Therapy - Intention to reestablish a physiological situation of the vagina. How does the optimal therapy look? Reduces the sensible quantity of germs AND represses the subjective disturbances. General antimicrobial (Bacteria, Fungal, Virus). Vaginal equilibrium is established and keep alive itself. Shouldn’t cause Resistance and should be applicable as Prophylaxes. Antibacterial mechanism of action of Propolis: DNA dependant on RNA Polymerase as follows: Bacteria are spited slowly Penetrability of cell membrane increased as follows: Bacteria get more sensitiv. The Hydroxy-cinnamon-acid inhibits reversible the Motility of Bacteria s follows: slow dissermination Visit our Website: www.imi.co.at

1. Propolis – a nature alternative by
vaginal disturbances?
Martin Imhof MD, PhDMartin Imhof MD, PhD
University Hospital for Gynecology ViennaUniversity Hospital for Gynecology Vienna
Dep. of Endocrinology and Treatment ofDep. of Endocrinology and Treatment of
FertilityFertility

2. Vaginal Infektion
 InzidenceInzidence
 70-75% of all women 1 x in live70-75% of all women 1 x in live
 40-50% suffer from reoccuring Infection40-50% suffer from reoccuring Infection
(=> 4 Infections / year)(=> 4 Infections / year)

3. Vaginal Complaints
germgerm = Primary cause for= Primary cause for
complainscomplains
causecause = Failure of defense system= Failure of defense system

4. Therapy - Intention
…… to reestablish a physiologicalto reestablish a physiological
situation of the vaginasituation of the vagina

5. Problem of AB Therapy
Selection of a pathological germ-groupSelection of a pathological germ-group
Good case
Physiological equilibrium
is reached again
Worst case
another pathogenic
germ renews the
Infection => Relapse
1-6 weeks after Therapy

6. Antibiotika und Antimykotika
DisadvantageDisadvantage
 Adverse effects (for ins.: digestion)Adverse effects (for ins.: digestion)
 Resistance of treated germsResistance of treated germs
 barely prophylactic applicable!barely prophylactic applicable!

7. How does the optimal therapy look?
Reduces the sensible quantity of germs ANDReduces the sensible quantity of germs AND
represses the subjective disturbancesrepresses the subjective disturbances
General antimicrobial (Bacteria, Fungal, Virus)General antimicrobial (Bacteria, Fungal, Virus)
Vaginal equilibrium is established and keepVaginal equilibrium is established and keep
alive itselfalive itself
ShouldnShouldn’t cause Resistance and should be’t cause Resistance and should be
applicable as Prophylaxesapplicable as Prophylaxes

8. P R O P O L I S ?P R O P O L I S ?

9. Propolis
Makes the Bee-yard „asepticMakes the Bee-yard „aseptic““
““CementCement”” andand ““Carpet of epidemicCarpet of epidemic””

10. Antibacterial mechanism of action
of Propolis
 DNA dependant on RNA PolymeraseDNA dependant on RNA Polymerase
as follows: Bacteria are spited slowlyas follows: Bacteria are spited slowly
 Penetrability of cell membrane increasedPenetrability of cell membrane increased
as follows: Bacteria get more sensitiv.as follows: Bacteria get more sensitiv.
 The Hydroxy-cinnamon-acid inhibitsThe Hydroxy-cinnamon-acid inhibits
reversible the Motility of Bacteriareversible the Motility of Bacteria
as follows: slow disserminationas follows: slow dissermination

11. Anti-fungal effect of Propolis
 Propolis in the Concentration of 0,25% to 2% isPropolis in the Concentration of 0,25% to 2% is
effective against div. Dermal-phyteneffective against div. Dermal-phyten
 Flavenoide legates Enzymes und Metal-ionsFlavenoide legates Enzymes und Metal-ions
which is important for the fungal-metabolismwhich is important for the fungal-metabolism

12. Antiviral Effect of Propolis
 Is affected by different Virus (Influenza,Is affected by different Virus (Influenza,
Herpes, Polio, Hepatitis as well as felinesHerpes, Polio, Hepatitis as well as felines
HIV)HIV)
 viral DNA Productionviral DNA Production in vitro isin vitro is inhibited toinhibited to
factor 32.factor 32.
 Inhibits the viral Adsorption at the cellsInhibits the viral Adsorption at the cells
surface areasurface area

13. Effectively of Propolis against
Protozoa
 typical Parasite:typical Parasite: Trichomonas vaginalisTrichomonas vaginalis..
 Propolis in the Concentration of 150 µg/mlPropolis in the Concentration of 150 µg/ml
shows a significant Inhibition ofshows a significant Inhibition of
trichomonal Proliferation.trichomonal Proliferation.

14. Antibacterial effectively of
Propolis
0
10
20
30
40
50
60
70
80
90
100
0 200 400 600 800
concentration [µg/ml]
colonyformingunit[%ofcontrol]
6 h B.s.
18 h B.s.
18 h E.coli
Antibacterial effects of Propolis on colony formation by Bacillus subtilis (Gram +)
and Escherichia coli (Gram -) suspensions incubated on agar for 6 and 18 hours

15. In vitro Survival rate of Trichomonas
vaginalis in different Concentration of
Propolis
0
10
20
30
40
50
60
70
80
90
100
0 50 100 150 200 250
time [h]
survivalrate[%]
control
150 µg/ml
50 µg/ml
5 µg/ml
0.5 µg/ml
0.05 µg/ml

16. The local anesthetic Propolis effect
„„ ....... by subcutaneous application, the....... by subcutaneous application, the
Pinocembrin starts developing and the CaféPinocembrin starts developing and the Café
acid-rest has almost the same anestheticacid-rest has almost the same anesthetic
effect than Lidocaineeffect than Lidocaine““
Paintz M, Metzner J.Paintz M, Metzner J.
Pharmazie 1979 Dec;34(12):839-41Pharmazie 1979 Dec;34(12):839-41

17. Propolis-therapy
 Reduction of the total germ-exposureReduction of the total germ-exposure
 RELATIVE physiologic gap by LactobacillusRELATIVE physiologic gap by Lactobacillus
acidophilusacidophilus
 Reestablishment of physiologic situationReestablishment of physiologic situation

18. Propolis-therapy
 Rapid abatement of disorders through local-Rapid abatement of disorders through local-
anesthetic effect (reinforcement)anesthetic effect (reinforcement)
 No resistence due to biologic VariationNo resistence due to biologic Variation
 Low side effectsLow side effects

19. Propolis as a Therapy of
vaginal disorders
M ImhofM Imhof
Universitätsklinik für FrauenheilkundeUniversitätsklinik für Frauenheilkunde
WienWien

20. melprotect®
 Propolis (5%)
 camomile
 Lime-tree blossom
 pH 4.5

21. Study Propolis (melprotect®) -Irrigation
 56 symptomatic Patients with reoccuring56 symptomatic Patients with reoccuring
Vaginal-Infection (>=4/year)Vaginal-Infection (>=4/year)
 Anonymised questionnaires for EvaluationAnonymised questionnaires for Evaluation
2 weeks before and after the closing of2 weeks before and after the closing of
studies.studies.
 After 6 months telephonic questionnairesAfter 6 months telephonic questionnaires

22. Using of MELPROTECT
1 x daily 30 ml per Applicator for one week1 x daily 30 ml per Applicator for one week
After acute therapy reduce melprotect slowlyAfter acute therapy reduce melprotect slowly
(every 2 day, every 3 day etc.)(every 2 day, every 3 day etc.)

23. Questionnaire
 1. How strong have been/are the vaginal pains before/after the1. How strong have been/are the vaginal pains before/after the
therapy?therapy?
 2. How strong was/is the itching before/after the therapy?2. How strong was/is the itching before/after the therapy?
 3. How strong was the cauterization before/after the therapy?3. How strong was the cauterization before/after the therapy?
 4. How strong was/is the vaginal defluxion in the last month/after4. How strong was/is the vaginal defluxion in the last month/after
the therapy?the therapy?
 5. How hindering was/is the Vaginal-Infection before/after the5. How hindering was/is the Vaginal-Infection before/after the
therapy during the sexual intercourse?therapy during the sexual intercourse?
 6. How hindering was/is the eventual Vaginal-Infection6. How hindering was/is the eventual Vaginal-Infection
before/after the therapy during normal sportive activities?before/after the therapy during normal sportive activities?
 7. How hindering was/is the Vaginal-Infection in the last month /7. How hindering was/is the Vaginal-Infection in the last month /
after the therapy during the daily life activitiesafter the therapy during the daily life activities
(shopping, going out,...) ?(shopping, going out,...) ?
 8. How satisfied have you been/are you with the previous/actual8. How satisfied have you been/are you with the previous/actual
medicinal therapy for the Vaginal-Infection?medicinal therapy for the Vaginal-Infection?

24. Questionnaire - Analyse
0
1
2
3
4
5
6
7
8
Vorher 1,54 3,77 2,84 4,88 3,68 1,36 1,25 2,91
Nachher 0,13 1,09 0,93 2,09 0,79 0,11 0,38 7,36
Frage1 Frage2 Frage3 Frage4 Frage5 Frage6 Frage7 Frage8

25. Result
 49 (87%) of patients described a reduction of disorders49 (87%) of patients described a reduction of disorders
after the using of Propolis (melprotect)after the using of Propolis (melprotect)
 7 (13%) of patients couldn7 (13%) of patients couldn’’t notice a change of disorderst notice a change of disorders
after the using of Propolis (melprotect)after the using of Propolis (melprotect)
0
5
10
15
20
25
Abstrichauswertung vor Therapie
Soorinfektion
E1
Mischinfektion
Gardnerella
Abstrich o.B.
0
10
20
30
40
50
Abstrichauswertung nach
Therapie
Soorinfektion
E1
Mischinfektion
Gardnerella
Abstrich o.B.

26. Telephonic Questionnaire
after 6 Month
Following Question was asked:Following Question was asked:
 1. Did you suffer on a new infection?1. Did you suffer on a new infection?
 2. Did you get a therapy for the infected2. Did you get a therapy for the infected
disorders again?disorders again?
 3. How do you judge the therapy-success?3. How do you judge the therapy-success?

27. Telephonic - Questionnaire
Results
Patient, where an positive result was seen:Patient, where an positive result was seen:
31 (63%) of patients report no reinfection31 (63%) of patients report no reinfection
16 (33%) of patients report about the recurrence of16 (33%) of patients report about the recurrence of
SymptomsSymptoms
2 (4%) there was no questionnaire possible2 (4%) there was no questionnaire possible

28. * * ** * *
Imhof M, Lipovac M, Kurz Ch, Barta J, Wiesenthal
B, Huber J 5% propolis solution for the treatment of
chronic vaginitis
Int J Gynaecol Obstet. 2005 May;89(2):127-32.

29. Conclusion
 Antimicrobial effect against common germsAntimicrobial effect against common germs
 No resistance similar to a Antibiotic therapyNo resistance similar to a Antibiotic therapy
 Relative support of the physiological Vagina-floraRelative support of the physiological Vagina-flora
 Local-anaesthetic effectLocal-anaesthetic effect
 Allergic reaction very seldomAllergic reaction very seldom
 The use for Gardnarella- und Chlamydien-The use for Gardnarella- und Chlamydien-
infection is not assuredinfection is not assured

30. * * ** * *
Thank you very muchThank you very much
for yourfor your
attentionattention

31. Epicutaneous Test
 30 patients30 patients
 melprotectmelprotect®®
was applied in a test chamberwas applied in a test chamber
on the skin for 48hrson the skin for 48hrs
 evaluation after 42hrs and 78hrsevaluation after 42hrs and 78hrs
 no allergenicity in any patientno allergenicity in any patient
 no irritation in any patientno irritation in any patient