Fermalac is a vaginal suppository (pessary) that contains Lactobacillus rhamnosus, Lactobacillus delbrueckii subsp bulgaricus and Streptococcus salivarius subsp thermophilus. It come in a pack of 10 with an applicator and is marketed as a yeast infection treatment.
There are 2 billion bacteria in each suppository and 85% of these bacteria are Lactobacillus rhamnosus.
There is a strain of L rhamnosus that in combination with another probiotic has a wonderful reputation with woman's health but whether this is the strain that is in Fermalac - who knows?
However, this product just might work for some woman. It does have more evidence behind its claim that it will stop recurrent bacterial vaginosis or yeast infection than many products on the market that call themselves probiotic.
A 1984 Korean study showed that it reduced the vaginal pH from 4.95 to 4.45 after 2 weeks. The white discharge and itching disappeared in 90% of the 20 cases in the study. One vaginal tablet was inserted daily for 10 days. The study only lasted for 2 weeks so there was no indication of how long women stayed free of the discharge and itchiness. The study was NOT a randomized, placebo controlled, double blind study so the evidence is lacking in substance.
A second study in Czechoslovakia (peer reviewed so the evidence is a little stronger than in the Korean study) on the prevention of inflammation of the vagina (colpitis) during pregnancy indicates that it is of use. Unfortunately, the review is written in Czech!
There are probiotic treatments for vaginal infections with a much stronger background than this product but there is enough evidence to suggest that it might work for some women.
Lactobacilli which produce lactic acid, H2O2, biosurfactants and coaggregation molecules, are particularly important for the vaginal biosystem and the ones in Fermalac do just that.
You can buy it through one of the Canadian online pharmacies - usually listed as an over-the-counter product (not prescription). A search on Google for "buy Fermalac" will give you several choices.
1. Kang B C,Kim C Y, Rha J G. A Clinical Study on Effectiveness of Fermalac Vaginal in Patient with Vaginal Candidiasis. Korean Medical Database.
2. Chlebecek J, Reich I. Fermalac Vaginal (Rougier Inc.) in the prevention of colpitis in pregnancy. (in Czech) Gynekol. 1993;58(5):237?238.