The article is devoted to the problem of restoring the physiological conditions of vaginal contents with improving the degree of vaginal cleanliness and reducing atrophic manifestations of the vagina in postmenopausal patients, which reduces the recurrence of vaginal infections and improves the quality of life of menopausal women. The use of a combination of low concentrations of estriol and acidophilic lactobacilli, after the main etiotropic therapy allows to restore the vaginal ecosystem and reduce the manifestations of atrophic vaginitis in menopause.The objective: saving and recovering of the vaginal ecosystem after anti-inflammatory therapy and prevention of vaginal disorders in women in menopause; establishment of clinical effects of complex treatment of sexually transmitted infections, followed by normalization of vaginal flora using a combination of low doses of estriol with lactobacilli and lactose in the form of vaginal suppositories at menopause.Materials and methods. During the examination and treatment of women were divided as follows: I — the main group — 58 women with physiological menopause, who after a comprehensive treatment of colpitis with vaginal suppositorium with a combination of a minimum dose of estriol with lactobacilli and lactose (1 time per day for 12 days, then — 1 time per week for six weeks); ІІ — comparative — 29 patients who underwent only etiotropic therapy with no further correction of vaginal biocenosis.Results. The first control was performed 3–5 days after the end of the main therapy, the second control was performed two months later. After our proposed treatment, the percentage of women with pathological secretions in group I was 12% (7), in II — 66% (19). After 2 months in the main group there was no atrophic changes of the vagina in 39 (67,2%) patients, insignificant — 12 (20,7%), moderate — 6 (10,4%), pronounced — only in 1 (1,7%), and the absence of high atrophy. In the comparison group, the indicators remained unchanged. Conclusions. The combination of low doses of estriol, acidophilic lactobacilli and lactose contributes to sufficient population and maintenance of healthy vaginal flora, as well as the restoration of physiological properties of the vaginal mucosa in women during menopause, as evidenced by the reverse dynamics of atrophic disorders in the main group.