Monogin, a gynaecological solution containing polyhexamethylene biguanide (PHMB), is used to treat bacterial vaginosis (BV), HPV-related lesions, and vulvovaginal candidiasis (VVC).
PHMB’s broad-spectrum antiseptic properties make Monogin a modern alternative to traditional antibiotic therapies, offering benefits such as reduced systemic side effects and lower risks of antibiotic resistance.
Monogin availability
In Europe
Monogin is accessible through various European pharmacies in ovules or liquid solution.
North America, Australia, rest of the world
Monogin is not available outside of European pharmacies. Monogin should not be confused with another unrelated baby formula product available in the USA called Monogen.
Efficacy of Monogin in bacterial vaginosis
Clinical outcomes of Monogin for BV
Monogin has been tested as a single-dose treatment for bacterial vaginosis, compared to the standard seven-day regimen of clindamycin vaginal cream.
A multicentre, randomised, single-blind study1 involving 740 patients found that Monogin was equally effective as clindamycin in achieving clinical cure, Nugent score cure, and therapeutic cure.
No significant differences were observed in cure rates, with clinical cure rates of 64.3% for Monogin versus 63.2% for clindamycin and Nugent cure rates of 56.5% for Monogin versus 57.7% for clindamycin1,2.
Advantages of single-dose treatment of Monogin
The single-dose regimen of Monogin enhances patient compliance, as it is less burdensome than the multi-day application required for clindamycin. This simplifies patient treatment and minimises disruptions to daily life1.
Limitations of Monogin for BV
While Monogin performs equivalently to clindamycin in short-term efficacy, studies have not provided extensive data on its long-term effects, particularly regarding recurrence rates. Further research is needed to explore these outcomes1,2.
Impact on HPV-related lesions
Enhanced viral clearance
Monogin has shown promise in managing HPV infections. A study of 100 women demonstrated that Monogin increased the HPV regression rate to 90% over six months, compared to 70% in untreated controls. This underscores its potential as a non-invasive treatment for HPV-related lesions.
Combination therapy benefits
When combined with Coriolus-MRL, an immunostimulant, Monogin expedited the healing of genital warts and significantly reduced recurrence rates.
The combination therapy group patients experienced lesion clearance within the first month, while the control group required six months to achieve similar results2,3.
Research limitations
Despite encouraging results, studies on Monogin’s effectiveness against HPV are relatively small and lack diversity in patient populations. 2
Larger, long-term studies are required to confirm its benefits and evaluate its impact on the recurrence and progression of HPV-related conditions1,2.
Role of Monogin in treating vulvovaginal candidiasis
Pilot study findings
Monogin has also been evaluated for treating vulvovaginal candidiasis in a pilot study involving 40 women.
After a single application of Monogin, 80% of participants achieved complete resolution of their fungal infection.
Symptoms such as itching, burning, and inflammation were significantly reduced, with an overall symptom score reduction of 50%3.
Advantages of Monogin for patient comfort
The single-dose nature of Monogin makes it a convenient option for patients, avoiding the prolonged use of antifungal creams or oral medications, which often have systemic side effects3.
Study limitations
The study’s limitations include a small sample size and the absence of a control group, which restrict the generalisation of these findings. Further research is necessary to validate the pilot study results and examine long-term effects, including recurrence rates3.
Mechanism of action and safety profile of Monogin
Monogin’s active ingredient, PHMB, targets negatively charged phospholipids in bacterial and fungal cell membranes, disrupting their integrity and leading to pathogen death.
This specificity spares human cells, resulting in low cytotoxicity. Studies confirm its favourable safety profile, with no significant adverse effects reported in clinical trials1,3.
Where we’re at with Monogin
Monogin is a versatile and effective option for managing bacterial vaginosis, HPV-related lesions, and vulvovaginal candidiasis.
Its single-dose administration offers a significant advantage in compliance, and its antiseptic properties provide an alternative to traditional antibiotics.
While initial studies are promising, further research with larger sample sizes and long-term follow-ups is essential to establish Monogin’s efficacy and safety across its applications fully.
References
- 1.Koban I, Bender CP, Assadian O, Kramer A, Hübner NO. Clinical Use of the Antiseptic Polihexanide for Genital Tract Infections. Skin Pharmacol Physiol. Published online 2012:298-304. doi:10.1159/000340063
- 2.Gincheva D, Gincheva V, Konova E. Effect of combined therapy polyhexamethylene biguanide and Coriolus-MRL on human papilloma virus (HPV) cervical and vulvar-related lesions. International Journal of Medical Device and Adjuvant Treatments. Published online January 2020. doi:10.32113/ijmdat_20201_220
- 3.Biamonti A, Saracino A. Polyhexamethylene Biguanide in Vaginal Solution Is Effective in the Treatment of Vulvovaginal Candidiasis: A Pilot Study. OJOG. Published online 2017:7-15. doi:10.4236/ojog.2017.71002
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