The Rationale for Probiotics in Female Urogenital Healthcare

Gregor Reid PhD MBA, BSc (Hons); Jeremy Burton PhD; Estelle Devillard PhD

Disclosures
In This Article

Concluding Remarks

The first step in changing management paradigms is to understand the process of infection and the key factors associated with health maintenance. Lest we forget, studies from the 1970s documented the importance of the vaginal flora in both health and disease.[46,96] The second step is to accurately diagnose problems. The expense, timeframe, often-inaccurate diagnostic systems, and efficacy of some drugs led to widespread use of empirical therapy and self-medication in the latter part of the 1990s. But the frequency with which infections recur and the emergence of multidrug-resistant bacteria, as well as patient dissatisfaction with side effects of drugs, has led to an increased interest in better ways to diagnose, treat, and prevent infection. With the advent of DNA-based technologies, it should soon be possible to quickly and precisely diagnose the cause of infection or inflammation. The final step is prevention or treatment. With few new classes of antimicrobial agents emerging, it becomes more difficult to provide new-and-improved management guidelines. The recurrent nature of UTI, BV, and yeast vaginitis remains a major problem for practitioners and their patients. Indeed, it is nothing short of a silent epidemic worldwide.

Probiotics do not represent a magic bullet, but evidence is accumulating that the use of proven probiotic strains and manipulation of the host's own intestinal and vaginal/urethral microbiota will provide valuable options to help restore and maintain urogenital health. Once appropriate product formulations with supporting clinical data become available, it will be up to the physician to determine their place in patient management.

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