Based on your age, hormone profile and results of the VFA test, Dr. Fowler selects the proper place in the algorithm of mixed bio-identical hormone doses that you should start with. There are 42 different doses in the FGI algorithm. It takes 4 months to allow the majority of the response that will be induced by a particular dosage. The progress is measured by the change in the six VFA parameters.

Dr. Fowler has found that each woman has a narrow band-width to which they respond. There is no response with too little hormone and there is no response if too much hormone is given. Women with these conditions are different than the general population of women in that their vaginal mucosa only responds to the higher echelon of hormone levels and it must be the proper ratio of bio-identical hormones and it must be formulated in a base that will not cause any reaction. If any of these three things is wrong, the treatment will fail. The base is the medium through which the hormone is delivered. These are all vaginal preparations; the treatments are NOT given orally.

Women who have these conditions should look at it this way. You have a vagina like that of a jet engine compared to and automobile engine. As long as the jet gets it’s high octane Jet A fuel then the engine produces amazing horsepower. If it receives the lower octane fuel of Mogas, it sputters and spurts. In real terms, the vagina shrinks in caliber and length, the mucosa becomes dry, and an altered vaginal microflora pattern develops. This micro-environment is conducive to the growth of aberrant bacteria and yeast.  The vaginal secretions change from being soothing to an irritant. These secretions may have a new odor and plentiful enough to cause a new discharge. These secretions work their way down the vagina and onto the vestibule at the opening of the vagina. The vestibule is about 1/2” wide and made of endoderm. It is the endoderm that gets sensitized and causes burning, stinging or rawness. This tissue is flanked on both sides by ectoderm of the vagina and the ectoderm of the vulva. The ectoderm is more resilient and generally does not get sensitized.

The VRT treatment is aimed  at getting the flora to change back to normal, then the secretions are no longer irritating and the variable symptoms of burning, rawness, stinging, itching and/or urinary frequency/urgency resolve. Symptoms which are a direct result of the altered flora such as dryness, odor and discharge also resolve.

You may be tempted to order one of the many types of vaginal microbiome test kits available on the internet to determine if you have vaginal dysbiosis. These tests range between $60-200.00. While they sound impressive because they use next-gen sequencing and/or metaqgenomic sequencing.  they are stuck on making one of 4 types of vaginitis; bacterial vaginosis (BV), trichomonas, yeast or atropic vaginitis. Not one of these has been the underlying etiology of chronic vaginal disorders diagnosed and treated by FGI. Many of the tests also look for the STD’s chlamydia and Neisseria gonorrhoeae. Neither of these is an underlying etiology of the chronic vaginal conditions  either. What women need for the chronic vaginal symptoms addressed by FGI is a Vaginal Fluid Analysis (VFA ) test.

The VFA test was developed and published by Dr. Fowler while he practiced gynecology at Mayo Clinic. (In 2011, at the ISSVD World Congress XXI in Paris France, Dr. Fowler presented “Quantification of Normal Vaginal Constituents by New Wet Prep Technique,” subsequently published in: J Low Genit Tract Dis. 2012 Oct;16(4):437-41. The VFA test is  preformed exclusively at the CLIA certified Fowler Gyn International Laboratories (FGIL). It’s located at FGI headquarters and results are available in 7 minutes. This means you get your results and protocol at your appointment. FGI has the only laboratory in the country that I know of dedicated to the evaluation for the vaginal constituents. It’s a one of a kind.

It gives the relative quantitative measurement of constituents in the vagina that reflect vaginal health. These include the maturation index of squamous cells, the relative concentration of squamous cells and the pattern of bacteria on the cells; the presence, concentration and type of wbc’s; the relative concentration and quality of lactobacilli; the relative concentration of non-lactobacilli, anaerobic and aerobic bacteria; and the presence and relative concentration of blastospores and/or pheudohyphae yeast elements.

Thousands of women have been treated with success at Fowler Gyn International (FGI) with this breakthrough approach. It has been over a century that some of these conditions had no known etiology let alone any consistent successful treatment.  Now you can get your life back.