Probiotic suppositories for neo vaginas?

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u/[deleted]
Fri Dec 11 00:56:39 2020 UTC
(11 comments)

[deleted]

all 11 comments



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u/Maybebaby57
Fri Dec 11 04:42:03 2020 UTC
(9 children)

The reason that lactobacilli colonize the vagina epithelium is the estrogen-stimulated secretion of glycogen by the epithelium. The glycogen is a nutrient for the lactobacilli, which keeps them happy and able to suppress the growth of other bacteria.

Unless you have peritoneal tissue in there that has undergone metaplasia to resemble vaginal epithelium, there is no particular reason for lactobacilli to become a predominate species in neovaginas constructed from keratinized skin grafts (i.e. penile inversion vaginoplasty). I don't know if colon grafts undergo metaplasia.

The use of oral probiotics has been shown to introduce some vaginal colonization by lactobacilli, mostly through rectal contamination, but in relatively low amounts, not enough to influence vaginal pH or control less desirable bacterial species. I have actually heard of girls shoving yogurt up there, but I can't attest to the efficacy.

4
Fri Dec 11 07:16:06 2020 UTC
(5 children)

Kaufmann et al found that trans woman can get a good vaginal flora through oral probiotics.

3
Fri Dec 11 12:37:59 2020 UTC
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(4 children)

I am aware of this paper ( Sci Rep . 2014; 4: 3746, Molecular detection of Lactobacillus species in the neovagina of male-to-female transsexual women ). That was not actually the conclusion of the study. The purpose of the study was to examine the general opinion that penile skin lined neovaginas are not able to support the growth of lactobacilli. They found that Lactobacillus species were detectable in 47/63 transsexual women (75%). Thus, the take home message was "if you look hard enough, you can indeed find some".

"More than 90% of women harboured a combination of two or more neovaginal Lactobacillus species. In this study we report the frequent occurrence of lactobacilli from neovagina of transsexual women. Both, frequency and composition were similar to the normal lactic acid bacterial microflora in both women of reproductive age and postmenopausal women." (emphasis mine)

In other words, the occurrence and diversity of lactobacilli were similar to cis-vaginas. It says nothing about the relative amount of lactobacilli. In fact, one could infer that amount is small because the authors make a point that the PCR technique is sensitive enough that it can find species that were unculturable or undetectable by other means.

A better study to read is Microbiome volume 8 , Article number: 61 (2020), The neovaginal microbiome of transgender women post-gender reassignment surgery . This study examined the metaproteomics of secretions collected from the neovaginas ( n = 5) and rectums ( n = 7) of trans women surgically reassigned via penile inversion/scrotal graft with ( n = 1) or without ( n = 4) a sigmoid colon graft extension and compared with secretions from cis vaginas ( n = 32).

They found, on average, the most prevalent taxa by protein abundance in the neovaginal samples were Porphyromonas (30.2%), Peptostreptococcus (9.2%), Prevotella (9.0%), and Mobiluncus (8.0%), with a large proportion undistinguishable (16.9%). In cis vaginal secretions, the most abundant taxa were Lactobacillus (64.8%), Gardnerella (18.2%), Lysinibacillus (8.2%), and Prevotella (2.7%)

Their conclusion was that neovaginal bacterial composition is more similar to that of non- Lactobacillus -dominant (nLD)/polymicrobial than Lactobacillus -dominant (LD) cis vaginas .

2
Fri Dec 11 12:54:09 2020 UTC
(2 children)

Thanks for the clarification. I just defaulted to the position brought forth by Dr. Kaufmann herself last year. :) I think that with sufficient ph related care the lactobacilli will be the most prevalent bacterial species in a neovagina with mucousal tissue.

3
Fri Dec 11 17:58:24 2020 UTC
(1 child)

Well hold the phone, here. Kaufman has another paper ( European Journal of Obstetrics & Gynecology and Reproductive Biology 172 (2014) 102–105) that categorically states that "There was an improvement of vaginal lactobacilli microflora after of oral supplementation with lactobacilli strains in transsexual women." Using "an innovative probiotic lactobacilli composition containing four of the most common lactobacilli isolated from the microflora of healthy women’s vaginas for treatment of 7 days’ duration."

The improvement was seen in 48.5% of the women. They also saw an improvement in 14.8% of the control group, which seems a little odd, but there it is.

So oral supplements might help, but apparently you have to keep taking them to sustain the benefit.

2
Fri Dec 11 18:05:36 2020 UTC
(0 children)

There are ways to influence the ph value with special douche products and gels for vaginal insertion. That and oral probiotics are supposed to do the trick.

1
Fri Dec 11 15:48:52 2020 UTC
(0 children)

I'm fairly uneducated on this matter but are the prevalent bacteria in the neovagina healthy? Seeing that these percentages are an average it would only make sense that these bacteria have minimal negative affect, right? ... How do they affect pH? Or are these bacteria neither good nor bad?

Fri Dec 11 16:09:54 2020 UTC
(2 children)

[deleted]

2
Fri Dec 11 18:09:03 2020 UTC
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(1 child)

I believe all types can go through metaplasia.

There aren't a lot of studies on this, but it doesn't look like keratinized skin undergoes any significant cytological change (Ann. Plast. Surg. 2007 Nov;59(5):546-9, Do histologic changes in the skin-lined neovagina of male-to-female transsexuals really occur? )

Here is the abstract:

"Controversy exists on whether or not the epidermal keratinizing squamous epithelium of skin grafts and flaps applied to line a neovagina changes histologically to a nonkeratinizing mucosal type squamous epithelium after vaginoplasty in male-to-female transsexuals. To end this discussion, the aim of this study was to objectify the short-term and long-term histologic aspect of this neovaginal epithelial lining. Biopsies were taken from the epithelium lining of the neovagina of 9 male-to-female transsexuals, from the moment of vaginoplasty up to 14 years after. These were stained with hematoxylin-eosin and periodic acid-Schiff stain for histologic comparison to normal vaginal biopsies. Because no changes that might have been induced by local influences or hormonal therapy were found, we concluded that short-term and long-term changes in the histologic aspect of inverted skin flaps do not occur after penile and scrotal skin vaginoplasty in male-to-female transsexuals."

There is a later paper ( Cytopathology 2017;28:184–191, Cytology of the neovagina in transgender women and individuals with congenital or acquired absence of a natural vagina) which is not much more encouraging:

"The cytological findings of bowel and (penile) skin-lined neovaginas in patients with gender dysphoria (GD) and in individuals with a congenital or acquired absence of a natural vagina resembled the cytology of the normal vagina in only 10%. Sigmoid-derived neovaginas demonstrated special cytomorphology with a predominance of degenerated columnar cells. Abnormalities of squamous cells were found in 25% of patients, emphasizing the need for patients with neovaginas to engage in cancer screening programmes."

So basically your odds of getting cancer are greater than metaplasia.

I do have mucosal secretions

I do too, but it seems to come from the urethral tissue used to make my labia minora. I never really noticed any increase in wetness down there after getting a peritoneal graft, but gad I get gooshy wet upon arousal now when I play with myself. Weird.

u/[deleted]
Fri Dec 11 01:08:45 2020 UTC
(2 children)

[deleted]

Fri Dec 11 01:44:10 2020 UTC
(1 child)

[deleted]

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u/[deleted]
Fri Dec 11 03:54:43 2020 UTC
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(0 children)

I've tried them in (oral) pill form and they seem to help

edit - I just started using Good Girl Probiotics and have noticed my smell, at least deeper in the canal, is now basically gone and is now slightly pleasant

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u/SarahBear81
Fri Dec 11 19:35:35 2020 UTC
(0 children)

What should I be taking for supplements?

Acidophilus?

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u/LavenderValley
Thu Jan 7 18:01:05 2021 UTC
(0 children)

My surgeon specifically prescribed that after my surgery.