# Expert Opinion on the Use of Probiotics in General Gynecological Conditions

## TL;DR

Experts recommend using probiotics, especially Lactobacillus, to manage common gynecological conditions like bacterial vaginosis and menopause symptoms by improving vaginal health and microbiota.

## Contribution

This expert opinion highlights the role of Lactobacillus-based probiotics in managing multiple gynecological conditions through microbiota restoration.

## Key findings

- Probiotics, particularly Lactobacillus, help manage bacterial vaginosis by restoring healthy vaginal microbiota.
- Probiotics aid in preventing and treating recurrent urinary tract infections and vulvovaginal candidiasis.
- Probiotic supplementation improves reproductive health in women with polycystic ovarian syndrome.

## Abstract

Various gynecological conditions, including bacterial vaginosis, urinary tract infection, genitourinary syndrome of menopause, polycystic ovarian syndrome, and vulvovaginal candidiasis, impose a significant global burden, including among the Indian population. This expert opinion emphasizes the importance of oral probiotic supplementation in managing these conditions. A physical meeting with 14 experts was conducted on June 29-30, 2024, during which they highlighted that probiotics, particularly Lactobacillus species, have beneficial effects on restoring and maintaining healthy vaginal microbiota. Probiotics also promote vaginal health and aid in treating conditions such as bacterial vaginosis, vulvovaginal candidiasis, polycystic ovarian syndrome, and genitourinary syndrome of menopause.

Probiotics are proven effective in managing bacterial vaginosis by enhancing beneficial bacteria and reducing harmful ones. They help prevent and treat recurrent urinary tract infections by increasing lactobacilli levels, inhibiting Candida growth, and maintaining vaginal pH to prevent vulvovaginal candidiasis. Symptoms of genitourinary syndrome of menopause, such as vaginal dryness, itching, and recurrent urinary tract infections, can be alleviated through a combination of Lactobacillus-based probiotics and estrogen therapy. Experts also recommended probiotic supplementation for women with polycystic ovarian syndrome to improve both chemical and clinical pregnancy rates. Probiotics help modulate gut microbiota; improve blood glucose levels, insulin resistance, cholesterol, and androgen levels; restore the LH/FSH ratio; and enhance reproductive health. This expert opinion underscores the key role of Lactobacillus species in treating and preventing various gynecological disorders such as bacterial vaginosis, vulvovaginal candidiasis, genitourinary syndrome of menopause, urinary tract infection, and polycystic ovarian syndrome by restoring and maintaining vaginal microbiota, thus supporting overall feminine health.