Maturation Of Vaginal Epithelium Research Articles

Maturation of Vaginal Epithelium and Dyspareunia Symptoms in Equol Producing and Non-Producing Menopausal Women

Introduction: Equol is a metabolite of soy isoflavon called daidzein which is produced by gastrointestinal tract bacteria. This research aims to analyze the maturation of vaginal epithelium and dyspareunia symptoms in producing and non-producing equol menopausal women.Method: This is a cross sectional research. Subject was a community of menopausal women who fulfilled inclusion criteria. Subjects were asked to sign a written informed consent. Subjects underwent vaginal epithelium maturation assessment and were asked whether she experienced dyspareunia. Research was conducted in January 2017.Result: There was a significant difference on the maturation of vaginal epithelium and dyspareunia symptoms between equol producing and non-producing women (p < 0.05). This research found that in equol producing menopausal women, there was a shift-to-the-right vaginal epithelium maturation with more superficial cells compared to parabasal cells produced and less dyspareunia. Meanwhile, in women who did not produce equol, there was a shift-to-the-left vaginal epithelium maturation with more parabasal cells compared to superficial cells produced and more dyspareunia.Conclusion: In equol producing menopausal women, vaginal epithelium will undergo a shift-to-the-right maturation, with more superficial cells produced compared to women who did not produce equol.Maturasi Epitel Vagina dan Gejala Dispareunia pada Wanita Menopause yang Menghasilkan Equol dan Wanita yang Tidak Menghasilkan EquolAbstrakPendahuluan: Equol adalah metabolit isoflavon kedelai yang disebut daidzein yang diproduksi oleh bakteri saluran pencernaan. Penelitian ini bertujuan untuk menganalisis maturasi epitel vagina dan gejala dispareunia pada wanita menopause yang memproduksi dan tidak memproduksi equol.Metode: Penelitian ini merupakan penelitian cross sectional. Subjek penelitian adalah sekelompok wanita menopause yang memenuhi kriteria inklusi. Subjek diminta untuk menandatangani persetujuan tertulis dan menjalani penilaian maturasi epitel vagina dan ditanya apakah mengalami dispareunia. Penelitian dilakukan pada Januari 2017.Hasil: Terdapat perbedaan yang signifikan pada maturasi epitel vagina dan gejala dispareunia antara wanita yang memproduksi equol dan yang tidak memproduksi (p <0,05). Pada wanita menopause yang memproduksi equol, terjadi pematangan epitel vagina shift-to-the-right disertai produksi sel superfisial yang lebih banyak dibandingkan sel parabasal dan lebih sedikit gejala dispareunia. Sementara itu, pada wanita yang tidak menghasilkan equol, terjadi pergeseran shift-to-the-left maturasi epitel vagina dengan produksi sel parabasal lebih banyak dibandingkan sel superfisial dan lebih sering gejala dispareunia.Kesimpulan: Wanita menopause yang memproduksi equol mengalami maturasi epitel vagina shift-to-the-right disertai produksi sel superfisial yang lebih banyak dibandingkan dengan wanita menopause yang tidak memproduksi equol.Kata kunci: Dyspareunia; equol; maturasi epitel vagina

Maturation of Vaginal Epithelium and Dyspareunia Symptoms in Equol Producing and Non-Producing Menopausal Women

Introduction : Equol is a metabolite of soy isoflavon called daidzein which is produced by gastrointestinal tract bacteria. This research aims to analyze the maturation of vaginal epithelium and dyspareunia symptoms in producing and non-producing equol menopausal women. Method : This is a cross sectional research. Subject was a community of menopausal women who fulfilled inclusion criteria. Subjects were asked to sign a written informed consent. Subjects underwent vaginal epithelium maturation assessment and were asked whether she experienced dyspareunia. Research was conducted in January 2017. Result : There was a significant difference on the maturation of vaginal epithelium and dyspareunia symptoms between equol producing and non-producing women (p < 0.05). This research found that in equol producing menopausal women, there was a shift-to-the-right vaginal epithelium maturation with more superficial cells compared to parabasal cells produced and less dyspareunia. Meanwhile, in women who did not produce equol, there was a shift-to-the-left vaginal epithelium maturation with more parabasal cells compared to superficial cells produced and more dyspareunia. Conclusion : In equol producing menopausal women, vaginal epithelium will undergo a shift-to-the-right maturation, with more superficial cells produced compared to women who did not produce equol. Maturasi Epitel Vagina dan Gejala Dispareunia pada Wanita Menopause yang Menghasilkan Equol dan Wanita yang Tidak Menghasilkan Equol Abstrak Pendahuluan : Equol adalah metabolit isoflavon kedelai yang disebut daidzein yang diproduksi oleh bakteri saluran pencernaan. Penelitian ini bertujuan untuk menganalisis maturasi epitel vagina dan gejala dispareunia pada wanita menopause yang memproduksi dan tidak memproduksi equol. Metode : Penelitian ini merupakan penelitian cross sectional. Subjek penelitian adalah sekelompok wanita menopause yang memenuhi kriteria inklusi. Subjek diminta untuk menandatangani persetujuan tertulis dan menjalani penilaian maturasi epitel vagina dan ditanya apakah mengalami dispareunia. Penelitian dilakukan pada Januari 2017. Hasil : Terdapat perbedaan yang signifikan pada maturasi epitel vagina dan gejala dispareunia antara wanita yang memproduksi equol dan yang tidak memproduksi (p <0,05). Pada wanita menopause yang memproduksi equol, terjadi pematangan epitel vagina shift-to-the-right disertai produksi sel superfisial yang lebih banyak dibandingkan sel parabasal dan lebih sedikit gejala dispareunia. Sementara itu, pada wanita yang tidak menghasilkan equol, terjadi pergeseran shift-to-the-left maturasi epitel vagina dengan produksi sel parabasal lebih banyak dibandingkan sel superfisial dan lebih sering gejala dispareunia. Kesimpulan: Wanita menopause yang memproduksi equol mengalami maturasi epitel vagina shift-to-the-right disertai produksi sel superfisial yang lebih banyak dibandingkan dengan wanita menopause yang tidak memproduksi equol. Kata kunci : Dyspareunia; equol; maturasi epitel vagina

The effect of serotonin reuptake inhibitors on the vaginal epithelium in postmenopausal women

Purpose: Selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) are used as alternative treatments for the vasomotor symptoms of menopause in women who are unwilling or unable to receive hormone therapy. These agents have been associated with sexual dysfunction and xerostomia (dry mouth), but the effect on the vagina has not been studied. The objective of this study was to determine the effect of SSRIs and SNRIs on the vaginal epithelium and sexual function in postmenopausal women, using both subjective and objective measures.Materials and methods: A cross-sectional study of postmenopausal women not using any local or systemic estrogen therapy was conducted. The main outcomes included the Female Sexual Function Index (FSFI), vaginal epithelial maturation index (MI), and pH.Results: Sixty-six women were recruited, 30 using SSRIs/SNRIs and 36 who were not (control). Both the proportion of superficial vaginal epithelial cells and the total MI were higher in the SSRI/SNRI group (p = 0.006 and p = 0.047, respectively). There were no significant differences in FSFI scores, vaginal pH, or total MI values.Conclusion: The use of serotonin reuptake inhibiting drugs does not appear to have a negative influence on the vaginal epithelium and associated vaginal atrophy.

Short-Term Isoflavone Intervention in the Treatment of Severe Vasomotor Symptoms after Surgical Menopause: A Case Report and Literature Review.

Isoflavones are soy phytoestrogens that potentially exert various favorable effects in postmenopausal women, for example, alleviating vasomotor episodes, attenuating bone loss, and stimulating vaginal epithelial maturation. There has, however, been lack of consensus regarding those therapeutic effects. Most clinical studies of isoflavones have been conducted with women who had undergone natural menopause, but not those who had undergone surgical menopause. This study reports on a 51-year-old woman who presented with severe vasomotor episodes after undergoing a hysterectomy and a bilateral oophorectomy due to hypermenorrhea secondary to myoma uteri. She refused hormone therapy due to fear of adverse drug reactions so was treated with oral soy isoflavones (two capsules twice daily, equivalent to at least 100 mg daily dose) for 8 weeks. The number and severity of hot flushes and her menopause-specific quality of life dramatically improved from baseline values. The serum bone resorption marker (beta C-telopeptide) decreased markedly, while vaginal epithelial maturation improved slightly, suggesting the potential of isoflavones in attenuating bone loss and stimulating vaginal maturation. The intervention did not adversely affect the hormonal profile (FSH, LH, and estradiol) and liver or renal functions. Thus, isoflavones could be an option for women experiencing severe vasomotor episodes after surgical menopause.

Evaluation of the Efficacy of Flaxseed Meal and Flaxseed Extract in Reducing Menopausal Symptoms

The objective of this study was to evaluate the efficacy of flaxseed meal and flaxseed extract in reducing climacteric symptoms of menopausal women. Ninety menopausal women were randomly distributed into three study groups: group I received 1 g per day of flaxseed extract containing at least 100 mg of secoisolariciresinol diglucoside (SDG), group II received 90 g per day of flaxseed meal containing at least 270 mg of SDG, and group III received 1 g per day of collagen (placebo group). Subjects were assessed for menopausal symptoms by the Kupperman index at the beginning and at the end of the 6 months of treatment. Subjects were also assessed for endometrial thickness and vaginal cytology. The Kupperman index values at the beginning and end of the treatments were analyzed using the paired t-test. Both the flaxseed extract (P=.007) and the flaxseed meal (P=.005) were effective in reducing the menopausal symptoms when compared with the placebo control (P=.082). Alternatively, the changes in Kupperman index were also computed and submitted to analysis of variance. In this case, no significant differences were found (P=.084) although the data indicate a decreasing tendency for the Kupperman index by both the flaxseed extract and the flaxseed meal groups. Neither the flaxseed extract nor the flaxseed meal exerted clinically important estrogenic effects on the vaginal epithelium or endometrium as revealed by the absence of changes in the blood levels of follicle stimulating hormone and estradiol, as well as in the endometrial thickness, and vaginal epithelial maturation value. No serious adverse events related to the treatments were reported. Although the results of the present study do not allow an unequivocal conclusion about the action of flaxseed on the menopausal symptoms, they suggest that it could be premature to conclude that no such action exists. Clearly the matter still deserves further experimental attention.

Effects of Resveratrol, Raloxifene, Tibolone and Conjugated Equine Estrogen on Vaginal Squamous Cell Maturation of Ovariectomized Rats

Objective: The effects of estrogen replacement therapy, selective estrogen receptor modulators, or tibolone on vaginal squamous cell maturation in postmenopausal women are not well established. Resveratrol (3,5,4′-trans-trihydroxystilbene) has been shown to bind the estrogen receptor in rat uteri. The aim of this study was to cytologically evaluate vaginal smears from ovariectomized rats treated with resveratrol, raloxifene, tibolone and conjugated equine estrogen, and to compare each drug with regard to vaginal epithelial maturation. Material and Methods: Forty-two bilaterally ovariectomized Wistar albino rats were equally randomized into 6 groups: (1) control sham-operated rats; (2) ovariectomized rats administered 0.1% ethanol; (3) ovariectomized rats administered resveratrol at a dose of 5 mg/kg/day p.o.; (4) ovariectomized rats administered conjugated equine estrogen (CEE) at a dose of 0.1 mg/kg/day p.o.; (5) ovariectomized rats administered tibolone at a dose of 0.25 mg/kg/day p.o., and (6) ovariectomized rats administered raloxifen at a dose of 1 mg/kg/day p.o. Administration of drugs started 5 days after bilateral ovariectomy and continued for 35 days. After 35 days of treatment a vaginal smear was obtained from each rat. Smears were stained with the usual Papanicolaou method, and observed with a light microscope by an experienced cytopathologist. Cytological grading was made according to the extent of parabasal, intermediate, superficial and anuclear squamous cells. Results: Ovariectomized rats had lower scores for superficial and anuclear cells when compared to sham-operated rats (p < 0.05). The CEE group had higher scores for superficial and anuclear cells than those of the ovariectomized, raloxifene and tibolone groups (p < 0.05). The resveratrol-treated rats had higher scores for superficial cells but lower scores for parabasal cells than ovariectomized rats (p < 0.05). The raloxifene and tibolone groups had the same scores for intermediate, superficial and anuclear cells but lower scores for parabasal cells compared to ovariectomized rats. Conclusion: The results of our study suggest that resveratrol offsets the reduction in vaginal stratification generally observed after oophorectomy.

Behaviour of vaginal epithelial maturation and sex hormone binding globulin in post-menopausal breast cancer patients during the first year of tamoxifen therapy.

To evaluate the effect of tamoxifen on vaginal epithelial maturation and on oestrogen-related hepatic synthesis, we prospectively studied the karyopyknotic index (KPI), the maturation index (MI), expressed as a percentage of parabasal (MI-1), intermediate (MI-2) and superficial (MI-3) cells, as well as the serum levels of the oestrogen-dependent sex hormone binding globulin (SHBG). Tests were performed at baseline, after 1, 3, 6 and 12 months of therapy in 64 post-menopausal breast cancer patients. Basal KPI ranged from 0 to 9 (mean 1.5 +/- 0.3) and rose 13.5-fold to 21 +/- 2.5 (P = 0.000) after the first 30 days of tamoxifen. Absence of KPI rise was observed in 23% of patients. Pretreatment MI figures 1, 2 and 3 were 56.9 +/- 5.6, 41.7 +/- 5.4 and 1.4 +/- 0.3, respectively, and sharply shifted to the right (P = 0.000) after 1 month of therapy, indicating an increase of vaginal epithelial maturation. At baselines the SHBG mean value was 62.1 +/- 3.3 nmol/l and underwent an increase of 44% (P = 0.000) after 30 days of tamoxifen. All of these observed 1-month modifications remained stable up to the studied 12 months of therapy. Present findings indicate an early and persistent oestrogenic effect of tamoxifen on the vaginal epithelium and the hepatic synthesis of SHBG.

Cigarette smoking and other correlates of cytologic estrogen effect in postmenopausal women

Cigarette smoking and other factors associated with estrogen-related diseases may influence risk through hormonal mechanisms. To investigate the sex hormone associations of these risk factors, vaginal scrape cytology specimens and questionnaire data were obtained on 215 postmenopausal women at the time of routine pelvic examination. All specimens were read blindly by one cytologist, and the relationships between the indices of maturation and risk factors were assessed with regression techniques. Current cigarette smoking and obesity were associated with increased maturation. In contrast, years past menopause, parity, and coffee and tea consumption were all unrelated to vaginal epithelial maturation. These results elucidate the mechanisms underlying the antiestrogenic effect of cigarette smoking and support the concept that obesity is associated with an estrogenic effect.