The Three L’s – lactulose, lactobacilli and lactoferrin – are a strong combo. The 3 L’s treatment goal is to repopulate the vagina with healthy lactobacilli and boost vaginal and overall immunity to maintain results.
Lactoferrin is an immune booster, used orally. Lactulose is food only for your protective flora, lactobacilli, so they thrive, multiply and colonise, displacing pathogens. We use all three.
Support total recovery of protective vaginal flora with oral and vaginal prebiotic, probiotic and immune booster, plus pH strips.
This treatment is suitable for
- Those with little to no vaginal lactobacilli
- Those with a clear diagnosis of bacterial vaginosis (BV) or unexplained vaginal infection or dysbiosis
- Those with a pH over 4.5
- Those tested clear of sexually transmitted infections
Who shouldn’t use the 3 Ls
- Do not use the Three L’s if you may have cytolytic vaginosis (CV) (lactobacilli overgrowth syndrome) or aerobic vaginitis (AV) – it may make these conditions worse
- You are allergic to dairy
- If you are lactose or casein intolerant, the treatment should not cause issues
- You have haemochromatosis
What you get in the Three Ls Fixer Box
- Bovine lactoferrin and colostrum 60 caps
- Pure pharmaceutical grade lactulose 50mL
- Probiotic containing vagina-specific lactobacilli (Life-Space Women’s Microflora) 60 caps
- 50 vagina-safe vegetable capsules
- Accurate vaginal pH strips
Understanding the Three L’s treatment
1. Lactulose – prebiotic (good bug food)
Lactulose vaginally boosts colonies of healthy lactobacilli while deterring pathogens. Lactulose selectively feeds lactobacilli, starving most pathogens.
Lactulose is an inert sugar (lactose), a prebiotic, derived from heated cow’s milk. Lactulose is sold as an oral treatment for constipation (a laxative) and medically for some liver conditions.
2. Lactobacilli – the probiotic
Lactulose is best used with an appropriate vagina-specific probiotic, strong vaginal protectors and colonisers, typically:
- L. gasseri
- L. crispatus
- L. jensensii
- L. rhamnosus
The probiotic in the kit is the Life-Space Women’s Microflora, our preferred probiotic, because it has six great strains of lactobacilli. The capsules are pure vegetable, and not enteric coated, so are vagina-safe.
3. Lactoferrin – the immune booster
Lactoferrin is safe during pregnancy and works on boosting immunity. Immunity matters in vaginal dysbiosis because something has fallen down somewhere along the line in terms of your body being able to defend itself from invaders. We’re propping it up a little.
If you experience digestive upset, halve the dose and work your way back up.
Notes on lactoferrin – iron, pregnancy, allergies
There are two types of lactoferrin: apolactoferrin and bovine lactoferrin. They are both derived from bovine (cow milk), but apolactoferrin is a refined version that is iron-free.
There are some important safety differences that may apply to you, so please check.
Lactoferrin during pregnancy, haemochromatosis, dairy allergy or vegan
Lactoferrin (bovine or apolactoferrin) is safe during pregnancy, and is used to promote iron levels, which are lower during pregnancy.
If you have high iron levels (hemochromatosis), are allergic to dairy or are a vegan, bovine lactoferrin is NOT appropriate for you.
My Vagina’s lactoferrin product
We sell a combination of high-quality bovine lactoferrin and bovine colostrum. Colostrum is from the first milk let-down after birth and is jam-packed with immune-boosting proteins.
This combination is superior to pure lactoferrin or apolactoferrin, but colostrum does contain a small amount of lactose. It is not typically enough for anyone lactose intolerant to see any impact on digestion.
30-day Three Ls Fixer Box Treatment Schedule
Days 1 – 30
- Lactoferrin capsules orally – take as directed on the package
Days 1 – 7
Use the lactulose and probiotic vaginally week by week (see instructions below), while you sleep, taking a few days break after each seven days to do a symptom and pH check.
If, after seven days of vaginal treatments, you still have symptoms or your pH is above 4.5, do another week, and so on. Remember, a pH of 4.5 is respectable!
Days 9+
Repeat vaginal treatment as needed.
Do not overuse lactulose! Too much lactulose in a short space of time can contribute to lactobacilli overgrowth syndrome, which is characterised by itching, burning and a thick or sticky white discharge.
How to use the Three Ls Fixer Box treatment
Taking the oral lactoferrin and probiotic
- Take the lactoferrin as per the label every day until it runs out.
- Take one probiotic orally per day
Applying lactulose and probiotic vaginal treatments
- Use 1 probiotic capsule and 1 capsule of lactulose deep vaginally before bed
- If your microbiome report shows 30-60 per cent lactobacillus (not including L. iners), only use vaginal probiotics with the lactulose for the first three days
- If using as an irrigation, use 2ml lactulose and 8ml water, mix well in a small glass. Suction into a 10ml syringe and insert deep vaginally. Tilt hips upwards. Let it run out onto a towel or in the bath or shower, two applications per day.
When to start Three Ls treatments
If you do not get periods, start anytime you like. If you are still menstruating, start the day you stop bleeding to get the most period-free days of treatment possible.
When to stop Three Ls treatments
It’s important to stop vaginal treatments every seven days and do a pH and symptom check. Do not stop taking oral lactoferrin when you take vaginal treatment breaks. Write down and rate your symptoms and pH before you start.
Every seven days, repeat the vaginal treatment process (treat, then stop and check), logging your pH and symptoms on the break days. You can check your pH during treatments, but expect it to be 4.0 or 4.5 because of the lactobacilli (they produce lactic acid). The reading will only be accurate after 2-3 days without treatments.
You must check pH! If you don’t have vaginal pH strips, get some now. The Three L’s comes with pH strips.
When you have no symptoms and your pH is 4.0 – 4.5, stop all treatments except the oral lactoferrin, keep checking pH, and see what happens. If the clearance lasts, congratulations!
If you start to experience symptoms of lactobacillus overgrowth such as itching, thick white or clumpy discharge, stop using all treatments except the lactoferrin and see if it dissipates on its own. An overgrowth isn’t the end of the world and does NOT mean you have CV, so let it be and see how you go.
Tips and tricks for using the Three Ls
- Don’t freeze lactulose – it doesn’t freeze well and will just become more viscous (and harder to use as a liquid)
- Use the dropper or free pour to fill the vegetable capsules – lactulose is very sticky!
- Wash all your treatment tools immediately and air dry for the next day
- If you have vulvar or anal symptoms, rub the mixture into affected areas as well
- You can prepare vegetable capsules a few days in advance, but if you live in a humid environment, keep them in an airtight container with a moisture-absorbing sachet or they may go soft – do an experiment
What to expect from the Three Ls treatment
Each of you is a bit different in terms of what will happen, but the theory is simple: feed the lactobacilli so they proliferate and kill off pathogens and unhealthy biofilms as they go, while supporting your innate cellular immunity.
The 3 L’s shouldn’t irritate, but if it does, stop. It’s a great treatment for those of you that have sensitive vaginas and don’t tolerate other treatments very well, but it’s not magic, and caution is advised in regard to AV and lactobacilli overgrowth.
If the lactoferrin causes digestive problems, halve the dose, and if symptoms persist, stop.
How to tell if you have lactobacillus overgrowth/cytolytic vaginosis (CV)
If you start to experience different symptoms such as itching, burning or yeast-infection-like symptoms after a while of using lactulose vaginally, you may have ended up with a temporary lactobacilli overgrowth.
In the right circumstances, this can turn into a condition known as cytolytic vaginosis where it becomes difficult to dislodge a single species that has taken over, mainly Lactobacillus crispatus, sitting at above 97 per cent on a comprehensive vaginal microbiome test. Take a break from all treatments for a few weeks and see if it resolves by itself.
If it resolves and your vaginal symptoms do not return, congratulations! You’ve successfully recolonised. CV can cause unpleasant symptoms that should resolve once you stop putting probiotics, lactulose or milk kefir into your vagina or mouth.
Your body will adjust the balance of microbes based on food availability. Resolution might take a few weeks. If it doesn’t resolve, look into histamine intolerance or book in for an appointment to talk it through.
Safety and cautions of the Three Ls
Lactulose is usually safe to use vaginally, but as with all treatments, if you experience irritation, stop using it, take a treatment break, or reduce the dose.
Avoid lactoferrin in dairy allergy.
Getting support
If you’re not getting the results you’re after, please book with a My Vagina vulvovaginal specialist practitioner for effective, personalised 100% holistic treatments. We understand what is happening to you and can help.
References1
- 1.Collins SL, McMillan A, Seney S, et al. Promising Prebiotic Candidate Established by Evaluation of Lactitol, Lactulose, Raffinose, and Oligofructose for Maintenance of a Lactobacillus-Dominated Vaginal Microbiota. Elkins CA, ed. Appl Environ Microbiol. Published online March 2018. doi:10.1128/aem.02200-17
Specially formulated probiotic for vaginal application to promote a healthy vaginal microbiome.
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