Abstract

INTRODUCTION: Bacterial vaginosis (BV) is a vaginal dysbiosis causing pain, irritation, discharge, odor, and itching. Antibiotic treatment is standard of care, but BV recurs in up to 50% of patients in 1 year. We hypothesized that using the Flourish Vaginal Care (FVC) system (an over-the-counter kit by Good Clean Love), with iso-osmotic components to optimize vaginal pH and Lactobacillus levels would reduce BV recurrence. METHODS: Ten women with two or more BV episodes within the past 2 years were enrolled in the pilot study for 11 weeks. Participants were treated with metronidazole and simultaneously started on a daily external wash with pH<4.4; iso-osmolar intravaginal lactic acid-containing gel every other day, and vaginal homeopathic suppository in a probiotic base every 3 days. Outcomes were vaginal pH, BV, and yeast occurrence tested biweekly. Participants journaled associated symptoms daily. Patient satisfaction was determined via telephone interview 10-12 months post trial. RESULTS: During the trial, no participants had BV recurrence. Mean vaginal pH decreased from 4.54 to 4.08 at baseline to study end. Journals showed decreased frequencies of pain and irritation (∼2-fold) and itching (∼4-fold). All (100%) of subjects participating in telephone interviews were satisfied with their symptom resolution 10-12 months post trial. CONCLUSION: Our pilot study shows that consistent use of vaginal products that are iso-osmotic and support optimal vaginal pH with bio-matched lactic acid prevents BV recurrence and alleviates associated symptoms. This work has important implications for prevention of recurrent BV and is evidence for the importance of maintaining the vaginal microbiome.

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