Management of Disease and Disorders by Prebiotics and Probiotic Therapy: Probiotics in Bacterial Vaginosis

The homeostasis of the vaginal ecosystem results from complex interactions and synergies among the host and different microorganisms that colonize the vaginal mucosa. The vaginal microbiota of healthy reproductive age women is dominated by Lactobacillus species. Bacterial vaginosis (BV) is a common polymicrobial disorder of the vaginal microbiota characterised by loss of lactobacilli and increasing numbers of anaerobes and Gram negative rods. Probiotics represent an alternative approach for the prophylaxis and therapy of BV. The rationale for the use of probiotics in BV is based on the regulatory role played by lactobacilli in the vaginal ecosystem and the need for restoration of the microbial homeostasis. The present chapter reviews the most relevant current literature and investigations on probiotics’ potential to prevent and treat BV focusing also on the different dosage forms (oral or vaginal) used for the delivery of functional bacteria.