Indications

• Flora SAP can help prevent and treat recurrent vulvovaginal candidiasis and bacterial vaginosis.
• Flora SAP may help prevent growth of Group-B streptococci (GBS) during pregnancy.
• Flora SAP can be used to help prevent spontaneous preterm delivery associated with intrauterine infection.
• Flora SAP can be used to help prevent recurrent urinary tract infections.

Ingredients

Each capsule of Flora SAP contains:
L. rhamnosus... 3 billion
L. acidophilus ... 3 billion
L. fermentum... 3 billion
L. casei... 50 million
L. thermophilus... 50 million

Flora SAP contains no artificial flavours, colours, soy, gluten or preservatives.

Description

Genitourinary infections affect more than 1 billion women worldwide every year and are the most common reason a women will see a gynecologist.(1) These infections can be bacterial in nature (called bacterial vaginosis) or fungal in nature (called vulvovaginal candidiasis). The types of bacteria in the vaginal canal will fluctuate based on a variety of factors including hormone levels, diet, sexual contact and douching; however, the basic composition is Lactobacilli-dominant in healthy females.(1) It is the depletion of these healthy organisms that can leave a woman prone to urinary and vaginal infections.(1) There are probiotic bacteria that can help in modulating the immune system and displacing pathogens that can cause these infections.(2) A healthy vaginal canal should be colonized by Lactobacilli as the dominant bacterial species. Lactobacilli produce H2O2, which helps maintain a vaginal pH close to 4.0, which is essential for vaginal health.(3) Maintenance of a vaginal pH around 4.0 decreases a woman's chances of developing vaginosis.(3)

Quantity

10 capsules/bottle

Dose

Use one capsule inserted vaginally per night for 10 days or as recommended by your health care
practitioner.

Potential side effects/Safety

Lactobacilli are considered to be safe because they are components of the commensal human
flora and due to the fact that they have been used for a long time in food industry and in douches,
even by pregnant women, without harmful effects.(3)

References

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1. Reid, G. “Probiotic Lactobacilli for urogenital health in women”. Journal of Clinical
Gastroenterology 42, Suppl 3 Pt 2 (2008): S234–S236.
2. Reid, G., J. Dols, and W. Miller. “Targeting the vaginal microbiota with probiotics as a
means to counteract infections”. Current Opinion in Clinical Nutrition and Metabolic Care
12, No. 6 (2009): 583–587.
3. Krauss-Silva, L., M.E. Moreira, M.B. Alves, et al. “Randomized controlled trial of probiotics
for the prevention of spontaneous preterm delivery associated with intrauterine infection:
study protocol”. Reproductive Health 7 (2010): 14.
4. Stapleton, A.E., M. Au-Yeung, T.M. Hooton, et al. “Randomized, placebo-controlled phase
2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent
urinary tract infection”. Clinical Infectious Diseases 52, No. 10 (2011): 1212–1217.
5. Delia, A., G. Morgante, G. Rago, et al. “[Effectiveness of oral administration of Lactobacillus
paracasei subsp. paracasei F19 in association with vaginal suppositories of Lactobacillus
acidofilus in the treatment of vaginosis and in the prevention of recurrent vaginitis]”.
Minerva Ginecologica 58, No. 3 (2006): 227–231.
6. Marcone, V., G. Rocca, M. Lichtner, and E. Calzolari. “Long-term vaginal administration
of Lactobacillus rhamnosus as a complementary approach to management of bacterial
vaginosis”. International Journal of Gynaecology and Obstetrics 110, No. 3 (2010): 223–226.
7. Coudeyras, S., G. Jugie, M. Vermerie, and C. Forestier. “Adhesion of human probiotic
Lactobacillus rhamnosus to cervical and vaginal cells and interaction with vaginosisassociated
pathogens”. Infectious Diseases in Obstetrics and Gynecology 2008 (2008):
549640.
8. Falagas, M.E., G.I. Betsi, and S. Athanasiou. “Probiotics for prevention of recurrent
vulvovaginal candidiasis: a review”. The Journal of Antimicrobial Chemotherapy 58, No. 2
(2006): 266–272.
9. Fichorova, R.N., A.B. Onderdonk, H. Yamamoto, et al; Extremely Low Gestation Age
Newborns (ELGAN) Study Investigators. “Maternal microbe-specific modulation of
inflammatory response in extremely low-gestational-age newborns”. mBio 2, No. 1 (2011):
e00280-10.
10. Z Á rate, G. and M.E. Nader-Macias. “Influence of probiotic vaginal lactobacilli on in
vitro adhesion of urogenital pathogens to vaginal epithelial cells”. Letters in Applied
Microbiology 43, No. 2 (2006): 174–180.
11. AÇikgÖz, Z.C., S. Gamberzade, S. GÖÇer, and P. Ceylan. “[Inhibitor effect of vaginal
lactobacilli on group B streptococci”. Mikrobiyoloji BÜlteni 39, No. 1 (2005): 17–23.
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