Persistence of Lactobacilli in Postmenopausal Women - A Double-Blind, Randomized, Pilot Study.

AIM: To investigate the ability of lactobacilli to persist in the genital area (vagina and labia) of women after the topical application of an ointment containing Lactobacillus gasseri LN40, L. fermentum LN99 and L. rhamnosus LN113. Secondary objectives were to study the presence of Escherichia coli and other contaminants, as well as subjective symptoms in the genital tract. METHODS: Eighteen healthy postmenopausal women were randomized to use either the study product or placebo for 10 days. Gynecological examinations, labial and vaginal samplings for bacterial cultivation were performed at baseline (visit 1), after treatment (visit 2), and at a 10-day follow-up (visit 3). LN strains were identified by specific cultivation methods. Subjective symptoms were evaluated by a self-administered questionnaire. RESULTS: The presence of LN99 was shown in 7 out of 8 women in the investigational group at visit 2 (p < 0.001 compared to placebo) and in 5 out of 8 at visit 3 (p < 0.05), whereas the presence of LN113 was shown in 2 out of 8 at visit 2 and in 1 out of 8 at visit 3. Subjective symptoms were significantly reduced (p < 0.01) at visits 2 and 3 for both products. CONCLUSION: Topical application of a probiotic ointment is feasible to achieve persistence of lactobacilli for at least 10 days.

Qualitative and semiquantitative analysis of Lactobacillus species in the vaginas of healthy fertile and postmenopausal Chinese women.

The present study aimed to investigate the prevalence and quantity of Lactobacillus species in the vaginas of healthy Chinese women. Vaginal samples from 92 fertile and 22 postmenopausal healthy Chinese women were analysed using a 16S rRNA gene clone library and species-specific PCR followed by sequencing and real-time PCR. A total of 13 different Lactobacillus species were detected. Species-specific PCR showed that 3% of the fertile women were colonized by one species of Lactobacillus and 97% were colonized by two or more species. Among the postmenopausal women, 91% were colonized by one species of Lactobacillus and 9% were colonized by two species. In the fertile women, L. iners (82.61%), L. crispatus (70.65%) and L. gasseri (67.39%) were more prevalent than L. jensenii (40.22%), L. acidophilus (39.13%), L. brevis (23.91%), L. plantarum (5.43%), L. johnsonii (3.26%), L. fermentum (2.17%), L. salivarius (2.17%), L. rhamnosus (1.09%), L. reuteri (1.09%) and L. paracasei (1.09%); L. delbrueckii was not detected. In the postmenopausal women, L. fermentum, L. rhamnosus, L. reuteri and L. delbrueckii were not detected, and the other 10 species were detected in just a few samples. The prevalence of these species according to the clone library differed from the prevalence indicated by the species-specific PCR. According to the semiquantitative analysis, the total Lactobacillus DNA concentrations were higher in fertile women than in postmenopausal women. Sixty-one per cent of the fertile women were predominantly colonized by L. iners, 35% by L. crispatus, and 2% by L. gasseri. Associations between pairs of Lactobacillus species in fertile women were significant (P<0.05) between the following pairs: L. iners and L. gasseri, L. iners and L. jensenii, L. iners and L. acidophilus, L. gasseri and L. acidophilus, and L. gasseri and L. jensenii. In conclusion, this study provided detailed information on Lactobacillus species colonizing the vaginas of healthy Chinese fertile and postmenopausal women. The study also showed that the diversity of Lactobacillus species in fertile women was higher than in postmenopausal women. According to our study, different techniques, such as species-specific PCR and comparison against a 16S rRNA gene clone library, resulted in different findings regarding species prevalence. These findings highlight the importance of standardization of techniques used for evaluation of bacterial communities. According to our findings regarding species associations, L. iners and L. gasseri may have influences on colonization and proliferation of other vaginal Lactobacillus species.

Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis.

This randomized double-blind placebo controlled study assessed the vaginal colonization of lactic acid bacteria and clinical outcome. Vaginal capsules containing L gasseri LN40, Lactobacillus fermentum LN99, L. casei subsp. rhamnosus LN113 and P. acidilactici LN23, or placebos were administered for five days to 95 women after conventional treatment of bacterial vaginosis and/or vulvovaginal candidiasis. Vulvovaginal examinations and vaginal samplings were performed before and after administration, after the first and second menstruation, and after six months. Presence of LN strains was assessed using RAPD analysis. LN strains were present 2-3 days after administration in 89% of the women receiving LN strains (placebo: 0%, p < 0.0001). After one menstruation 53% were colonized by at least one LN strain. Nine percent were still colonized six months after administration. Ninety-three percent of the women receiving LN strains were cured 2-3 days after administration (placebo: 83%), and 78% after one menstruation (placebo: 71%) (ns). The intervention group experienced less malodorous discharge 2-3 days after administration (p = 0.03) and after the second menstruation (p = 0.04), compared with placebo. In summary, five days of vaginal administration of LN strains after conventional treatment of bacterial vaginosis and/or vulvovaginal candidiasis lead to vaginal colonization, somewhat fewer recurrences and less malodorous discharge.