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Estrogen + probiotics is a combination therapy being investigated by the University Hospital, Ghent, specifically for the treatment of vulvovaginal atrophy (VVA) in breast cancer patients receiving endocrine therapy. This treatment is administered as a vaginal ovule and is one of four arms in the Phase 4 GRACE trial. The combination aims to address the symptoms of VVA—a common side effect of selective estrogen-receptor modulators (SERMs) or aromatase inhibitors—by using estrogen to restore the vaginal epithelium and probiotics to replenish the vaginal microbiome and maintain a healthy vaginal pH. The trial evaluates efficacy through patient-reported outcomes, vaginal pH, and the vaginal maturation index, while monitoring safety via systemic sex hormone levels.
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