Symptoms Of Atrophic Vaginitis Research Articles

Плазмолифтинг как метод выбора при лечении атрофического вагинита у женщин в состоянии климактерического периода

Данное исследование, проведенное в гинекологическом центре «Жамиля» (г. Семей, Казахстан), показывает эффект применения метода плазмолифтинга у женщин в состоянии климактерического периода, имеющих симптомы атрофического вагинита.

Атрофический вагинит у пациенток репродуктивного возраста

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

Therapeutic Approaches to Atrophic Vaginitis in Postmenopausal Women: A Systematic Review with a Network Meta-analysis of Randomized Controlled Trials.

ObjectivesAtrophic vaginitis (AV), which is common in postmenopausal women, is characterized by vaginal dryness, dyspareunia, and discomfort. There are a variety of therapeutic agents for the treatment of AV, besides hormone replacement therapy. We performed this systematic review to compare the effectiveness of various therapies for symptom improvement in AV patients.MethodsWe searched the Cochrane Library, EMBASE, MEDLINE, and other literature (Google Scholar, Web of Science, and hand search) for studies published between January 2010 and March 2015. AV was evaluated by the following outcomes: vaginal pH, dyspareunia, vaginal dryness, or cytological change (endometrial thickness, percentages of superficial cells and parabasal cells). They measured treatment efficacy with various outcomes pertaining to AV symptoms.ResultsMeta-analysis suggested that ospemifene was effective against dyspareunia, vaginal dryness, endometrial thickness, and percentage changes in superficial and parabasal cells. Vaginal pH was most affected by soy isoflavone vaginal gel. Ospemifene was effective for AV symptoms.ConclusionsThis systematic review compared the effects of several therapeutic agents on symptoms of AV through a network meta-analysis. This study provides objective evidence for clinical treatment and efficacy management in AV.

Abstract B26: Vaginal health assessment study for breast cancer survivors

Abstract Postmenopausal breast cancer survivors often have urogenital atrophy adversely affecting their quality of life. Symptoms of atrophic vaginitis include: vaginal irritation, dyspareunia, postcoital bleeding, and increased susceptibility to vaginal infections. Endocrine breast cancer therapies further decrease estrogen levels, exacerbating these symptoms. Current non-hormonal vaginal therapies used first-line are often given with vague instructions, or not given at all. Hormonal therapies including estrogen and progesterone may increase the risk of recurrence and are therefore rarely used. This scenario results in breast cancer patients not having resolution of their atrophic vaginitis symptoms. There is a lack of data for atrophic vaginitis symptoms reported by patients and treatments employed in this population of breast cancer survivors. Therefore, we conducted a pilot study of urogenital symptoms in breast cancer survivors. This is prevalence, cross-sectional study of female patients from the Breast Survivorship Clinic in the Cancer Prevention Center at the UT M.D. Anderson Cancer Center. Patients included in this study are women with a history of invasive breast cancer and are greater than five years after treatment; women with ductal carcinoma in situ (DCIS) are at least six months after treatment. Approximately 1000 individual patient's charts (over 4,800 clinic visits) were available for review during the time frame studied (July 1, 2010 to June 30, 2011). Two predefined age groups will be evaluated (<60, 60–75), focusing on the patients younger than 60 years of age. Taking the information from the chart review, we will present the number of breast cancer female patients reporting symptoms of atrophic vaginitis. We will also report the percent of patients with symptoms who actually get treatment and the types of treatment recommended and prescribed. Citation Information: Cancer Prev Res 2011;4(10 Suppl):B26.

Assessing and managing atrophic vaginitis

Practice NursingVol. 22, No. 3 Clinical Sexual HealthAssessing and managing atrophic vaginitisJean WatkinsJean WatkinsSearch for more papers by this authorJean WatkinsPublished Online:29 Sep 2013https://doi.org/10.12968/pnur.2011.22.3.140AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesBotash A (2010) Vaginitis. http://tiny.cc/vj75l (accessed 14 February 2011) Google ScholarCurran D (2011) Menopause. http://tinyurl.com/5svsxsw (accessed 14 February 2011) Google ScholarDermNet NZ (2010) Lichen sclerosus. http://tinyurl.com/635cxeg (accessed 14 February 2011) Google ScholarJoint Formulary Committee (2010) British National Formulary 60. September. BMJ Group and RPS Publishing, London Google ScholarPubMed Health (2009) Atrophic vaginitis. http://tiny.cc/rf54n (accessed 14 February 2011) Google ScholarRoyal College of Obstetricians and Gynaecologists (2009) RCOG and the hormone replacement therapy (HRT) debate. http://tinyurl.com/4ndrj2x (accessed 14 February 2011) Google ScholarWrong diagnosis (2011) Symptoms of atrophic vaginitis. http://tinyurl.com/48odqsh (accessed 14 February 2011) Google ScholarZieve D (2009) Vaginal dryness alternative treatments. http://tiny.cc/2a4lt (accessed 14 February 2011) Google Scholar FiguresReferencesRelatedDetails 1 March 2011Volume 22Issue 3ISSN (print): 0964-9271ISSN (online): 2052-2940 Metrics History Received 8 February 2011 Accepted 14 February 2011 Published online 29 September 2013 Published in print 1 March 2011 Information© MA Healthcare LimitedKeywordsSexual healthatrophic vaginitisthrushPDF download

The comparison of hyaluronic acid vaginal tablets with estradiol vaginal tablets in the treatment of atrophic vaginitis: a randomized controlled trial

To compare the effectiveness of the vaginal tablets of hyaluronic acid and estrodiol for the treatment of atrophic vaginitis. Forty-two postmenopausal women with symptoms of atrophic vaginitis were randomized to take vaginal tablets of 25 μg estradiol (n = 21) (group I) or 5 mg hyaluronic acid sodium salt (n = 21) (group II) for 8 weeks. The symptoms of atrophic vaginitis were evaluated by a self-assessed 4-point scale of composite score and the degree of epithelial atrophy was determined as, none, mild, moderate and severe. Vaginal pH and maturation index were measured and compared in both the groups. The symptoms were relieved significantly in both the groups (P < 0.001). The relief of symptoms was significantly superior in group I compared with group II (P < 0.05). A significant decrease in epithelial atrophy and vaginal pH were detected in both the groups (P < 0.01) after treatment. The vaginal maturation values were also significantly improved at both study groups (P < 0.001). The mean maturation value was significantly higher in group I when compared with group II (P < 0.001). Both treatments provided relief of vaginal symptoms, improved epithelial atrophy, decreased vaginal pH, and increased maturation of the vaginal epithelium. Those improvements were greater in group I. Hyaluronic acid vaginal tablets can be used in patients with atrophic vaginitis who do not want to or can not take local estrogen treatment.

Treatment of atrophic vaginitis

Up to 40%of postmenopausal women have symptoms of atrophic vaginitis. Since the condition is attributable to estrogen deficiency, it may also occur in premenopausal women who take antiestrogenic medications or who have medical or surgical conditions that result in decreased levels of estrogen. The thinned vaginal epithelium and increased vaginal pH level induced by estrogen deficiency predispose the vagina and urinary tract to infection and mechanical weakness. The earliest symptoms are decreased vaginal lubrication, followed by other vaginal and urinary symptoms, such as dryness, burning, itching and dyspareunia, which may be exacerbated by superimposed infection. These symptoms can contribute to sexual dysfunction, loss of sexual intimacy and may have a negative impact on overall quality of life. Once other causes of symptoms have been eliminated, treatment usually depends on estrogen replacement. Estrogen-replacement therapy decreases vaginal pH, thickens and revascularizes the vaginal epithelium, incr...

Vaginal estrogen preparations: a review of safety and efficacy for vaginal atrophy.

A theoretical advantage of local (i.e., vaginal) therapy of genitourinary symptoms could be avoidance of systemic adverse effects. Review of efficacy and adverse effects of commonly prescribed vaginal estrogens is of great clinical relevance. A Medline (1966-present) search was performed for randomized controlled trials involving vaginal estrogens. Reference lists of papers were reviewed for additional references. Twenty-two references were randomized controlled trials of vaginal estrogens used by postmenopausal women with signs or symptoms of vaginal atrophy. Subject numbers ranged from 20 to 251. Duration ranged from 2 weeks to 1 year. Different preparations and schedules were used across the trials. All treatments alleviated signs and symptoms of atrophic vaginitis, regardless of whether objective signs of atrophy were required for study entry. Data for urinary symptoms was conflicting; the ring may prevent recurrent urinary tract infections (UTIs). The trials with endometrial scrutiny were less than one year and had mixed results. Nonhormonal lubricant is effective in improving some atrophic signs and symptoms. All preparations were associated with vaginal irritation. Bleeding with vaginal estradiol tablets may be less than that with CEE cream. Vaginal tablets or rings were preferred over other preparations. There were no serious adverse events reported. There was occasional expulsion of estradiol ring in the setting of prior hysterectomy. All preparations are effective in decreasing signs and symptoms of vaginal atrophy, but they differ slightly in their adverse event profiles. Long-term safety of the preparations is best established for estradiol tablets (1 year), but is lacking for all preparations.

Comparison of usefulness of estradiol vaginal tablets and estriol vagitories for treatment of vaginal atrophy

Atrophic vaginitis is a common condition. This study compared the usefulness of estradiol vaginal tablets (EVT) and estriol vagitories (EV) in treatment of atrophic vaginitis. Ninety-six postmenopausal women with symptoms of atrophic vaginitis were treated for 24 weeks with either EVT or with EV. Patients used the medication daily for the first 2 weeks of the study, and twice-weekly thereafter. Both EVT and EV were effective in treating vaginal atrophy and patients in both treatment groups experienced a significant improvement in vaginal symptoms such as itching, irritation, dryness, and dyspareunia. At the end of the study three (6%) EVT treated women reported leakage and none needed to use sanitary towels. Among the EV treated women 31 (65%) reported leakage and 14 (29%) required sanitary protection. Furthermore, 90% in the EVT group perceived the medication as hygienic compared to 79% in the EV group, and 49% in the EVT group indicated that the product was easy to use compared to 28% in the EV group. Endometrial thickness was increased (1.1 mm with EVT and 0.5 mm on EV) in both treatment groups during the first 2 weeks of the study, but returned to baseline levels when the frequency of drug application was reduced to twice-weekly. Estradiol vaginal tablets provides an effective alternative to traditional forms of local estrogen therapy.

Atrophic vaginitis

Atrophic vaginitis is not only treatable but preventable. Because the vagina is an estrogen-dependent organ, the mainstay of management is estrogen replacement therapy, which should be initiated with the onset of ovarian decline at menopause or when a woman presents with symptoms of atrophic vaginitis. Lubricants and vaginal moisturizers may be useful adjuncts. Regular sexual activity is also helpful in maintaining a healthy, functional vagina.