Study: Replens – a review for BV symptoms and vaginal pH (spoiler – it doesn’t work that well)

TL;DR

A pilot study evaluating Replens polycarbophil gel for bacterial vaginosis (BV) symptoms and its impact on vaginal pH concludes that while there are some improvements in symptoms, Replens does not significantly alter vaginal pH or treat BV effectively. Despite its bioadhesive properties that promote hydration and a healthy vaginal environment, Replens falls short in combating the underlying biofilms associated with recurrent BV.

The pilot study for Replens polycarbophil gel for bacterial vaginosis (BV) found that there was some improvement in BV symptoms, but it did not affect vaginal pH. Replens is a special gel used for atrophic vaginitis, to moisten dry vaginas. Polycarbophil gels are known not to work on biofilms at a higher pH, found in BV. 

Replens is a product containing a bioadhesive polymer that transports up to 60 times its mass in water. It binds to the vaginal cells, and releases water and electrolytes which dilate the blood vessels, leading to greater hydration. The polymer is also acidic, which promotes a healthy vaginal pH.

The purpose of the study was to see if Replens use for one month would lower vaginal pH, and improve signs of BV.      

The study
The small study involved 17 women with BV self-administering Replens every third day for four weeks. The measurements used for changes were vaginal pH, the presence of amines, and Nugent scores.      

Results
At the four-week mark, there had been improvements in Nugent scores, reduced vaginal odours and reduced clue-cell count. Eleven of the women went from being amine-positive to amine-negative, however there was no significant change in vaginal pH.

The researchers concluded that Replens is associated with some improvements in BV symptoms, but does not change vaginal pH in any meaningful way. Replens in no way cures BV, does not remove the bacterial biofilm that causes recurrent BV, and is not a treatment for BV.      

References
Wua, Justine P, Fielding, Stephen L, Fiscellac, Kevin, 2007, The effect of polycarbophil gel (Replens) on bacterial vaginosis: A pilot study, European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 130, Issue 1, January 2007, Pages 132–136

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Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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