Ability of an orally administered lactobacilli preparation to improve the quality of the neovaginal microflora in male to female transsexual women

Eur J Obstet Gynecol Reprod Biol. 2014 Jan;172:102-5. doi: 10.1016/j.ejogrb.2013.10.019. Epub 2013 Oct 22.


Objective: Lactobacilli have been found in the neovagina of very low numbers of transsexual women. We undertook this study to determine whether an orally administered preparation of four lactobacilli strains exerts some measurable effect on the neovaginal microflora of female transsexuals.

Study design: 60 male to female transsexual women with penile linked neovagina were randomised into two groups. Women in the intervention group (n=33) received oral probiotic capsules and women in the control group (n=27) placebo in for 7 days. Swabs of the neovagina were taken before and after the therapy.

Results: Comparing the first and second swabs, we observed a significant improvement of the Nugent score in the intervention group 16 (48.5%) vs. low improvement in control group 4 (14.8%) (p<0.006). The neovaginal microflora was significantly enriched with lactobacilli after oral supplementation compared to placebo. In the intervention group, an increase by 10,000±600 colony forming units (CFU) of presumptive lactobacilli was observed, compared with an increase by 1600±100CFU in the control group (p<0.0001). When measured by real-time PCR (c/ml), lactobacilli increased by 1400±100c/ml in the intervention group and 300±100c/ml in the control group (p<0.0001).

Conclusion: There was an improvement of vaginal lactobacilli microflora after of oral supplementation with lactobacilli strains in transsexual women.

Keywords: Lactobacilli; Neovagina; Oral therapy; Probiotics; Transsexual women.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Colony Count, Microbial
  • Female
  • Humans
  • Lactobacillus*
  • Male
  • Microbiota*
  • Middle Aged
  • Probiotics / therapeutic use*
  • Sex Reassignment Surgery*
  • Transgender Persons
  • Treatment Outcome
  • Vagina / microbiology*