Vaginal Probiotics and Pessaries and Their Impact on the Vaginal Microenvironment

Inclusion Criteria: * Postmenopausal (no menstruation \>12 months) * Subjects presenting for 2 week post initial pessary insertion appointment or presenting for routine pessary care follow up appointment * Planning on continuing to use a pessary for treatment for at least 3 months * Pessary maintenance performed by provider (as opposed to self-care) * Able to understand English * Able/willing to sign informed consent document Exclusion Criteria: * Lack of cognitive ability to consent to participate in study and to complete the questionnaires * Planned prolapse surgery less than 3 months from enrollment * Presence of vaginal fistulas * Pessary self-care (patient changes and cleans her own pessary) * Receiving immunosuppressive therapy or history of immunodeficiency * Presence of an indwelling vascular access line or structural heart disease * Within 6 weeks from any abdominal or pelvic surgery or other major surgery * Allergy to lactobacillus (contents of probiotic) * Allergy to beta-lactam antibiotics, erythromycin and clindamycin * Use of any probiotic pills, creams, or suppositories currently