Gynoflor is a prescription-only vaginal medication that contains freeze-dried Lactobacillus acidophilus and a small amount of an oestrogen, oestriol (E3), for the treatment of atrophic vaginitis and repopulation after pharmaceutical treatment of yeast infections, bacterial vaginosis (BV), trichomoniasis, and other vaginal infections.
The recommended dose is 1-2 tablets inserted deep into the vagina at night before bed as prescribed by your practitioner, with treatment periods ranging from 6-12 days, stopping during menstrual bleeding, then continuing afterwards.
Studies showed that once inserted, the tablets disintegrate quickly, and the bacteria ‘come back to life’ within a couple of hours.
Those who shouldn’t use Gynoflor:
- Children and girls who do not yet have their first period are not to take Gynoflor
- Hypersensitivity to oestriol (E3) or any of the other constituents of Gynoflor
- Actual or suspected endometriosis
- Hormone-dependent tumour of the breast, uterus or vagina
- Raw, inflamed or painful vaginitis (medication against vaginitis)
- Bleeding of unknown origin
Strengths and weaknesses
What Gynoflor has that makes it more useful than inserting single-strain probiotic capsules is oestriol (E3), which while not impacting blood levels of the more prominent E1 and E2 oestrogens (which can be dangerous), E3 stimulates the vaginal, cervical and vulvar cells so they are active, and produce glycogen, a form of sugar used as a food source for growing friendly lactobacilli.
This means that the L. acidophilus can proliferate, excreting lactic acid and hydrogen peroxide to help encourage the growth of other friendly lactobacilli by changing the pH (to more acidic) and inhibiting the growth of other bacteria using the various ways and wiles these bacteria have at their disposal.
Stimulating the vaginal cells may be quite useful for women with atrophic vaginitis, since this is most often caused by menopause or near-menopause lowering of oestrogen throughout the body. This causes cells to ‘dry up’, including vaginal cells, leaving many menopausal women with dry, easily-torn vulvas and vaginas. Gynoflor, among many other oestrogenic options, provides the fodder (oestriol) the vagina needs to stimulate itself back to its juicy self.
Benefits of Gynoflor
- Low-dose, short-acting hormonal impact
- Includes healthy lactobacilli to help recolonise the vagina
- Pills contain lactose, a food source for lactobacilli
- E3 is not dangerous for cancers and the treatment barely introduces any oestrogen into the bloodstream, and when it does, it’s a small amount that is quickly metabolised and excreted
What Gynoflor won’t do
- Gynoflor is not used as a treatment for vaginal infections like BV.
- If you have recurrent BV, Gynoflor will likely not remove the biofilm that remains in place without extra efforts (but, it may and is worth trying if offered to you by your doctor).
- The lactobacilli inside Gynoflor are very limited in species and action, so it is advisable to take an oral probiotic and eat and drink fermented foods and drinks regularly.
- Gynoflor will not cause proliferation of the endometrium (which can cause major problems with cancers and endometrial hyperplasia).
- Gynoflor is not going to be very useful in treating oestrogen deficiency problems, since it is barely absorbed into the blood.
- Over the course of treatment, E3 levels did not rise.
Ingredients of Gynoflor
- Oestriol (E3) 0.03 mg
- At least 10 million viable freeze-dried Lactobacillus acidophilus
- ‘Lactose and other excipients’
What is E3?
E3 is a weak oestrogen usually only present in any significant amounts during pregnancy. It is in ongoing trials and being used as a treatment for atrophic vaginitis caused by menopause and some oestrogen-dependent cancer treatments. It has also proven to be useful in managing multiple sclerosis symptoms, and as a repopulation tool for post-treatment of bacterial vaginosis, yeast infections, trichomoniasis, and other vaginal infections.
Gynoflor for recolonisation – does it work?
Gynoflor was tested as a management tool for post-antibiotic or anti-fungal treatments for bacterial vaginosis, yeast infections and trichomoniasis, and was reasonably successful at least in the short-term.
Relapse rates are variable for each of these conditions separately, and it doesn’t make sense to compare them all at once, however since the study was not specifically looking at relapse rates, but the restoration of normal vaginal flora after antibiotic treatment, these findings are not well defined, and are grouped together. The relapse rates are also all within six weeks, which from other studies that work on longer time-frames – three months is ideal, since it allows the vaginal microflora to recover as much as it is going to (in the short term) post-antibiotics or other treatments, to see if it worked. Short-term treatments may seem to help immediately, but if the core problem is not resolved – dependent on the condition – then success is far from guaranteed.
What’s more, while treating yeast infections with anti-fungals during the trial, the researchers discovered they gave at least 50 per cent of the women taking metronidazole (an antibiotic) a raging yeast infection. This is so common to be thought of as ‘normal’, however antibiotic-induced yeast infections remain a problem for many women.
The relapse rates in this particular study were reported at just under eight per cent for all women, but the breakdown of these numbers needs examining in further detail, since the conditions treated all have different causes: yeast is usually first overgrown in the intestines; bacterial vaginosis is caused by a specific pathogenic bacteria that creates a biofilm that is sometimes very difficult to treat using antibiotics; and trichomoniasis is a sexually transmitted infection that, after antibiotic treatment, relapse becomes an impossibility.
The relapse rates in this study are therefore of very little use to us, and in terms of the treatment value of Gynoflor, it is – as with most things – worth a try depending on your circumstances, combined with other recolonisation efforts (fermented foods are a good and cheap place to start). Gynoflor is reported by the manufacturer to be safe to use during pregnancy, breastfeeding and lactation.
Side effects of Gynoflor
Side effects were uncommon in clinical trials, however included:
- General vaginal irritation
- Burning, itching, redness
- Allergic reaction
Gynoflor does not contain toxic ingredients, and those it does contain have been deemed safe at least for the duration of the treatment period.