Lactobacilli and lactic acid in maintaining and restoring women’s health

Abstract

The review article presents modern data on the vaginal microbiota as a component of the female microbiome in normal and pathological conditions. The compositions of different types of vaginal community and their role in ensuring women’s health are described. It is emphasized that lactobacilli, including L. crispatus, L. gasseri, L. jensenii, L. vaginalis, L. iners, are associated with healthy vaginal microbiota, while L. iners is also related to transitional and dysbiotic stages.All types of lactobacilli produce lactic acid, acetic acid and hydrogen peroxide, and maintain a vaginal pH of less than 4.5, inhibit the growth of pathogenic bacteria and excessive Candida albicans and, therefore, protect against the pathogens of bacterial vaginosis and vaginal candidiasis.The article provides data on the key role of lactic acid as a microbicidal and virulicidal factor with immunomodulatory activity. The role of colonization resistance of the vagina is highlighted. The importance of dysbiotic states of the vaginal microbiota in the development of adverse consequences for women’s health was analyzed.Existing methods of treatment of dysbiotic conditions of the vagina are described, which include such antibiotics as metronidazole, clindamycin, estrogen therapy, lactic and boric acids, probiotics, and transplantation of vaginal microbiota. Traditional antibacterial therapy for bacterial vaginosis with metronidazole or clindamycin does not always provide high efficacy in the long term, and there is a high rate of recurrence and cases of vaginal candidiasis after treatment.Systemic use of antibiotics has significant side effects. New strategies help improve treatment outcomes. The use of probiotics can improve the vaginal flora, increase the number of beneficial bacteria, reduce the number of harmful bacteria and further maintain the stability of the vaginal flora environment.The article also describes the advantages of a vaginal probiotic, which is a complex preparation that includes the most common, identical live lactobacilli in high concentration in combination with lactic acid, as an effective modern local support and preventive agent for dysbiotic conditions of the cervical and vaginal microbiota.

Modern approaches to restoring vaginal microbiocenosis

“…Із них найчастіше у здорових жінок у складі вагінальної мікрофлори виявляють L. crispatus [21,22], а у разі бактеріального вагінозу -L. gasseri та L. iners [11]. Дані літератури свідчать про варіювання домінуючих видів залежно від етнічної приналежності та географічного розташування міс-ця проживання [23][24][25]. Так, у європейських жінок найчастіше (50,6%) виділяють L. сrispatus, а в азіатських, африканських та латиноамериканських жінок -L. iners (53,2-58,3%).…”