Атрофический вагинит у пациенток репродуктивного возраста

Abstract

Objective. To study the effectiveness of the use of Acilact Duo for relieving the symptoms of atrophic vaginitis against the background of antiestrogen therapy. Patients and methods. The study included patients of reproductive age (n = 21) who were treated with goserelin (10.8 mg once every 3 months) in combination with tamoxifen (20 mg per day) for previously diagnosed breast cancer (luminal A type). Inclusion criteria were: age 28–45 years, complaints of vaginal dryness and micro-cuts, dyspareunia, breast cancer in anamnesis. Microscopic and bacteriological examination of the vaginal discharge was carried out. Patients filled out an individual questionnaire on the symptoms of atrophic vaginitis and dynamics of psycho-emotional state according to the Spielberger–Khanin scale. Results. The most common patients’ complaints were: dryness (up to 6.1 points) and the presence of vaginal micro-cuts (1.5 points), dyspareunia (1.3 points). After the course of treatment with Acilact Duo, the severity of symptoms decreased by 1.5 times. The assessment of psychological status demonstrated a low subjective evaluation of health and quality of life (36.7 ± 1.4 points). Twelve days after treatment, a mean anxiety score improved and amounted to 30.9 ± 0.6 points (р < 0.05). The intensity of vaginal microbial colonization in atrophic vaginitis is low and characterized by the absence of lactoflora and the predominance of enterobacteriaceae, atopobium vaginae, staphylococci, streptococci and peptostreptococci. After local therapy with Acilact Duo, there was an increase in colonization by lactobacilli (by 5.1 times, р < 0.05), a decrease in the level of colonization by streptococci (by 1.7 times, р < 0.05), staphylococci (by 2 times, р < 0.05), peptostreptococci (by 4.3 times, р < 0.05) and enterobacteriaceae (by 4 times, р < 0.05). Conclusion. A short 10-day course of treatment with Acilact Duo for patients with atrophic vaginitis can significantly reduce the severity of symptoms and improve the quality of life of women of reproductive age. Key words: atrophic vaginitis, genitourinary syndrome, lactobacilli, dyspareunia, breast cancer