The health of the female reproductive sphere correlates with its inhabiting microbiota. Lactobacilli, which dominate over all other representatives of microorganisms in the vagina of a healthy woman of reproductive age, provide colonization resistance, protect against non-communicable diseases of the reproductive sphere, and affect fertility and the physiological course of pregnancy. In turn, the species and quantitative composition of Lactobacilli depends on the hormonal background, race, age, bad habits of a woman, and the intake of hormonal and antimicrobial drugs. Bacterial vaginosis is one of the most common pathologies in gynecology. The signal for its onset may be an increase in the number of L. iners and a change in the morphology of Lactobacilli. In addition to traditional methods based on the collection of history data and morphological pattern, molecular genetic methods are used to diagnose vaginosis. Treatment policy for women includes the prescription of antimicrobial drugs, hormones, probiotics, and bacteriophages. Monotherapy with antibacterial drugs is ineffective in 30-60% of cases and requires repeated treatment. Several multistrain probiotics may be less effective than a single strain probiotic. Conclusion. The use of probiotics both intravaginally and orally causes a change in mucosal immunity, which not only contributes to the correction of normal biota, but also prevents premature delivery, including in pregnant women with gestational diabetes. A new direction in this treatment is vaginal microbiota transplantation that meets the requirements of personalized therapy.