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Taiwanese Journal of Obstetrics &... Mar 2019
Topics: Female; Hemostasis, Surgical; Humans; Natural Orifice Endoscopic Surgery; Vagina
PubMed: 30910132
DOI: 10.1016/j.tjog.2019.02.002 -
Journal of Pediatric and Adolescent... Oct 2016To explore adolescent's perceptions of vaginal health, practices, and vaginally-placed products.
STUDY OBJECTIVE
To explore adolescent's perceptions of vaginal health, practices, and vaginally-placed products.
DESIGN
Semistructured interviews were audio-recorded and transcribed until theoretical saturation was achieved.
SETTING
Adolescent medicine clinics in New York City.
PARTICIPANTS
Female adolescents (N = 22) who were sexually experienced, predominately Hispanic (73%, n = 16) with a mean age of 17.7 years (range, 15-20 years).
INTERVENTIONS
None.
MAIN OUTCOME MEASURES
Interviews were used to assess perspectives on vaginal health, specific vaginal hygiene practices, and attitudes about vaginally-placed products (contraceptive rings, intrauterine devices), and proposed multipurpose technologies administered as ring or gel). The interviews were transcribed and coded for relevant themes.
RESULTS
Overlapping themes included young women's view of their vagina as a space that needed to be healthy for sexual partners and future fertility. The vagina could not be presumed to be healthy and conversations about vaginal health were limited to include only specific individuals. All reported a variety of practices to maintain their vaginal health, including showering 1-5 times a day and using soaps specifically for the vagina. Attitudes about vaginally-placed products revealed concerns about the sensory experience of having a product in the vagina, safety concerns and interest in the product's objective (prevention of pregnancy or infection).
CONCLUSION
Adolescents have very specific views and practices about their vaginas. Clinicians should initiate conversations about vaginal health and hygiene with adolescents and focus on the normalcy of the vagina. Development of vaginally-placed products should focus on the sensory experience, safety, and purpose of the product.
Topics: Adolescent; Adult; Attitude to Health; Female; Health Knowledge, Attitudes, Practice; Humans; Hygiene; Intrauterine Devices; New York City; Pregnancy; Qualitative Research; Sexual Behavior; Sexual Partners; Vagina; Young Adult
PubMed: 27133374
DOI: 10.1016/j.jpag.2016.04.003 -
Lasers in Surgery and Medicine Feb 2021More studies are needed to assess the long-term safety profile and clinical outcomes of lasers and energy-based devices to treat the symptoms associated with...
BACKGROUND AND OBJECTIVES
More studies are needed to assess the long-term safety profile and clinical outcomes of lasers and energy-based devices to treat the symptoms associated with vulvovaginal atrophy. This study evaluated a series of three fractional CO laser treatments to the vulva and vagina with a 1-year follow-up in a postmenopausal population.
STUDY DESIGN/MATERIALS AND METHODS
In this prospective, self-controlled, open-label clinical study, 18 postmenopausal females with atrophic vaginitis received 3 monthly treatments to the vulva and vagina with a fractional CO laser system and 1-, 3-, 6-, and 12-month follow-up. Investigators used the Vaginal Health Index (VHI) to assess changes in vaginal elasticity, fluid volume, vaginal pH, epithelial integrity, and moisture. Sexual function at each timepoint was subject-reported, using the validated Female Sexual Function Index (FSFI).
RESULTS
Treatment of the vulva and vagina in postmenopausal women with fractional CO laser resurfacing resulted in statistically significant improvements as compared with baseline at all post-treatment and follow-up intervals to 12 months in VHI and FSFI (P ≤ 0.003 and P ≤ 0.03, respectively). Mean total VHI score increased from a baseline of 11.8-22.8 (93.2% improved) at 6-month follow-up (P = 0.0002) slightly decreasing to 21.4 (81.4% improved) at 12-month follow-up post-treatment (P = 0.0003). Mean FSFI Scores increased from a baseline of 17.9-26.3 (46.9% improvement) at 12-month follow-up post-treatment (P ≤ 0.0048). Cohort analysis revealed restoration of normal or near-normal (23-25) VHI following laser treatment in the recently menopausal (1-3 years) greatly exceeded that of the >3 years postmenopausal population and the difference was statistically significant (P ≤ 0.05). Normal/near-normal VHI at 3-, 6-, and 12-month post-treatment was 88%, 88%, and 63% in the recently postmenopausal cohort, as compared with 30%, 40%, and 10% of the >3 years postmenopausal group (P ≤ 0.05). Patient satisfaction following treatment was rated as high at 94% at 12-month follow-up. Safety findings demonstrated no-to-slight discomfort in the majority of subjects and transient erythema and edema, with no adverse events associated with treatment.
CONCLUSION
Fractional CO laser treatment of the vulva and vagina resulted in statistically significant improvements in VHI and FSFI compared with baseline in postmenopausal population that were sustained to 12-month follow-up. Restoration of normal VHI was observed in a statistically significant greater percentage in the recently postmenopausal cohort (1-3 years) as compared with postmenopausal cohort of >3 years, suggesting that early intervention is correlated with improved outcomes. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
Topics: Atrophy; Carbon Dioxide; Female; Humans; Lasers, Gas; Postmenopause; Prospective Studies; Treatment Outcome; Vagina; Vulva
PubMed: 32329093
DOI: 10.1002/lsm.23247 -
Fertility and Sterility Aug 2018For more than a century, the uterine cavity has been considered a sterile site maintained by the cervical plug. Humans are like coral that need symbiosis with...
For more than a century, the uterine cavity has been considered a sterile site maintained by the cervical plug. Humans are like coral that need symbiosis with microorganisms to be completely functional. In the era of precision medicine, the endometrial factor and specifically the microbiological view have long been neglected in reproduction, because it was considered an old concept with no potential improvement. In the last decade, important discoveries, led by improving technology, namely next generation sequencing, have been made in the study of microbial communities not only in the vagina but also in the endometrial cavity and its implication in reproductive health and disease, particularly chronic endometritis. From these studies, we have learned that microbes interact with the host cells along the female reproductive tract generating the physical, chemical and biological environment that the embryo will encounter during the peri-implantation period and throughout pregnancy.
Topics: Embryo Implantation; Endometrium; Female; Humans; Microbiota; Pregnancy; Reproduction; Uterus; Vagina
PubMed: 30037698
DOI: 10.1016/j.fertnstert.2018.06.041 -
Molecules (Basel, Switzerland) Jan 2022Endometriosis presents high prevalence and its physiopathology involves hyperactivation of endometrial and vaginal cells, especially by bacteria. The disease has no cure...
Endometriosis presents high prevalence and its physiopathology involves hyperactivation of endometrial and vaginal cells, especially by bacteria. The disease has no cure and therapies aiming to inhibit its development are highly desirable. Therefore, this study investigated whether Miodesin (10 µg/mL = IC; 200 µg/mL = IC), a natural compound constituted by , , and astaxanthin, could exert anti-inflammatory and anti-proliferative effects against Lipopolysaccharides (LPS) stimulation in endometrial and vaginal cell lines. VK2 E6/E7 (vaginal) and KLE (epithelial) cell lines were stimulated with (1 × 10 to 5 × 10/mL) and LPS (1 μg/mL), respectively. Miodesin inhibited mRNA expression for Nuclear factor kappa B (NF-κB), ciclo-oxigenase 1 (COX-1), and phospholipase A2 (PLA2), beyond the C-C motif chemokine ligand 2 (CCL2), CCL3, and CCL5 in VK2 E6/E7 cells ( < 0.05). In addition, the inhibitory effects of both doses of Miodesin (10 µg/mL and 200 µg/mL) resulted in reduced secretion of interleukin-1β (IL-1β), IL-6, IL-8, tumor necrosis factor α (TNF-α) (24 h, 48 h, and 72 h) and CCL2, CCL3, and CLL5 ( < 0.05) by VK2 E6/E7 cells. In the same way, COX-1 Miodesin inhibited LPS-induced hyperactivation of KLE cells, as demonstrated by reduced secretion of IL-1β, IL-6, IL-8, TNF-α (24 h, 48 h, and 72 h) and CCL2, CCL3, and CLL5 ( < 0.05). Furthermore, Miodesin also inhibited mRNA expression and secretion of matrix metalloproteinase-2 (MMP-2), MMP-9, and vascular endothelial growth factor (VEGF), which are key regulators of invasion of endometrial cells. Thus, the study concludes that Miodesin presents beneficial effects in the context of endometriosis, positively affecting the inflammatory and proliferative response.
Topics: Biological Products; Candida albicans; Chemokines; Cytokines; Endometrium; Female; Humans; Lipopolysaccharides; Phospholipases A2; RNA, Messenger; Vagina
PubMed: 35164046
DOI: 10.3390/molecules27030782 -
PloS One 2014There are increasing numbers of reports describing human vaginal tissue composition in women with and without pelvic organ prolapse with conflicting results. The aim of...
OBJECTIVE
There are increasing numbers of reports describing human vaginal tissue composition in women with and without pelvic organ prolapse with conflicting results. The aim of this study was to compare ovine and human posterior vaginal tissue in terms of histological and biochemical tissue composition and to assess passive biomechanical properties of ovine vagina to further characterise this animal model for pelvic organ prolapse research.
STUDY DESIGN
Vaginal tissue was collected from ovariectomised sheep (n = 6) and from postmenopausal women (n = 7) from the proximal, middle and distal thirds. Tissue histology was analyzed using Masson's Trichrome staining; total collagen was quantified by hydroxyproline assays, collagen III/I+III ratios by delayed reduction SDS PAGE, glycosaminoglycans by dimethylmethylene blue assay, and elastic tissue associated proteins (ETAP) by amino acid analysis. Young's modulus, maximum stress/strain, and permanent strain following cyclic loading were determined in ovine vagina.
RESULTS
Both sheep and human vaginal tissue showed comparable tissue composition. Ovine vaginal tissue showed significantly higher total collagen and glycosaminoglycan values (p<0.05) nearest the cervix. No significant differences were found along the length of the human vagina for collagen, GAG or ETAP content. The proximal region was the stiffest (Young's modulus, p<0.05), strongest (maximum stress, p<0.05) compared to distal region, and most elastic (permanent strain).
CONCLUSION
Sheep tissue composition and mechanical properties showed regional differences along the postmenopausal vaginal wall not apparent in human vagina, although the absolute content of proteins were similar. Knowledge of this baseline variation in the composition and mechanical properties of the vaginal wall will assist future studies using sheep as a model for vaginal surgery.
Topics: Aged; Animals; Biomechanical Phenomena; Collagen; Female; Glycosaminoglycans; Humans; Middle Aged; Pelvic Organ Prolapse; Postmenopause; Sheep; Vagina
PubMed: 25148261
DOI: 10.1371/journal.pone.0104972 -
American Journal of Reproductive... Sep 2021Access to safe, effective, and affordable contraception is important for women's health and essential to mitigate maternal and fetal mortality rates. The progestin-based... (Review)
Review
BACKGROUND
Access to safe, effective, and affordable contraception is important for women's health and essential to mitigate maternal and fetal mortality rates. The progestin-based contraceptive depot medroxyprogesterone acetate (DMPA) is a popular contraceptive choice with a low failure rate and convenient administration schedule.
AIM
In this review, we compiled observational data from human cohorts that examine how DMPA influences the mucosal biology of the female genital tract (FGT) that are essential in maintaining vaginal health, including resident immune cells, pro-inflammatory cytokines, epithelial barrier function, and the vaginal microbiome MATERIALS AND METHODS: This review focused on the recent published literature published in 2019 and 2020.
RESULTS
Recent longitudinal studies show that DMPA use associates with an immunosuppressive phenotype, increase in CD4+CCR5+ T cells, and alterations to growth factors. In agreement with previous meta-analyses, DMPA use is associated with minimal effects of the composition of the vaginal microbiome. Cross-sectional studies associate a more pro-inflammatory relationship with DMPA, but these studies are confounded by inherent weaknesses of cross-sectional studies, including differences in study group sizes, behaviors, and other variables that may affect genital inflammation.
DISCUSSION & CONCLUSION
These recent results indicate that the interactions between DMPA and the vaginal mucosa are complex emphasizing the need for comprehensive longitudinal studies that take into consideration the measurement of multiple biological parameters.
Topics: Contraceptive Agents, Female; Delayed-Action Preparations; Female; Genitalia, Female; Humans; Medroxyprogesterone Acetate; Microbiota; Mucous Membrane; Vagina
PubMed: 33991137
DOI: 10.1111/aji.13455 -
Viruses Jul 2020Besides bacteria, fungi, protists and archaea, the vaginal ecosystem also contains a range of prokaryote- and eukaryote-infecting viruses, which are collectively... (Review)
Review
Besides bacteria, fungi, protists and archaea, the vaginal ecosystem also contains a range of prokaryote- and eukaryote-infecting viruses, which are collectively referred to as the "virome". Despite its well-described role in the gut and other environmental niches, the vaginal virome remains understudied. With a focus on sexual and reproductive health, we summarize the currently known components of the vaginal virome, its relationship with other constituents of the vaginal microbiota and its association with adverse health outcomes. While a range of eukaryote-infecting viruses has been described to be present in the female genital tract (FGT), few prokaryote-infecting viruses have been described. Literature suggests that various vaginal viruses interact with vaginal bacterial microbiota and host immunity and that any imbalance thereof may contribute to the risk of adverse reproductive health outcomes, including infertility and adverse birth outcomes. Current limitations of vaginal virome research include experimental and analytical constraints. Considering the vaginal virome may represent the missing link in our understanding of the relationship between FGT bacteria, mucosal immunity, and adverse sexual and reproductive health outcomes, future studies evaluating the vaginal microbiome and its population dynamics holistically will be important for understanding the role of the vaginal virome in balancing health and disease.
Topics: Animals; Female; Host Microbial Interactions; Humans; Immunity, Mucosal; Mice; Microbiota; Reproductive Health; Sexual Health; Vagina; Virome
PubMed: 32751611
DOI: 10.3390/v12080832 -
Microbial Genomics Mar 2021The vaginal microbiome plays an important role in human health and species of vaginal bacteria have been associated with reproductive disease. Strain-level variation is...
The vaginal microbiome plays an important role in human health and species of vaginal bacteria have been associated with reproductive disease. Strain-level variation is also thought to be important, but the diversity, structure and evolutionary history of vaginal strains is not as well characterized. We developed and validated an approach to measure strain variation from metagenomic data based on SNPs within the core genomes for six species of vaginal bacteria: , , , , and . Despite inhabiting the same environment, strain diversity and structure varies across species. All species except are characterized by multiple distinct groups of strains. Even so, strain diversity is lower in the species, consistent with a more recent colonization of the human vaginal microbiome. Both strain diversity and the frequency of multi-strain samples is related to species-level diversity of the microbiome in which they occur, suggesting similar ecological factors influencing diversity within the vaginal niche. We conclude that the structure of strain-level variation provides both the motivation and means of testing whether strain-level differences contribute to the function and health consequences of the vaginal microbiome.
Topics: Adult; Bacteria; Cohort Studies; Female; Humans; Microbiota; Phylogeny; Pregnancy; Vagina; Young Adult
PubMed: 33656436
DOI: 10.1099/mgen.0.000543 -
Journal of Biosciences Oct 2019Compared to other human microbiota, vaginal microbiota is fairly simple with low bacterial diversity and high relative abundance of Lactobacillus species. Lactobacillus... (Review)
Review
Compared to other human microbiota, vaginal microbiota is fairly simple with low bacterial diversity and high relative abundance of Lactobacillus species. Lactobacillus dominance is even more pronounced during pregnancy. Genetic factors, such as ethnicity, along with environmental, individual and lifestyle factors all have an impact on vaginal microbiota composition. The composition of the vaginal microbiota appears to play an important role in pregnancy as recent studies have linked it to adverse obstetric outcomes such as preterm birth, a leading cause of neonatal morbidity and mortality worldwide. However, the same vaginal microbiota does not seem to cause the same response in all women, calling for future research to fully understand the complex host-microbiota interplay in normal and complicated pregnancies.
Topics: Female; Humans; Infant, Newborn; Labor, Induced; Microbiota; Pregnancy; Premature Birth; Vagina
PubMed: 31719225
DOI: No ID Found