Gynoflor

Gynoflor is a prescription vaginal tablet that combines the estrogen estriol with the probiotic Lactobacillus acidophilus. Each tablet delivers a low‑dose estriol formulation (strength not specified) together with lyophilized lactobacilli, designed for local application in the vagina. The product is marketed in the European Union and is classified as an estrogen therapy for the treatment of genitourinary syndrome of menopause and improves vaginal health in women.

Gynoflor is indicated for the local treatment of estrogen‑deficient conditions of the lower genital tract.

- Relief of vulvovaginal atrophy symptoms such as dryness, itching, and burning. - Restoration of normal vaginal epithelium thickness. - Re‑establishment of a healthy Lactobacillus‑dominant vaginal microbiota. - Management of genitourinary syndrome of menopause (GSM) including dyspareunia. - Adjunct therapy after systemic estrogen withdrawal or in women who cannot use systemic hormone therapy.

The safety profile of Gynoflor reflects the local estrogen exposure and the probiotic component.

Common: - Vaginal discharge or spotting. - Mild irritation or burning sensation. - Headache. - Nausea. - Increased vaginal secretions.

Serious: - Vaginal bleeding not related to menstrual cycle. - Signs of estrogen‑dependent tumor growth (e.g., breast mass). - Severe allergic reaction such as angioedema or anaphylaxis. - Thromboembolic events (rare). - Persistent pelvic pain.

Before prescribing Gynoflor, clinicians should consider several precautionary factors to ensure safe use.

- Not recommended for women with known estrogen‑dependent malignancies (e.g., breast, endometrial, ovarian cancer). - Use with caution in patients with a history of thromboembolic disease. - Avoid in active or untreated vaginal infections until resolved. - Contraindicated during pregnancy and lactation unless benefits outweigh risks. - Monitor for signs of abnormal uterine bleeding. - Assess liver function in patients with severe hepatic impairment.

Gynoflor may interact with other medications or substances that influence estrogen activity or vaginal environment.

Avoid: - Systemic estrogen therapy (e.g., oral contraceptives, hormone replacement) due to additive estrogen effect. - Antifungal or antibacterial vaginal agents taken concurrently, which may disrupt probiotic viability.

Use with caution: - Anticoagulants (e.g., warfarin) because estrogen can affect clotting factors. - Selective estrogen receptor modulators (SERMs) as they may counteract estrogenic action. - Hormonal chemotherapy agents.