title: The role of vaginal Lactobacillus Rhamnosus (Normogin®) in preventing Bacterial Vaginosis in women with history of recurrences, undergoing surgical menopause: a prospective pilot study.
abstract: BACKGROUND
  Bacterial vaginosis (BV), a poly-microbial clinical syndrome, is the most common cause of vaginal symptoms among women. The recurrence rate of BV is up to 30% after traditional antimicrobial therapy. Lactobacillus rhamnosus vaginal tablets have demonstrated to be a reliable topical effective and safe treatment to reduce the BV recurrence rate.
  
  
  OBJECTIVE
  to assess topical long-lasting (6 months) Lactobacillus rhamnosus effectiveness in decreasing recurrences in women with positive anamnesis of recurrent BV and concomitant hypo-estrogenism as consequence of surgical menopause.
  
  
  METHODS
  A total of 22 consecutive patients affected by recurrent BV and treated for surgical menopause for benign pathology were enrolled. All women were treated with Lactobacillus rhamnosus vaginal tablets (Normogin(®)) according to the following protocol: 1 tablet/day for 6 days, than two tablets per week for 2 months and then one tablet once a week till 6 months.
  
  
  RESULTS
  Of the 22 women enrolled only one has been lost after the first visit. A total of 21 cases were reported; 7 out of 21 had only one case of recurrence, while 2 out of 21 had two episodes of BV during the year successive to menopause. No side effects have been reported.
  
  
  CONCLUSIONS
  Considering the low recurrence rate of BV during follow-up it seems that long-lasting treatment with vaginal tablets of Lactobacillus rhamnosus could reduce the BV recurrence also in women at high risk with positive history of pathology and undergoing surgical menopause with a safe profile. This study supports the use of vaginal Lactobacillus rhamnosus administration in high risk population without side effects.
authors.affiliation: Gynecological Department, Vita Salute San Raffaele, Scientific Institute, Milan, Italy. martaparma@hotmail.it
authors.forename: M
authors.initials: M
authors.lastname: Parma
authors.forename: M
authors.initials: M
authors.lastname: Dindelli
authors.forename: L
authors.initials: L
authors.lastname: Caputo
authors.forename: A
authors.initials: A
authors.lastname: Redaelli
authors.forename: L
authors.initials: L
authors.lastname: Quaranta
authors.forename: M
authors.initials: M
authors.lastname: Candiani
mesh_terms: D005260:Female; D006801:Humans; D052201:Lacticaseibacillus rhamnosus / Q000502:physiology*; D008593:Menopause; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012008:Recurrence; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000517:prevention & control*