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Women's Healthcare Q3 2023

Probiotics: a partner in women’s intimate health

Dr. Barbara Hersant

Pain, discomfort, sexual problems: women’s intimate health is not always an easy journey. Probiotics are an ideal support in the prevention of pain or alongside medical treatment or surgery. Professor Barbara Hersant, plastic and aesthetic surgeon who specialises in intimate surgery for women, shares her perspectives.

It is rare for “bacteria” to be associated with positive health effects. Nevertheless, they are all over and inside our body, and we need good bacteria to function normally. That is the job of our microbiome: all the micro-organisms (bacteria, viruses, parasites and non-pathogenic fungi) that live in our body. And what is the function of probiotics? They improve the health and restore the balance of our microbiome.

Benefits of probiotics for the vulvo-vaginal area

“The vulvo-vaginal microbiome has a key role: it protects the mucous membranes, preventing damage, fungal infections, itching, and pain during sexual intercourse,” explains Professor Hersant.

“Probiotics improve the quality of the mucous membranes and skin, restore the natural microbiome and improve tissue trophicity, leading in turn to improved comfort. That makes them the ideal adjuvant to standard treatments in the area of women’s health.”

Personalised prevention

Professor Hersant explains: “The problem with medicine today is that we treat patients when things have gone wrong. We should be taking care of them long beforehand, to prevent diseases from developing. I hope that medicine will become more preventive and personalised in the future.”

This personalised approach proves its worth when it comes to probiotics, where one person’s needs are very different from another’s. “Naturally not everyone’s microbiome is the same, so it makes perfect sense to offer probiotics that are adapted to match the individual profile.”

I hope that medicine will become more preventive and personalised in the future.

Five situations in which probiotics are essential

Probiotics can be useful to all women as a preventive treatment. Nevertheless, the Professor looks in greater detail at five specific situations in which probiotics are particularly useful because of their role in protecting vaginal mucous membranes.

The first one is pregnancy, “a period when vulvo-vaginal problems tend to occur more often. However, there are a wide range of medicines that pregnant women are not allowed to take. In this situation, probiotics come to the rescue. Not only to avoid discomfort, but also to prepare the vulvo-vaginal area for childbirth, a time when a healthy vulvo-vaginal microbiome will be beneficial to the baby.”

Many patients also present with subsequent problems that occur after a pregnancy: “vulvo-vaginal laxity, complications following episiotomy or a perineal tear during childbirth: these are also areas where treatment with probiotics can improve the situation.”

The third important situation: vulvo-vaginal atrophy, when the mucous membranes become too damaged, resulting in “urinary incontinence, pain during sexual intercourse or even wounds and bleeding. In these situations hormonal support or injections are proposed, and the use of probiotics alongside is vital.”

Probiotics are important for women with breast cancer too. “The standard treatments for breast cancer often cause vulvo-vaginal atrophy in female patients. However, those treatments cannot be interrupted due to the risk of recurrence. Hormonal support is not an option either, since that also carries a risk of reactivating the cancer. Adjuvant treatment with probiotics is therefore an option that has proved useful.”

Finally, prior treatment with probiotics in women wishing to have vulvar plastic surgery for aesthetic reasons or because of pain can also be very helpful, Professor Hersant concludes: “ avoiding the need for surgery in some cases .”

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