play a role in modeling the structure of the
vaginal microbiome. These orally enter bacteria probably
reach the vagina through not very clear mechanisms, which
involve transition through the anus, perineum, and vulvar
skin (Reid and Hammond, 2005). It is believed that
capsules, ie suppositories containing Lactobacillus
crispatus inserted into the vagina can help regulate the flora
(Ma et al., 2013). The protective role of Lactobacillus
crispatus has been confirmed and identified in numerous
studies. The role of Lactobacillus iners is unclear, as it is
detected in normal conditions as well as in vaginal
dysbiosis and BV. It is considered that they contribute to
the onset and maintenance of vaginal dysbiosis, as well as
they are a risk factor for a negative pregnancy outcome.