Background: Dysbiotic disorders of the vaginal microflora remain one of the most pressing problems in obstetrics and gynecology today. According to the Ministry of Health of the Russian Federation, this condition accounts for about 40% of all gynecological pathology cases in the general population. Bacterial vaginosis (BV), in case of untimely diagnosis and treatment, poses a threat to the development of inflammatory diseases of the small pelvis, premature birth, genitourinary menopausal syndrome.
Objective: Clinical evaluation of the effectiveness of including сomplex biologically active supplement with probiotic action in the scheme for correcting vaginal biotope disorders in women during perimenopause.
Materials and methods: An observational case-control study was conducted at the Department of Obstetrics and Gynecology No. 2 of the Voronezh State Medical University named after N.N. Burdenko in the period from 2024 to 2025. The study involved 50 women during the perimenopausal transition (STRAW+10). 3 comparison groups were formed: Group 1 (n=20) – perimenopausal patients receiving the classical regimen for the correction of dysbiotic disorders (metronidazole 500 mg + chloramphenicol 200 mg + natamycin 150 mg + hydrocortisone acetate 15 mg for 10 days, then Maxilac© for 10 days); Group 2 (n=20) – perimenopausal patients receiving a combined experimental regimen for the correction of dysbiotic disorders (metronidazole 500 mg + chloramphenicol 200 mg + natamycin 150 mg + hydrocortisone acetate for 10 days, then lactobacilli preparation for 10 days); Group 3 – control (n=10) – perimenopausal patients without vaginal biotope disorders. Women included in the experiment underwent a full range of laboratory and instrumental studies in accordance with the clinical recommendations of the Russian Ministry of Health “Bacterial vaginosis” and “Menopause and climacteric state in women”. Statistical processing was performed in Statistica 10.0 (StatSoft), differences were considered statistically significant at p<0.05.
Results: For patients of Group 2 receiving the classical BV therapy regimen, in comparison with the Group 2 receiving the experimental regimen (taking the synbiotic Maxilac©), a relatively low rate of pathogen elimination was characteristic, as well as a low rate of colonization of the vaginal biotope with acidophilic lactobacilli. In the Group 2 of the experimental BV therapy regimen, early elimination of pathogenic and opportunistic microflora, early colonization with normoflora were established.
Conclusion: Inclusion of synbiotic Maxilac© in the treatment regimen for BV in perimenopausal women improves the clinical effects of therapy due to the relatively rapid elimination of opportunistic and pathogenic pathogens, as well as due to the early restoration of the vaginal biocenosis.

Keywords: lactobacilli, Gynecology, perimenopause, bacterial vaginosis, probiotics