Bacterial vaginosis (BV) is a dysbiosis of the vagina, characterised by an overgrowth of bacterial microbes such as Gardnerella vaginalis, Prevotella species, Mycoplasma hominis, and Mobiluncus species, and a loss of lactobacilli[sup]1[/sup].

As a result, the vagina loses its normal acidity, and vaginal pH increases to > pH 4.5.



Bacterial vaginosis (BV) is the most common vaginal infection in women of childbearing age, with a global prevalence of 23-29% of women in the general population[sup]1[/sup]. It can lead to[sup]1[/sup]:

• Reduced quality of life
• Increased antibiotic use
• Increased risk of Sexually Transmitted Infections
• Increased risk of obstetric complication such as late miscarriage and premature labour

Recurrence is high, affecting nearly 60% of women within 12 months and 1 in 4 at one month after treatment[sup]1[/sup].

Maintaining a healthy vaginal microbiome, predominantly composed of Lactobacillus spp., plays an essential role in preventing both Bacterial Vaginosis and Thrush. Lactobacilli play a crucial role in protecting the vagina by[sup]4[/sup]:
• Maintaining a slightly acidic vaginal pH (3.5-4.5)
• Preventing pathogens from adhering to the vaginal lining
• Competing with pathogens for nutrients
• Producing antimicrobial substances such as lactic acid, hydrogen peroxide, and bacteriocins, which inhibit the growth of harmful bacteria and yeast

Live bacteria, specifically Lactobacillus acidophilus, La-14® and Lactobacillus rhamnosus, HN001™, have shown impressive results in supporting vaginal health and managing BV and Thrush in randomised placebo-controlled trials[sup]5-8[/sup].

Several clinical studies have demonstrated the effectiveness of La-14® and HN001™ , in combination with lactoferrin, in managing BV[sup]5-7[/sup]:

• Colonises the vagina after oral consumption in just 7 days[sup]5-7[/sup]
• Improves BV symptoms: Significantly reduces symptoms like vaginal discharge and itching, leading to greater comfort and improved quality of life[sup]5-7[/sup]
• Normalises the Nugent score (a standard scoring system used to
  diagnose BV based on a microscopic examination of vaginal fluid): significantly improves the Nugent score in women with BV, demonstrating a shift towards a healthier bacterial balance[sup]6-7[/sup]
• Reduces BV recurrence rate by half at 6 months vs. placebo[sup]7[/sup]. This long-term benefit is particularly important because BV recurrence is a common problem.

Supplementation with La-14®, HN001™ and lactoferrin, has also demonstrated efficacy in managing Thrush, in a double-blind placebo-controlled RCT[sup]8[/sup] involving women treated with topical clotrimazole (100mg). Supplementation during active treatment, plus a maintenance phase for a total of 6 months resulted in:
• Significant improvements in Thrush symptoms, such as itching and discharge compared to placebo, at 3 and 6 months[sup]8[/sup]
• Significantly reduced thrush recurrence in supplemented group vs placebo at 3 and 6 months follow-up[sup]8[/sup]