Urogenital Probiotics For Women

Probiotics are useful for more than a gastrointestinal health. In fact, there are certain probiotic products that can help prevent and treat female urinary conditions such as bacterial vaginosis, vulvovaginal candidiasis, urinary tract infections and associated complications of all three.

This should not come as a big surprise. The amount of good research is being conducted on the digestive probiotics continues to grow each year. And although the vaginal tract is not internally connected to the alimentary canal are two closely linked. The bacteria that pass through the digestive system can climb over the perineum to the vagina. So it's almost a no-brainer to expect what promotes gastrointestinal health have importance for urogenital health. However, they are not the same. Although the intestinal microbiota has similarities vaginal microbiota, easy care intestinal microbiota May not be enough to ensure the urogenital health.

Vaginal Microbiota: What is it?
Microbiota commonly found in the vaginal consists of a large number of lactobacilli (gram-positive rods) and a small number of gram-negative rods and gram-positive coccobacilli.Mililitru vaginal fluid contains, on average, about 100 million microorganisms 50-10 types, 95% of what are the genus Lactobacillus (anuka, 2006 ).

bacteria that live in the vagina are similar in all women around the world. This indicates a relationship that was established long ago and which has remained robust over time. From an evolutionary perspective, this trend suggests an adaptive advantage for bacteria and humans. But why? The simple answer is that certain bacteria are hot and humid place to live in return, protect the vagina and help prevent the growth of pathogens.

of several health
It is a long held belief that lactobacilli, in bulk, to promote the health of the vagina helps in maintaining an acidic pH in vaginu.Logika seems sound: increased vaginal pH and reduced the number of lactobacilli are symptomatic of various infections ergo lactic acid producing lactobacilli prevent infection probably maintain the low pH of the vagina . This reasoning led to the recommendations of consumption of yogurt with the expectation that lactobacilli, particularly L. acidophilus and other "active cultures" to promote the health of the vagina.

poking under the hood of this theory led to some interesting observations. Researchers have found that the interaction of microorganisms in the vagina is more complex than a simple pH modulacija.Riječnih: finding healthy women who seemed to lack the colonization of lactobacilli. If a large number of lactobacilli was necessary to regulate the vaginal pH in most women, so that these exceptions to reconcile? It turns out that your wife is not a lack of lactobacilli, they were only present as a very small minority. However, the fact that they existed in such small quantities suggested that mechanisms of vaginal health, stronger than ordinary lactic acid.

lactic acid was not found to be important, and something similar urogenital 90:10 rule, have been identified. Most strains of Lactobacillus produce lactic acid, but only some strains produce bacteriocins and other specific factors that regulate to prevent adhesion, colonization, growth and survival of undesirable species. Such factors may play a prominent effect even at very low concentrations. A strains that produce them can be present in miniscule amounts, but still have a major impact on the health of the urogenital. They are healthy women with very little lactobacilli help elucidate this.

bacterial vaginosis: Under the Radar
Bacterial vaginosis (BV) is the most common vaginal infection and is considered a problem in approximately 10-29% of the female population at any given time (Allsworth, 2007, Reid and Heinemenn, 1998). It is important to be aware that lactobacilli levels tend to track the level of estrogen. This means that even for women who feel healthy, you may be at increased risk of infection, when estrogen levels are low, and at the beginning and end of the menstrual cycle or after menopause goes. BV is estimated that the burden of the health system in the amount of more than 4 million office visits annually in the U.S. (Van Kessel, 2003). However, despite these numbers, it is believed that many cases still go untreated or mistreated BV.

BV can be a problem that occurs when the vaginal microbiota becomes unbalanced. BV is characterized by a shift in the vaginal microbiota from predominantly commensal microorganisms such as lactobacilli, others, such as the type genus Gardnerella, Atopobium, and Prevotella. Some of these organisms produce amines, which raises the pH in the vagina and cause "fishy" smell. Clinically, Amsel criteria and Nugent scoring is used to diagnose BV.

BV Symptoms are somewhat similar to those of yeast infections, of which more women are aware of. Because these symptoms tend to be a sensitive issue because of over-the-counter anti-fungal treatments are readily available, many women are trying to treat BV with anti-yeast medications. Unfortunately, anti-fungal treatments do not help treat BV and may even worsen.

ounce of prevention
Although it is not internally connected, the bacteria that pass through the alimentary canal can climb into the vagina over a short distance from the external perineum. This is perfectly normal, not a matter of bad hygiene. In fact, this is typical of the way into the vagina for most people. Knowing this, stands to reason that a healthy environment urogenital can start with a healthy digestive tract.

Beneficial intestinal microbiota, are more apt to flourish when exposed to a diet rich in fiber (especially prebiotic fiber) and low in simple sugars and refined carbohydrates. Pathogenic bacteria tend to proliferate at a greater rate of probiotic bacteria in contact with these characteristics diet rich in processed hrana.Zdraviji intestinal microbiota is a lower concentration of interfering organisms that pass through the digestive tract into the vagina. Eating yogurt with live active cultures may help, although the clinical evidence supporting this is somewhat ambiguous. Digestive health can be better served by taking a probiotic product or supplement that contains several strains that have been clinically documented to support health.

Women can also act preventively against BV with probiotic products that are particularly valued for vaginal health, and found to promote healthy vaginal microbiota.Idealno would be a strain that was originally isolated from healthy women and has been well characterized by a vaginal action against offenders . There are very few products on the market made ​​with probiotic strains that actually meet this standard. Two strains of Lactobacillus rhamnosus doing the GR-1 and Lactobacillus reuteri RC-14. Used together, L. rhamnosus GR-1 and L. reuteri RC-14 are shown to promote healthy vaginal microbiota, which is important in helping to prevent BV (see "Research Review ").

BV Treatment & Probiotics
Standard treatment for bacterial vaginosis include antibiotic therapy, administered either orally or locally primijeniti.Usmene route usually involves a daily intake of metronidazole or clindamycin for one week. Locally, metronidazole gel or clindamycin cream 2% may also be prescribed for a similar duration. Some report that the use of clindamycin leads to higher rates of return than metronidazole. In addition, the local use of clindamycin is contraindicated for pregnant women because of possible links to birth defects. Regardless of the antibiotic option is used, the statistics show that approximately 30% of BV infection to return within one month and about 80% within 9 months.

A growing number of physicians are recommending that their patients follow the regimen of antibiotics along with a course of probiotics for gastrointestinal health, in order to support the good bacteria that are uništile.Isti advice applies to the urogenital microbiota probiotici.Vaginalni is equally susceptible to a wide spectrum antibiotics as the intestinal microbiota. And although there was no firm evidence to suggest probiotics themselves are effective as a treatment for existing infections, probiotic supplementation can provide a dividend before, during and after treatment with antibiotics. As summarized in the "Research Review", some probiotic strains can actually improve the effectiveness of antibiotic treatment of BV.

secondary effects of BV: preterm birth and STI acquisition risk
Awareness of BV is particularly important because it can cause health problems are more serious than the immediate symptoms that women tend to notice: irritation, decreased well-being, and reduced sexual health. BV can lead to local inflammation, increased susceptibility to sexually transmitted infections and increased risk of preterm birth in pregnant women.

In the U.S., 70-10% of all babies are delivered early, while it is estimated that women are threatening preterm labor costs the health care system U.S. $ 360 million godišnje.Ukupan number of premature births has actually risen in the U.S. during the last ten years, as well. It's a little disturbing, though not incredible. Pregnant women are increasingly being given antibiotics as a defense against group B streptococci found in their vagina as a precaution when the amniotic sac ruptures prematurely. Increased antibiotic, on average, means more attacks on the vaginal microbiota of pregnant women leads to greater overall risk of BV.

In spite of medical science do not have a good grasp of what causes preterm birth, it has been known for some time that there is a correlation between the frequency of BV in pregnant women and preterm birth (Chaim, 1997; Hillier, 1992; Purwar, 2001). As mentioned above, the antibiotics used to treat BV or other conditions can cause complications during pregnancy and disrupt the microbiota of the mother. Disorder in the microbiota is concern about the transfer of endogenous bacteria from mother to infant during birth occurs, and shortly thereafter, helping to establish their own infant microbiota and the immune system. Because of this association, the use of antibiotics in the treatment of pregnant women have flaws. He was previously postulated that probiotic therapy can help eliminate the conditions that cause premature birth, and thus avoid the premature birth itself (Reid, AJOG, 2003). Some preliminary research suggests that the urogenital probiotics can help reduce the risk of preterm birth (see "Research Review ").

Sexually Transmitted Infections
The incidence of BV was also associated with greater occurrence of sexually transmitted infections such as HIV (anuka, Sex Transm Dis, 2006, Sewankambo, 1997), cytomegalovirus (Ross, 2005), chlamydia (Nilsson, 1997; Joesoef, 1996), gonorrhea (Joesoef, 1996) and pelvic inflammatory disease (Brotman, 2007). For the most part, the relationship between BV and increased risk of sexually transmitted diseases, there remains the question of causation or correlation. Investigation continues in understanding mechanisms of BV and STI acquisition and relationship between the two.

vulvovaginal candidiasis: Bacteria against yeast
More commonly known as yeast vaginitis, or colloquially as a "yeast infection" about 75% of women have the occurrence of vulvovaginal candidiasis (VVC) in life. Recurring problems of bacterial microbiota, as BV, VVC can be done more often, recurrence is likely, and difficult to treat outbreaks. Standard treatment involves the prescription of oral antimycotics fluconazole used daily for two weeks. Local antifungal creams and pessaries are common to prescription or available over-the-counter. Topical treatments tend to eliminate the superficial parts without achieving embedded sections causative organisms. VVC treatment can inhibit the growth of endogenous lactobacilli present in the vagina.

VVC results from across the proliferation of Candida species (Candida albicans accounts for 85-90% of infections), a group of organisms that are normally present in the vagina to a low bloom razinama.Candida often causes increased inflammation of the vaginal mucosa and can lead to vaginal discharge and irritation. VVC is often characterized by a thick, whitish, and uniform discharge, which usually does not have a "fishy" smell. Irritation during intercourse, and itching / inflammation of the vagina and surrounding areas is common. Clinical, microscopic examination of vaginal smears after treatment with 10% KOH may allow visualization of Candida hyphae.

healthy urogenital microbiota reduces the risk of VVC. As explained earlier, there are some steps women can take to promote healthy urogenital microbiota, including taking the probiotic strains targeted. Preventive probiotic use is one way to support a healthy microbiota and prevent the uncontrolled growth of Candida yeast (Reid, 2003, FEMS). No probiotic studies to date have shown efficacy in the treatment of existing infection itself, but there have been some preliminary results that indicate a standard antifungal treatment in combination with L. rhamnosus GR-1 / L. reuteri RC-14 probiotic resulted in significantly fewer symptoms of yeast infection in relation to standard treatment alone (see "Overview of research ").

Bacteria inappropriate
It is estimated that 25-30% of women aged between 20 and 40 had at least one urinary tract infection (UTI). In 85% of cases, the bacteria responsible for UTIs occur in our own intestines or vagina. Recurrent infections are common. Nearly 20% of women who have one UTI will have another one.

IMS may be another victim of an unhealthy urogenital microbiota.IMS is a bacterial infection of the urinary tract, including kidney, ureter, bladder and urethra. Urinary tract infections are one of the most common cause of doctor visits for women. IMS is the most frequent need to urinate with burning sensation when urinating. Urine may appear cloudy or off-odors. Pain, tenderness and pressure in the vicinity of the bladder are also common. Typical clinical assessment including urinanalysis detect nitrite, leukocytes, and leukocyte esterase.

standard treatment for UTI include regimen of oral antibiotics for 7 days, usually trimethoprim or co-trimoxazole. Repetition can be an indicator of cystitis, where the bacteria invade cells umbrella making innate immune factors and antibiotics less učinkovite.Zdrav urogenital microbiota reduces the risk of urinary sustava.Urogenitalne probiotic can be used while undergoing treatment with antibiotics to speed up recovery, reduce side effects, and begin to establish a useful vaginal microbiota to help guard against relapse.

All in all, the message that patients should be reiterated that the urogenital health is not the absence of bacteria, but the right deal. Probiotic strains have been clinically tested for their effectiveness in supporting urogenital health excellent choice to promote the balanced microbiota and prevention of urogenital infections. Prevention deserves serious consideration as options for the treatment of vaginal infections can sometimes be of limited effectiveness, especially for recurring infections. Urogenital probiotic strains can also be a useful adjuvant to standard treatment in many cases, helps to alleviate the side effects, and in some cases, strengthening the effectiveness of treatment. Urogenital problems plague many women and the cause of much concern, women are often relieved to learn that there are no longer able to work. Tell them that.

Urogenital Probiotics: Research Review

impact on Urogenital Microbiota
Forty-two clinically healthy women were randomized into three treatment groups and one control group received skupine.Liječenje various dose regimes of L. rhamnosus GR-1 / L. reuteri RC-14 (GR-1/RC-14) a probiotic supplement and control group received L. rhamnosus GG daily for twenty eight days. All three treatment groups saw a significant increase in healthy vaginal microbiota, while the control group remained isti.Dva times daily treatment group had the greatest beneficial effect with 90% of patients maintain a normal vaginal microbiota after two weeks tretmana.Studija suggests that a daily dose of about 1 billion (109) living organisms GR-1/RC-14 is suitable as a prophylactic regimen (Reid, 2001, FEMS ).

lactobacilli, yeasts and coliforms
Sixty-four clinically healthy women were randomized into two skupine.Liječenje group received a daily oral supplement GR-1/RC-14 while the control group received capsules containing calcium carbonate for sixty days. Microscopy analysis on day 28 found that the treatment group had a nearly 10-fold increase in lactobacilli during the primary and the much lower growth of yeasts and coliforms compared with placebo. In contrast, the placebo group showed reduced counts of lactobacilli and large increase in yeast and coliforms (Reid, 2003, FEMS ).

prevention of bacterial vaginosis
In a previous study, Nugent scoring blinded technician was used to evaluate prevention BV.GR-1/RC-14 group fared much better than in the control group. Of those who have a healthy vaginal microbiota at the start, 24% (6 / 25) and women in the placebo group developed BV day thirty-five study compared to 0% (0 / 23) in the treatment group (Reid, 2003, FEMS).

BV treatment in combination with antibiotics
After BV infection, combination treatment using GR-1/RC-14 (1 capsule, 10 billion CFUs, bid) with metronidazole (500 mg orally bid) more than doubled (88%) only the effectiveness of metronidazole (40%) in return vaginal microbiota in healthy condition. Of the remaining 12% of patients in the treatment group whose microbiota is not judged to be healthy in a follow-up, as it was found that the intermediate status with zero cases of BV (anuka, 2006 ).

of preterm birth
Thirty pregnant women who were diagnosed with BV and identified as clinically high risk of preterm birth, were randomized into two skupine.Liječenje group was given a daily oral capsule for 15 GR-1/RC-14 dana.Kontrolne group did not give any what type of lactobacilli, but the monitors in accordance with the clinical standard. After a follow-up one month later, the treatment group showed much better vaginal health with reduced BV indicators. But, more importantly, 100% of mothers in the treatment group, as opposed to 67% in the control group delivered at term. No side effects were reported (Dobrokhotova, 2007 ).

vulvovaginal candidiasis
Sixty-eight women who were positive for VVC were randomized into two groups and zaslijepljen.Liječenje group received fluconazole (150 mg) plus 2 GR-1/RC-14 gelatin capsule (10 billion organisms) once daily for 28 dana.Kontrolna groups received fluconazole (150 mg) plus placebo in the same order. After 28 days, the treatment group showed more than threefold reduction in the levels of both yeast and vaginal discharge compared to the control group (Martinez, 2009 ).

Urinary Tract Infections
One study sought to compare the recurrence rate of UTI in women treated with either standard 3-day antibiotic therapy alone or together with the GR-1 combination probiotic. First, either norfloxacin or co-trimoxazole was prescribed to 41 women in this group studiji.Norfloxacin the recurrence rate of 29%, while co-trimoxazole group returned at a rate of 41%. After that, all women were then randomized into two groups and administered GR-1 combination product or sterilized skim milk as a pessary. These vaginal suppositories were given twice weekly for two weeks, with two additional instillations at 4 weeks and 8 tjedana.GR-1 group has a recurrence rate of 21% compared to emerge six months, while the skim milk group showed 47% incidence of recurrence (Reid, 1992 ).

In another randomized, double-blind study, recurrence rates of UTI were re Primary cilj.Tjedno GR-1 combination of probiotics (10 billion CFUs) was given a pessary for one year. This resulted in a reduced influence occurrence rate of 6 per year for these patients in the year preceding the survey, only 1.6 per year during the study (Reid, 1995 ).

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