No, you don’t need the ‘Barbie drug’ to tan, whatever TikTok says. Here’s why melanotan-II is so risky

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TikTok and Instagram influencers have been peddling the “Barbie drug” to help you tan.

But melanotan-II, as it’s called officially, is a solution that’s too good to be true. Just like tanning, this unapproved drug has a dark side.

Doctors, researchers and Australia’s drug regulator have been warning about its side effects – from nausea and vomiting to brain swelling and erection problems.

There are also safer ways of getting the tanned look, if that’s what you’re after.

AtlasStudio/Shutterstock

What is melanotan-II?

No, it’s not a typo. Melanotan-II is very different from melatonin, which is a hormonal supplement used for insomnia and jet lag.

Melanotan-II is a synthetic version of the naturally ocurring hormone α-melanocyte stimulating hormone. This means the drug mimics the body’s hormone that stimulates production of the pigment melanin. This is what promotes skin darkening or tanning, even in people with little melanin.

Although the drug is promoted as a way of getting a “sunless tan”, it is usually promoted for use with UV exposure, to enhance the effect of UV and kickstart the tanning process.

Melanotan-II is related to, but different from, melanotan-I (afamelanotide), an approved drug used to treat the skin condition erythropoietic protoporphyria.

Melanotan-II is not registered for use with Australia’s Therapeutic Goods Administration (TGA). It is illegal to advertise it to the public or to provide it without a prescription.

However, social media has been driving unlicensed melanotan-II sales, a study published last year confirms.

There are many black market suppliers of melanotan-II injections, tablets and creams. More recently, nasal sprays have become more popular.

What are the risks?

Just like any drug, melanotan-II comes with the risk of side effects, many of which we’ve known about for more than a decade. These include changes in the size and pigmentation of moles, rapid appearance of new moles, flushing to the face, abdominal cramps, nausea, vomiting, chest pain and brain swelling.

It can also cause rhabdomyolysis, a dangerous syndrome where muscle breaks down and releases proteins into the bloodstream that damage the kidneys.

For men, the drug can cause priapism – a painful erection that does not go away and can damage the penis, requiring emergency treatment.

Its use has been linked with melanoma developing from existing moles either during or shortly after using the drug. This is thought to be due to stimulating pigment cells and causing the proliferation of abnormal cells.

Despite reports of melanoma, according to a study of social media posts the drug is often marketed as protecting against skin cancer. In fact, there’s no evidence to show it does this.

Social media posts about melanotan-II rarely mention health risks.

There are no studies on long-term safety of melanotan-II use.

Then there’s the issue of the drug not held to the high safety standards as TGA-approved products. This could result in variability in dose, undeclared ingredients and potential microbial contamination.

Young, pale man walking along street, looking down at phone in hand
Thinking about melanotan-II? The drug can cause a long-lasting painful erection needing urgent medical care. Eugenio Marongiu/Shutterstock

The TGA has previously warned consumers to steer clear of the drug due to its “serious side effects that can be very damaging to your health”.

According to an ABC article published earlier this week, the TGA is cracking down on the illegal promotion of the drug on various websites. However, we know banned sellers can pop back up under a different name.

TikTok has banned the hashtags #tanningnasalspray, #melanotan and #melanotan2, but these products continue to be promoted with more generic hashtags, such as #tanning.

Part of a wider trend

Australia has some of the highest rates of skin cancer in the world. The “slip, slop, slap” campaign is a public health success story, with increased awareness of sun safety, a cultural shift and a decline in melanoma in young people.

However, the image of a bronzed beach body remains a beauty standard, especially among some young people.

Disturbingly, tan lines are trending on TikTok as a sought after summer accessory and the hashtag #sunburnttanlines has millions of views. We’ve also seen a backlash against sunscreen among some young people, again promoted on TikTok.

The Cancer Council is so concerned about the trend towards normalising tanning it has launched the campaign End the Trend.

You have other options

There are options beyond spraying an illegal, unregulated product up your nose, or risking unprotected sun exposure: fake tan.

Fake tan tends to be much safer than melanotan-II and there’s more long-term safety data. It also comes with potential side effects, albeit rare ones, including breathing issues (with spray products) and skin inflammation in some people.

Better still, you can embrace your natural skin tone.

Rose Cairns, Senior Lecturer in Pharmacy, NHMRC Emerging Leadership Fellow, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Green Paneer Flatbreads

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    These are versatile little snacks that can be eaten alone or served as part of a buffet; great for warm summer nights!

    You will need

    • 1 lb block of paneer (you can also use our plant-based high-protein paneer recipe)
    • 7 oz unsweetened yogurt (your choice what kind; plant-based is fine; live cultured is best)
    • 1 tomato, thinly sliced
    • ½ red onion, thinly sliced
    • 2 oz spinach leaves
    • 1 tbsp lime juice
    • 1 tsp red chili powder
    • 4 wholewheat flatbreads

    And then the marinade:

    • 3 oz spinach
    • ½ bulb garlic
    • 1 tsp cumin seeds
    • 1 tsp coriander seeds
    • 1 tsp chili flakes
    • ½ tsp MSG or 1 tsp low-sodium salt (MSG being the preferable and healthier option)
    • 2 tbsp extra virgin olive oil
    • Juice of ½ lime

    Method

    (we suggest you read everything at least once before doing anything)

    1) Blend the marinade ingredients in a blender.

    2) Cut the paneer into long cuboid chapes (similar to fish fingers) and put them in a bowl. Pour ⅔ of the marinade over them, and gently mix to coat evenly.

    3) Heat a ridged griddle pan, and when hot, add the paneer and cook for 1–2 minutes each side without stirring, jiggling, or doing anything other than turning once per uncooked side.

    4) Combine the onion, tomato, spinach leaves, lime choice, and chili powder to make the salad.

    5) Add the remaining marinade to the yogurt to make a green dip.

    6) Toast your flatbreads under the grill.

    5) Assemble, putting the paneer and salad with a spoonful of the dip on the flatbread, and serve:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Dandelion: Time For Evidence On Its Benefits?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In recent decades often considered a weed, now enjoying a resurgence in popularity due its benefits for pollinators, this plant has longer-ago been enjoyed as salad (leaves) or as a drink (roots), and is typically considered to have diuretic and digestion-improving properties. So… Does it?

    Diuretic

    Probably! Because of the ubiquity of anecdotal evidence, this hasn’t been well-studied, but here’s a small (n=17) study that found that it significantly increased urination:

    The diuretic effect in human subjects of an extract of Taraxacum officinale folium over a single day

    You may be thinking, “you usually do better than an n=17 study” and yes we do, but there’s an amazing paucity of human research when it comes to dandelions, as you’ll see:

    Digestion-improving

    There’s a lot of fiber in dandelion greens and roots both, and eating unprocessed or minimally-processed plants is (with obvious exceptions, such as plants that are poisonous) invariably going to improve digestion just by virtue of the fiber content alone.

    As for dandelions, the roots are rich in inulin, a great prebiotic fiber that indeed definitely helps:

    Effect of inulin in the treatment of irritable bowel syndrome with constipation (Review)

    When it comes to studies that are specifically about dandelions, however, we are down to animal studies, such as:

    The effect of Taraxacum officinale on gastric emptying and smooth muscle motility in rodents

    Note that this is not about the fiber; this is about the plant extract (so, no fiber), and how it gets the intestinal muscles to do their thing with more enthusiasm. Of course you, dear reader, are probably not a rodent, we can’t say for sure that this will have this effect in humans. However, generally speaking, what works for mammals works for mammals, so it probably indeed helps.

    For liver health

    More about rats and not humans, but again, it’s promising. Dandelion extract appears to protect the liver, reducing the damage in the event of induced liver failure:

    Protective Effects of Taraxacum officinale L. (Dandelion) Root Extract in Experimental Acute on Chronic Liver Failure

    In other words: the researchers poisoned the rats, and those who took dandelion extract suffered less liver damage than those who didn’t.

    …and more?

    It may help improve blood triglycerides and reduce ischemic stroke risk, but most of this research is still in non-human animals:

    New Perspectives on the Effect of Dandelion, Its Food Products and Other Preparations on the Cardiovascular System and Its Diseases

    And while we’re on the topic of blood, it likely has blood-sugar-lowering effects too; once again (you guessed it), mostly non-human animal studies, though, with some in vitro studies:

    The Physiological Effects of Dandelion (Taraxacum Officinale) in Type 2 Diabetes

    Want to try some?

    We don’t sell it, but if you have a garden, that’s a great place to grow this very easy-to-grow plant without having to worry about pesticides etc.

    Alternatively, if you’d like to buy it in supplement form, here’s an example product on Amazon 😎

    Enjoy!

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  • We looked at over 166,000 psychiatric records. Over half showed people were admitted against their will

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Picture two people, both suffering from a serious mental illness requiring hospital admission. One was born in Australia, the other in Asia.

    Hopefully, both could be treated on a voluntary basis, taking into account their individual needs, preferences and capacity to consent. If not, you might imagine they should be equally likely to receive treatment against their will (known colloquially as being “sectioned” or “scheduled”).

    However, our research published in British Journal of Psychiatry Open suggests this is not the case.

    In the largest study globally of its kind, we found Australians are more likely to be treated in hospital for their acute mental illness against their will if they are born overseas, speak a language other than English or are unemployed.

    What we did and what we found

    We examined more than 166,000 episodes of voluntary and involuntary psychiatric care in New South Wales public hospitals between 2016 and 2021. Most admissions (54%) included at least one day of involuntary care.

    Being brought to hospital via legal means, such as by police or via a court order, was strongly linked to involuntary treatment.

    While our study does not show why this is the case, it may be due to mental health laws. In NSW, which has similar laws to most jurisdictions in Australia, doctors may treat a person on an involuntary basis if they present with certain symptoms indicating serious mental illness (such as hallucinations and delusions) which cause them to require protection from serious harm, and there is no other less-restrictive care available. Someone who has been brought to hospital by police or the courts may be more likely to meet the legal requirement of requiring protection from serious harm.

    The likelihood of involuntary care was also linked to someone’s diagnosis. A person with psychosis or organic brain diseases, such as dementia and delirium, were about four times as likely to be admitted involuntarily compared to someone with anxiety or adjustment disorders (conditions involving a severe reaction to stressors).

    However, our data suggest non-clinical factors contribute to the decision to impose involuntary care.

    Compared with people born in Australia, we found people born in Asia were 42% more likely to be treated involuntarily.

    People born in Africa or the Middle East were 32% more likely to be treated this way.

    Overall, people who spoke a language other than English were 11% more likely to receive involuntary treatment compared to those who spoke English as their first language.

    Some international researchers have suggested higher rates of involuntary treatment seen in people born overseas might be due to higher rates of psychotic illness. But our research found a link between higher rates of involuntary care in people born overseas or who don’t speak English regardless of their diagnosis.

    We don’t know why this is happening. It is likely to reflect a complex interplay of factors about both the people receiving treatment and the way services are provided to them.

    People less likely to be treated involuntarily included those who hold private health insurance, and those referred through a community health centre or outpatients unit.

    Our findings are in line with international studies. These show higher rates of involuntary treatment among people from Black and ethnic minority groups, and people living in areas of higher socioeconomic disadvantage.

    A last resort? Or should we ban it?

    Both the NSW and Australian mental health commissions have called involuntary psychiatric care an avoidable harm that should only be used as a last resort.

    Despite this, one study found Australia’s rate of involuntary admissions has increased by 3.4% per year and it has one of the highest rates of involuntary admissions in the world.

    Involuntary psychiatric treatment is also under increasing scrutiny globally.

    When Australia signed up to the UN Convention on the Rights of Persons with Disabilities, it added a declaration noting it would allow for involuntary treatment of people with mental illness where such treatments are “necessary, as a last resort and subject to safeguards”.

    However, the UN has rejected this, saying it is a fundamental human right “to be free from involuntary detention in a mental health facility and not to be forced to undergo mental health treatment”.

    Others question if involuntary treatment could ever be removed entirely.

    Where to from here?

    Our research not only highlights concerns regarding how involuntary psychiatric treatment is implemented, it’s a first step towards decreasing its use. Without understanding how and when it is used it will be difficult to create effective interventions to reduce it.

    But Australia is still a long way from significantly reducing involuntary treatment.

    We need to provide more care options outside hospital, ones accessible to all Australians, including those born overseas, who don’t speak English, or who come from disadvantaged communities. This includes intervening early enough that people are supported to not become so unwell they end up being referred for treatment via police or the criminal justice system.

    More broadly, we need to do more to reduce stigma surrounding mental illness and to ensure poverty and discrimination are tackled to help prevent more people becoming unwell in the first place.

    Our study also shows we need to do more to respect the autonomy of someone with serious mental illness to choose if they are treated. That’s whether they are in NSW or other jurisdictions.

    And legal reform is required to ensure more states and territories more fully reflect the principal that people who have the capacity to make such decisions should have the right to decline mental health treatment in the same way they would any other health care.

    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

    Amy Corderoy, Medical doctor and PhD candidate studying involuntary psychiatric treatment, School of Psychiatry, UNSW Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Fitness Walking and Bodyweight Exercises – by Frank S. Ring

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    A lot of exercise manuals assume that the reader has a “basic” body (nothing Olympian, but nothing damaged either). As we get older, increasingly few of us fall into the “but nothing damaged either” category!

    Here’s where Ring brings to bear his decades of experience as a coach and educator, and also his personal recovery from a serious back injury.

    The book covers direct, actionable exercise advice (with all manner of detail), and also offers mental health tips he’s learned along the way.

    Ring, like us, is a big fan of keeping things simple, so he focusses on “the core four” of bodyweight exercises:

    1. Pushups
    2. Squats
    3. Lunges
    4. Planks

    These four exercises get a whole chapter devoted to them, though! Because there are ways to make each exercise easier or harder, or have different benefits. For example, adjustments include:

    • Body angle
    • Points of contact
    • Speed
    • Pausing
    • Range of motion

    This, in effect, makes a few square meters of floor (and perhaps a chair or bench) your fully-equipped gym.

    As for walking? Ring enjoys and extols the health benefits, and/but also uses his walks a lot for assorted mental exercises, and recommends we try them too.

    A fine book for anyone who wants to gain and/or maintain good health, but doesn’t pressingly want to join a gym or start pumping iron!

    Pick up “Fitness Walking and Bodyweight Exercises: Supercharge Your Fitness, Build Body Strength, and Live Longer” on Amazon today!

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  • An RSV vaccine has been approved for people over 60. But what about young children?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The Therapeutic Goods Administration (TGA) has approved a vaccine against respiratory syncytial virus (RSV) in Australia for the first time. The shot, called Arexvy and manufactured by GSK, will be available by prescription to adults over 60.

    RSV is a contagious respiratory virus which causes an illness similar to influenza, most notably in babies and older adults.

    So while it will be good to have an RSV vaccine available for older people, where is protection up to for the youngest children?

    A bit about RSV

    RSV was discovered in chimpanzees with respiratory illness in 1956, and was soon found to be a common cause of illness in humans.

    There are two key groups of people we would like to protect from RSV: babies (up to about one year old) and people older than 60.

    Babies tend to fill up hospitals during the RSV season in late spring and winter in large numbers, but severe infection requiring admission to intensive care is less common.

    In babies and younger children, RSV generally causes a wheezing asthma-like illness (bronchiolitis), but can also cause pneumonia and croup.

    Although there are far fewer hospital admissions among older people, they can develop severe disease and die from an infection.

    A baby sitting on a bed.
    Babies account for the majority of hospitalisations with RSV.
    Prostock-studio/Shutterstock

    RSV vaccines for older people

    For older adults, there are actually several RSV vaccines in the pipeline. The recent Australian TGA approval of Arexvy is likely to be the first of several, with other vaccines from Pfizer and Moderna currently in development.

    The GSK and Pfizer RSV vaccines are similar. They both contain a small component of the virus, called the pre-fusion protein, that the immune system can recognise.

    Both vaccines have been shown to reduce illness from RSV by more than 80% in the first season after vaccination.

    In older adults, side effects following Arexvy appear to be similar to other vaccines, with a sore arm and generalised aches and fatigue frequently reported.

    Unlike influenza vaccines which are given each year, it is anticipated the RSV vaccine would be a one-off dose, at least at this stage.

    Protecting young children from RSV

    Younger babies don’t tend to respond well to some vaccines due to their immature immune system. To prevent other diseases, this can be overcome by giving multiple vaccine doses over time. But the highest risk group for RSV are those in the first few months of life.

    To protect this youngest age group from the virus, there are two potential strategies available instead of vaccinating the child directly.

    The first is to give a vaccine to the mother and rely on the protective antibodies passing to the infant through the placenta. This is similar to how we protect babies by vaccinating pregnant women against influenza and pertussis (whooping cough).

    The second is to give antibodies directly to the baby as an injection. With both these strategies, the protection provided is only temporary as antibodies wane over time, but this is sufficient to protect infants through their highest risk period.

    A pregnant woman receives a vaccination.
    Women could be vaccinated during pregnancy to protect their baby in its first months of life.
    Image Point Fr/Shutterstock

    Abrysvo, the Pfizer RSV vaccine, has been trialled in pregnant women. In clinical trials, this vaccine has been shown to reduce illness in infants for up to six months. It has been approved in pregnant women in the United States, but is not yet approved in Australia.

    An antibody product called palivizumab has been available for many years, but is only partially effective and extremely expensive, so has only been given to a small number of children at very high risk.

    A newer antibody product, nirsevimab, has been shown to be effective in reducing infections and hospitalisations in infants. It was approved by the TGA in November, but it isn’t yet clear how this would be accessed in Australia.

    What now?

    RSV, like influenza, is a major cause of respiratory illness, and the development of effective vaccines represents a major advance.

    While the approval of the first vaccine for older people is an important step, many details are yet to be made available, including the cost and the timing of availability. GSK has indicated its vaccine should be available soon. While the vaccine will initially only be available on private prescription (with the costs paid by the consumer), GSK has applied for it to be made free under the National Immunisation Program.

    In the near future, we expect to hear further news about the other vaccines and antibodies to protect those at higher risk from RSV disease, including young children.The Conversation

    Allen Cheng, Professor of Infectious Diseases, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Vaginal Probiotics: What Does The Science Say?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝Is there any merit to vaginal probiotics?❞

    What a fun question! First let’s break it down, as this could mean two different things:

    1. Probiotics, which you consume, using your mouth, which are marketed as benefiting vaginal health
    2. Probiotics taken as a vaginal pessary/suppository, to act directly there

    The former has limited evidence for it, but generally speaking, improving one’s gut health improves all other areas of health, so it’s not surprising if it helps this too.

    See for example:

    Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis

    Some notes:

    • candidal vaginitis means a yeast infection causing vaginal inflammation
    • bacterial vaginosis means a vaginal bacterial imbalance (generally also featuring vaginal inflammation, though it can be asymptomatic)

    In the latter case, the “imbalance” in question is usually a shortage of Lactobacillus sp. (that is to say, the diverse species of the Lactobacillus genus) resulting in an overgrowth of other kinds of bacteria, which in turn results in changing the vaginal microbiome to make it warmer and more acidic than it should be.

    While a healthy vagina shouldn’t smell of roses, it shouldn’t smell fishy either; if it does, that’s a sign of bacterial vaginosis.

    What it’s supposed to be like: slightly bitter, slightly salty, distinctly umami, along with a cocktail of personal pheromones (and if menstruating or otherwise* vaginally bleeding, then of course add: iron/”metallic”). The pheromones will also reflect any hormonal changes, but should never make anything smell bad, just different.

    *e.g. due to PCOS, fibroids, etc. Note that in the case of PCOS, it may also smell a little different (if it does, then usually: a little more musky), due to often different hormone levels. Again: it still shouldn’t smell bad, though, just different.

    In the above-linked study, taking more live Lactobacillus acidophilus (in yogurt, eating it, with their mouths) improved levels of L. acidophilus in the vagina. While the study authors concluded “this ingestion of yogurt may have reduced episodes of bacterial vaginosis”, which is rather a weak claim, it can be argued that it merely improving the levels of L. acidophilus in the vagina was already a win.

    That was a small (n=42, and only 7 followed through to completion) and old (1996) study, and it bears mentioning that most of the studies into this seem to be small and old, but conclude similarly with weakly positive statements.

    However, it does make a difference what kind of Lactobacillus is used, for example in this next study…

    • L. fermentum RC-14 worked well (90% success rate)
    • L. rhamnosus GR-1 worked somewhat (40% success rate)
    • L. rhamnosus GG did not work (0% success rate)

    So, diversity is key, and getting a wide range of Lactobacillus sp. seems to be a safe bet.

    Short version: enjoying probiotics as part of your diet probably improves vaginal health, just like it improves pretty much everything else.

    See also: Make Friends With Your Gut (You Can Thank Us Later)

    You would think that this would mean that taking probiotics as a vaginal pessary/suppository would be even better, but the results are weaker, as in this study, which produced temporary improvements in about half the study group, with only 3 out of 28 being free of bacterial vaginosis the next month:

    Treatment of bacterial vaginosis with lactobacilli

    This study got better results, with a 61% success rate:

    Effectiveness of Lactobacillus-containing vaginal tablets in the treatment of symptomatic bacterial vaginosis

    Important note

    Do note that this last category, involving topical treatments (i.e., manually introducing Lactobacillus sp. to the vagina) were all in cases of pre-existing bacterial vaginosis, not as a prophylactic and/or general health-improving thing.

    If your vagina seems happy right now, then do not mess with its happy bacterial balance!

    And at all times (regardless of whether it seems happy right now or not): do not douche (it does not need it and will not benefit from it; the vagina is self-cleaning*) as this will wash out many of your Lactobacilli and will do absolutely nothing against any Candida there (C. albicans being a rooted fungus, whereas Lactobacillus is a sausage-shaped bacterium with many tiny appendages but no actual ability to stay put), so Candida will flourish in the Lactobacillus’s absence.

    *by the vagina, we are referring to the vaginal canal. The vulva—the outside part consisting of the two pairs of labia, the glans clitoris, and clitoral hood—are not self-cleaning, and should just be washed gently per your normal bath/shower routine; that’s perfectly fine and good.

    And definitely don’t put any “cleansing” toiletries inside the vagina (or any toiletries at all, for that matter), even if they are sold and marketed for that purpose; they will not help and they will harm.

    Also, due to their neighborliness, messing up the microbiome inside the vagina is a common way to also get Candida inside the urethra:

    How To Avoid Urinary Tract Infections (UTIs)

    One other option

    Finally, unless you have a “very good friend” you have a pressing urge to swap germs with, you might want to leave this one to the scientists, but we share this paper just for interest:

    The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review

    Lastly…

    Going back to oral supplementation, if you’d like to try that then check out this for further notes on what, why, how, etc:

    How Much Difference Do Probiotic Supplements Make To Health?

    Take care!

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