Importance of Lactic Acid in Maintaining Vaginal Health: A Review of Vaginitis and Vaginosis Etiopathogenic Bases and a Proposal for a New Treatment

The most frequent cause of visits to the gynecologist in the western world is vaginal discomfort (vaginitis and vaginosis) whose origin lies in the uncontrolled proliferation of bacteria, such as haemophilus vaginalis or Candida-type fungi, normally considered as saprophytes. Such uncontrolled development of saprophytes is caused by some types of aggression against Döderlein bacilli and/or by a significant decrease in the amount of lactic acid (use of broad-spectrum antibiotics, douches with aggressive products, etc.). Consequently, as the vagina creates a progressively alkalinized and increasingly inadequate environment for the lactobacilli activity, a more favorable environment for the growth of saprophytes is created. The more alkaline the medium becomes, the lower the production of lactic acid. Therefore a vicious circle is created, resulting in the bacillus acidophilus near the lack of metabolism and the disappearance of lactic acid, hydrogen peroxide and bacteriocins. All of the above make it possible for saprophytic bacteria to proliferate and become pathogenic. So far, all vaginitis and vaginosis treatments have solely been focused on attacking the disproportionately developed bacteria but have not addressed the restoration of a vaginal acidic environment, i.e. the environment allowing the proliferation of lactic acid-producing bacillus acidophilus. This explains the high rate of relapse occurring after the treatment of these vaginal profiles. In this paper we propose a new treatment focused on the use of lactic acid to prevent recurrence after a vaginitis or vaginosis treatment.