SynthesisPloS one2021
Lactic acid-containing products for bacterial vaginosis and their impact on the vaginal microbiota: A systematic review.
Synthesis in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- The Effect of Exogenous Sex Steroids on the Vaginal Microbiota: A Systematic Review.Frontiers in cellular and infection microbiology · 2021Pooled it
- Adjunct vaginal lactic acid with single-dose metronidazole for bacterial vaginosis: a randomized controlled trial.BMC women's health · 2026Trial
- Effectiveness and tolerability of lactic acid vaginal gel compared to oral metronidazole in the treatment of acute symptomatic bacterial vaginosis: a multicenter, randomized-controlled, head-to-head pilot study.BMC women's health · 2025Trial
- Intravaginal lactic acid gel versus oral metronidazole for treating women with recurrent bacterial vaginosis: the VITA randomised controlled trial.BMC women's health · 2023Trial
- Intravaginal Combination Therapy of Acetic and Lactic Acid in premenopausal women with recurrent vulvovaginal candidiasis: A randomized, double-blind placebo-controlled feasibility trial.Women's health (London, England)Trial
- The Impact of the Vaginal Microbiome and Microbial Metabolites on HIV Transmission at the Female Reproductive Tract Epithelial Barrier.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Review
- Novel liquid-based approaches for transmucosal drug delivery.Acta pharmaceutica Sinica. B · 2026Review
- The vaginal microbiome in pregnancy and preterm birth: mechanisms, disparities, and therapeutic opportunities.NPJ biofilms and microbiomes · 2026Review
- The Women's Microbiome: Molecular Insights, Clinical Gaps, and Future Frontiers in Precision Health with Implications for Gulf Cooperation Council Populations.International journal of molecular sciences · 2026Review
- Correlation analysis between vaginal microbiota and quality of life across different female life stages.BMC microbiology · 2026Article
- Bifidobacterium breve promotes growth and lipid alteration in Trichomonas vaginalis transiently through transcriptomic reprogramming.Scientific reports · 2026Article
- Progress in interventions for vaginal microecology.Frontiers in cellular and infection microbiology · 2026Review
- Microbiome-Metabolome Crosstalk in HPV Pathogenesis: From Ecosystem Dynamics to Translational Biomarkers.Computational and structural biotechnology journal · 2026Review
- A prodrug strategy for sustained release of lactic acid from silicone elastomer vaginal rings.International journal of pharmaceutics · 2025Article
- Lactic acid produced by optimal vaginal Lactobacillus spp. potently and specifically inactivates HIV-1 in vitro by targeting the viral RNA genome and reverse transcriptase.PLoS pathogens · 2025Article
- Association Between Vaginal Community States and Preeclampsia Status in Pregnant Individuals.bioRxiv : the preprint server for biology · 2025Article
- Bacterial vaginosis.Nature reviews. Disease primers · 2025Review
- Scratching the Surface: A Comprehensive Guide to Understanding and Managing Vulvovaginal Itching.American journal of clinical dermatology · 2025Review
- The Role of Lactic Acid in Episiotomy Wound Healing: A Systematic Review.Healthcare (Basel, Switzerland) · 2025Review
- An in silico framework for the rational design of vaginal probiotic therapy.PLoS computational biology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe vaginal microbiota in bacterial vaginosis (BV) typically has low abundance of lactic acid producing lactobacilli. Lactic acid has properties that may make it effective for treating BV and/or restoring an optimal lactobacillus-dominated vaginal microbiota. We conducted a systematic review to describe the effect of intravaginal lactic acid-containing products on BV cure, and their impact on vaginal microbiota composition (PROSPERO registration: CRD42018115982).
methodsPubMed, Embase and OVID were searched from inception to November 2019 to identify eligible studies. Included studies evaluated an intravaginal lactic acid-containing product and reported BV cure using established diagnostic methods, and/or vaginal microbiota composition using molecular methods. Studies were independently screened and assessed, and the proportion of women cured post-treatment was calculated. Study results were described in a qualitative manner.
resultsWe identified 1,883 articles and assessed 57 full-texts for eligibility. Seven different lactic acid-containing products were evaluated and differed with respect to excipients, lactic acid concentration and pH. Most studies had medium or high risk of bias. Three trials compared the efficacy of a lactic acid-containing product to metronidazole for BV cure. One study found lactic acid to be equivalent to metronidazole and two studies found lactic acid to be significantly inferior to metronidazole. Two studies included a control group receiving a placebo or no treatment. One reported lactic acid to be superior than no treatment and the other reported lactic acid to be equivalent to placebo. Lactic acid-containing products did not significantly impact the vaginal microbiota composition.
conclusionThere is a lack of high-quality evidence to support the use of lactic acid-containing products for BV cure or vaginal microbiota modulation. However, adequately powered and rigorous randomised trials with accompanying vaginal microbiota data are needed to evaluate the efficacy of lactic acid as a BV treatment strategy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.