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International Journal of Women's Health 2023To evaluate the dynamically impact of the coronavirus disease 2019 (COVID-19) on the female reproductive system.
BACKGROUND
To evaluate the dynamically impact of the coronavirus disease 2019 (COVID-19) on the female reproductive system.
METHODS
An online survey was shared to women of reproductive age who had been infected with COVID-19 and recovered in China between January and March 2023.
RESULTS
In total, 610 women of childbearing age completed the menstrual component of the survey and 82.6% (n=504) women self-purchased medications without hospitalization. 254 women were menstruating during COVID-19 infection. 66.9% of them reported changes in menstruation, including cycle length (64.7%), menstrual flow (72.4%), and duration (53%), compared to pre-COVID-19. COVID-19-related chest tightness (OR: 9.5; 95% CI: 1.9-46.3), COVID-19-related stress (OR: 18.4; 95% CI: 1.4-249.7), and COVID-19-related low mood (OR: 6.2; 95% CI: 1.4-28.2) were associated with these menstrual changes. However, over 73% of women who menstruated during and after COVID-19 regained their pre-infection menstrual cycle (73%), duration (79.6%), and flow (75.2%) during their first menstruation after COVID-19 recovery. Compared to pre-infection, 19.7% (n=124) women reported changes in lower reproductive tract during COVID-19, including volume and color of vaginal discharge, vulvar pruritus, and vaginitis. These changes were significantly increased in those with a history of pelvic inflammatory disease (OR: 12.1; 95% CI: 3.1-48.2), ovarian cysts (OR: 4.9; 95% CI: 1.2-19.4), and vaginitis (OR: 5.5; 95% CI: 2.1-14.4) prior to COVID-19. However, 52.4% reported that their lower reproductive tract health had returned to its pre-infection within the first month after recovery from COVID-19, while 73.5% reported a return to the pre-infection within 2 months.
CONCLUSION
Changes in menstruation and lower reproductive tract associated with COVID-19 are transient. Menstruation and lower reproductive tract health will gradually return to pre-COVID-19 status within 2 months of recovery, which can help alleviate excessive concerns about the effects of COVID-19 on the reproductive system.
PubMed: 38152614
DOI: 10.2147/IJWH.S433516 -
Alternative Therapies in Health and... Oct 2023Kundur, Boswellia serrata Roxb. ex Colebr., is prescribed by Unani (Greco-Arab) scholars clinically under conditions similar to vulvovaginal candidiasis (VVC) and has... (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
Kundur, Boswellia serrata Roxb. ex Colebr., is prescribed by Unani (Greco-Arab) scholars clinically under conditions similar to vulvovaginal candidiasis (VVC) and has been supported by recent pharmacological studies, but scientific evidence is scarce.
OBJECTIVES
The study intended to investigate the drug's scientific parameters and to compare its efficacy and safety to that of Miconazole nitrate (2% w/w) in treatment of VVC.
DESIGN
The research team designed a randomized controlled trial (RCT).
SETTING
The RCT was performed in the Department of Ilmul Qabalat wa Amraze Niswan at Luqman Unani Medical College Hospital and Research Center in Vijaypura, India, between November 2018 and March 2020.
PARTICIPANTS
Participants were 40 married women, aged 18 to 45 years, who had been clinically examined and diagnosed with VVC.
INTERVENTIONS
Participants were randomly allocated to the Boswellia serrata (Kundur) group, the intervention group (n = 20), or to the miconazole group, the control group (n = 20). The Kundur group took a one-gram tablet of Kundur as a vaginal insert every day at bedtime for 21 days, while the control group used vaginal suppositories with 100 mg of miconazole (2% w/w) every day at bedtime for seven days.
OUTCOME MEASURES
The primary outcome measures were changes: (1) in vulval itching (pruritus), (2) in vaginal discharge, (3) in painful urination (dysuria), (4) in recurrent genital pain (dyspareunia), and (5) in quality of life (QoL). The secondary outcome measures were mycological clearing on a potassium hydroxide (KOH) test and a per-speculum pelvic examination for the presence or absence of curdy discharge, vulval erythema, and vulval swelling.
RESULTS
The response to the intervention was greater than that of the control in reducing pruritus vulvae and vaginal discharge. However, both drugs were equally effective in improving the rest of the parameters, including QoL.
CONCLUSION
The VVC symptoms were equally and significantly improved in both the intervention and the control groups, and Boswellia serrata Roxb. ex Colebr. was shown to be efficacious in the management of VVC. Further studies with a rigorous design and larger sample size are needed to reinforce scientific evidence.
Topics: Adolescent; Adult; Female; Humans; Middle Aged; Young Adult; Antifungal Agents; Boswellia; Candidiasis, Vulvovaginal; India; Miconazole; Vaginal Discharge
PubMed: 35751891
DOI: No ID Found -
Cellular and Molecular Biology... Jun 2024This work compared the effects of dural puncture epidural (DPE), combined spinal epidural analgesia (CSEA) and epidural analgesia (EA) on labor analgesia for primiparae...
This work compared the effects of dural puncture epidural (DPE), combined spinal epidural analgesia (CSEA) and epidural analgesia (EA) on labor analgesia for primiparae and their impacts on maternal and infant safety. A total of 204 primiparae in need of labor analgesia for vaginal delivery were allocated to DPE, CSEA and EA groups. At 10 min, 30 min and 1 h after analgesia, the DPE and CSEA groups showed lower VAS scores and quicker onset of action than EA group. There was no significant difference in the duration of analgesia and labor and fetal decelerations among the 3 groups. At 1 min and 5 min after childbirth, the neonatal Apgar scores showed no significant difference between the 3 groups. The Bromage scores of DPE and EA groups were lower than those of CSEA group. The incidence of pruritus, hypotension, and postpartum headache in DPE and EA groups were lower than those in CSEA group. To sum up, the efficacy of DPE in labor analgesia for primiparae is similar to that of CSEA, with no obvious effect on labor stage and neonatal Apgar score, no additional complications and less LLMB, pruritus, hypotension and postpartum headache.
Topics: Humans; Female; Pregnancy; Analgesia, Epidural; Adult; Labor, Obstetric; Analgesia, Obstetrical; Infant, Newborn; Apgar Score; Parity; Young Adult
PubMed: 38836685
DOI: 10.14715/cmb/2024.70.6.6 -
World Journal of Urology Feb 2024Urinary Tract Infections (UTIs) and Genital Tract Infections (GTIs) are common yet serious health concerns. Precise diagnosis is crucial due to the potential severe...
BACKGROUND
Urinary Tract Infections (UTIs) and Genital Tract Infections (GTIs) are common yet serious health concerns. Precise diagnosis is crucial due to the potential severe consequences of misdiagnosis. This study aims to distinguish between UTIs and GTIs, highlighting the importance of accurate differentiation.
MATERIALS AND METHODS
The study encompassed 294 patients, categorized into 4 groups: Group GNI (no infection, N = 57), Group GUI (urinary infection, N = 52), Group GGI (genital infection, N = 139), and Group GGUI (both infections, N = 46). Methods included patient interviews, clinical examinations, and laboratory tests such as urine and vaginal swab cultures.
RESULTS
The investigation revealed no significant differences in age, BMI, residency, or nationality across groups. However, socioeconomic status varied, with Group GNI having the lowest proportion of low socioeconomic status. In obstetrical characteristics, non-pregnancy rates were higher in Groups GUI and GGUI, with GGUI showing a notably higher abortion rate. Symptom analysis indicated lower symptom prevalence in Group GNI, with pain, itching, pruritus, and vaginal discharge being less frequent, suggesting a link between infection presence and symptom severity. Treatment patterns showed higher usage of ciprofloxacin, antifungals, and vaginal tablets in Groups GUI and GGUI. Laboratory findings highlighted significant Leucocyte Esterase presence and variations in WBC and RBC counts, particularly in Group GGUI.
CONCLUSION
The study emphasizes the need for advanced diagnostic techniques, especially those focusing on individual microbial patterns, to enhance UGTI diagnosis. Variations in symptom presentation and treatment across groups underline the necessity for personalized diagnostic and treatment strategies.
Topics: Female; Humans; Reproductive Tract Infections; Lebanon; Urinary Tract Infections; Diagnostic Errors
PubMed: 38308683
DOI: 10.1007/s00345-024-04770-3 -
International Urogynecology Journal Mar 2024The genitourinary syndrome of menopause (GSM), apart from symptoms related to vulvovaginal atrophy (VVA), also consists of lower urinary tract symptoms (LUTS). Based on...
INTRODUCTION AND HYPOTHESIS
The genitourinary syndrome of menopause (GSM), apart from symptoms related to vulvovaginal atrophy (VVA), also consists of lower urinary tract symptoms (LUTS). Based on the common embryological origin of the genital and lower urinary system, the presence of estrogen receptors, and the high prevalence of VVA and LUTS in the menopausal population, the two conditions can coexist. This study is aimed at investigating the prevalence and risk factors of LUTS in a sample of Greek peri- and postmenopausal women.
METHODS
Four hundred and fifty (450) women, aged 40-70 years, attending three outpatient gynecology clinics for routine examination, completed a structured interview and responded to a validated questionnaire (International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms, ICIQ-FLUTS).
RESULTS
Urinary urgency or frequency affected 51.6% and dysuria 43.6% of the participants. Mild urgency or frequency was described by 25.6%, moderate by 14.4%, and severe by 11.6% of the women. Mild dysuria was reported by 26.26%, moderate by 5.8%, and severe by 11.6%. Age, weight, BMI, and number of pregnancies and abortions correlated with a higher ICIQ-FLUTS score. Women with moderate/severe symptoms of VVA, such as irritation, a burning sensation, and pruritus of the vulva or vagina, had a higher ICIQ-FLUTS score than women without such symptoms (beta coefficient 2.42, CI 1.204, 3.635, p < 0.001).
CONCLUSIONS
Lower urinary tract symptoms are very common among peri- and postmenopausal women and are linked to symptoms of VVA. Our data support the need for prompt evaluation of women transitioning to menopause, as these symptoms compromise the quality of life.
Topics: Female; Humans; Vaginal Diseases; Dysuria; Quality of Life; Greece; Menopause; Vagina; Vulva; Atrophy; Lower Urinary Tract Symptoms
PubMed: 38280043
DOI: 10.1007/s00192-024-05724-4 -
Alternative Therapies in Health and... Sep 2023To investigate the effect of Wandai decoction combined with traditional Chinese medicine fumigation and washing in patients with chronic vaginitis after sintilimab...
Efficacy Analysis of Wandai Decoction Combined with Traditional Chinese Medicine Fumigation and Washing in Patients with Chronic Vaginitis After Sintilimab Treatment for Small Cell Lung Cancer.
OBJECTIVE
To investigate the effect of Wandai decoction combined with traditional Chinese medicine fumigation and washing in patients with chronic vaginitis after sintilimab treatment for small cell lung cancer.
METHODS
We recruited 80 patients who developed chronic vaginitis after sintilimab treatment for small cell lung cancer from Hainan General Hospital from January 2020 to June 2022; using a random number table, 40 were assigned to a control group and 40 were assigned to an observation group. The control group was treated with Wandai decoction, and the observation group was treated with Wandai decoction combined with traditional Chinese medicine fumigation and washing. The 2 groups were compared for improvement of the symptoms of vulvar pruritus subsidence time, leukorrhea recovery time, and traditional Chinese medicine symptom score; levels of the vaginal microecological environment factors immunoglobulin G, secretory immunoglobulin A, and pH; levels of the serum inflammatory factors C-reactive protein, tumor necrosis factor, and interleukin-6; and clinical efficacy.
RESULTS
After treatment, the observation group had significantly higher vulvar pruritus subsidence time, leukorrhea recovery time, traditional Chinese medicine symptom score, and pH value; significantly lower levels of C-reactive protein, tumor necrosis factor, and interleukin-6; and significantly higher levels of immunoglobulin G, secretory immunoglobulin A, and total effective rate compared with the control group (all P < .0.001).
CONCLUSIONS
Wandai decoction combined with traditional Chinese medicine fumigation and washing was effective in treating chronic vaginitis after sintilimab treatment for small cell lung cancer. The treatment ameliorated symptoms of leukorrhea abnormalities, vulvar pruritus, and local inflammation, and promoted the recovery of the vaginal microbial environment. Despite the limitations of our study (small sample size and lack of comparison between different types of chronic vaginitis, which hinders the confirmation of extensive efficacy), we consider Wandai decoction combined with traditional Chinese medicine fumigation and washing worthy of promotion and application in clinical practice.
Topics: Female; Humans; Leukorrhea; Small Cell Lung Carcinoma; C-Reactive Protein; Fumigation; Interleukin-6; Medicine, Chinese Traditional; Vaginitis; Tumor Necrosis Factors; Immunoglobulin A, Secretory; Immunoglobulin G; Lung Neoplasms; Pruritus
PubMed: 37318889
DOI: No ID Found -
Cureus Aug 2023Plasma cell, or Zoon's, vulvitis (PCV) is a rare inflammatory disorder of the female genital tract. Clinically, it is characterized by erythematous mucosal lesions...
Plasma cell, or Zoon's, vulvitis (PCV) is a rare inflammatory disorder of the female genital tract. Clinically, it is characterized by erythematous mucosal lesions associated with burning, pruritus, and dyspareunia. Histologically, it is characterized by the thinning of the epithelium with the infiltration of plasma cells in the underlying dermis. There are few case reports describing predominantly vaginal symptoms. Our patient is a 53-year-old postmenopausal female presenting for the gynecologic evaluation of a vaginal pinching sensation and vulvar irritation for three months. On examination, vaginal mucosa was notable for erythematous macules and papules with focal tenderness. Initial evaluation was significant for bacterial vaginosis. This was treated, but it did not improve the patient's presenting symptoms. Our preliminary working diagnosis was vulvovaginal atrophy. Biopsies showed plasmacytosis mucosae consistent with Zoon's vaginitis. The patient was treated with external clobetasol ointment and hydrocortisone 25 mg vaginal suppositories with improvement in symptoms. Female genital tract lesions engender a range of differential diagnoses, including infectious, immunologic, and malignant causes. In this patient, our initial working diagnosis of genitourinary syndrome of menopause suggested that local hormonal treatment was indicated. However, histological diagnosis directed the use of steroid treatment, ultimately improving the patient's symptoms.
PubMed: 37692699
DOI: 10.7759/cureus.43260 -
Medicina (Kaunas, Lithuania) Nov 2023: Signs and symptoms of vulvovaginitis, especially when recurrent, have a significant impact on a woman's quality of life. The aim of this study was to survey... (Observational Study)
Observational Study
Efficacy of a Novel Rigenase and Polyhexanide (Fitostimoline Septagel) Hydrogel Device for the Treatment of Vulvovaginitis Symptoms: Cross-Sectional Analysis of a National Survey and Prospective Observational Study.
: Signs and symptoms of vulvovaginitis, especially when recurrent, have a significant impact on a woman's quality of life. The aim of this study was to survey gynecologists about their habits regarding the treatments of the pathology and to evaluate the efficacy of a novel vaginal hydrogel composed of wheat extracts and polyhexanide aimed at reducing vulvovaginitis symptomatology. : A cross-sectional analysis of a national survey using 155 Italian gynecologists and a prospective, open-label, observational study were carried out in 75 outpatient clinics across Italy. Pre- and postmenopausal women with suspicion of vulvovaginitis due to at least four of the following symptoms (leucoxanthorrhea, bad odor from genitalia, vulvovaginal dryness, petechiae, burning, and pruritus) while waiting for microbiological swab analysis were included and treated with one hydrogel application every 3 days for 1 week. Primary endpoint was the complete resolution of symptomatology. : The pre-study survey reported that, for most clinicians, local or oral treatment (65.7% and 82.8%, respectively) with antibiotics or antifungals is used very often. Therefore, we proceeded to carry out an observational study. Overall, 615 (362 of fertile age and 253 in postmenopause) women were included in this study. At the 28th follow-up examination, complete resolution of symptomatology was achieved in 578/615 (94.1%; < 0.001) within 12.72 ± 6.55 and 13.22 ± 6.33 days for those of fertile age and in postmenopause, respectively ( = 0.342). All of the evaluated symptoms were significantly reduced after treatment ( = 0.001) without differences according to the patient's menopausal status. A slightly significant reduction in ( = 0.040) and ( = 0.049) was found after treatment. No patient reported side effects, adverse reactions, or discontinued therapy. : This pilot study showed that a hydrogel based on Rigenase (wheat extract) and polyhexanide could be a promising treatment for the relief of vulvovaginitis symptoms. However, these results are limited by the absence of a control group. Additional comparative and randomized controlled trials between the hydrogel and other non-antibiotic devices as well as local antibiotic therapy should be performed to increase the validity of the findings.
Topics: Female; Humans; Cross-Sectional Studies; Hydrogels; Prospective Studies; Pilot Projects; Quality of Life; Vulvovaginitis; Anti-Bacterial Agents
PubMed: 38004053
DOI: 10.3390/medicina59112004 -
Climacteric : the Journal of the... Aug 2023Genitourinary syndrome of menopause (GSM) is caused by chronic deprivation of estrogen and other sex steroids during the postmenopausal period, which leads to changes in...
Genitourinary syndrome of menopause (GSM) is caused by chronic deprivation of estrogen and other sex steroids during the postmenopausal period, which leads to changes in the vulvovaginal tissues. These changes cause bothersome symptoms, such as vaginal dryness, pruritus, dyspareunia, increased daytime urinary frequency, urgency and urinary incontinence, which have considerable negative effects on women's quality of life and sexual function. Recent studies have investigated a novel treatment approach for GSM. Pelvic floor muscle (PFM) rehabilitation, a low-cost conservative management with no side-effects, has been studied alone or in combination with other treatment modalities to reduce the signs and symptoms of GSM. The aim of this article is to discuss why PFM rehabilitation could be useful for women with GSM, how it may help improve signs and symptoms of GSM and when this treatment should be recommended.
Topics: Female; Humans; Vagina; Pelvic Floor; Quality of Life; Menopause; Postmenopause; Atrophy
PubMed: 37019140
DOI: 10.1080/13697137.2023.2194527 -
BMC Women's Health Dec 2023Infectious vaginitis is one of the most prevalent conditions affecting women of reproductive age with significant clinical consequences. Bacterial vaginosis (BV),...
BACKGROUND
Infectious vaginitis is one of the most prevalent conditions affecting women of reproductive age with significant clinical consequences. Bacterial vaginosis (BV), vulvo-vaginal candidiasis (VVC), and trichomoniasis (TV) are the main etiologies. Unfortunately, there is limited data on the prevalence and associated risk factors, especially in sub-saharan Africa. This study, thus, determined the prevalence and risk factors of infectious vaginitis among women seeking reproductive health services at a Marie-stopes health facility in urban areas of Kampala, Uganda.
METHODS
A cross-sectional study with 361 participants was conducted from July to October 2021. Data on risk factors and infection were collected via a structured questionnaire and laboratory analysis of vaginal swabs, respectively, with data analysis performed using Stata version 14.0 college station, Texas 77,845 US.
RESULTS
The ages of participants ranged from 18 to 49 years, with a mean age of 29.53 years. Overall, 58.45% were infected, of whom 33.24% had VVC, 24.93% had BV, and 0.28% had TV. Bivariate analysis revealed that women with pruritus (COR: 3.057, 95% CI: 1.940-4.819), pregnancy (COR: 4.914, 95% CI: 1.248-19.36), antibiotic use (COR: 1.592, 95% CI: 1.016-2.494), douching (COR: 1.719, 95% CI: 1.079-2.740), and multiple partners (COR: 1.844, 95% CI: 1.079-2.904) were more likely to have VVC, whereas having higher education status (University; Vocational) (COR: 0.325, 95% CI: 0.134-0.890; COR: 0.345, 95% CI: 0.116-0.905) reduced the risk. On the other hand, women with a smelly discharge (COR: 1.796, 95% CI: 1.036-3.110), IUD use (COR: 1.868, 95% CI: 1.039-3.358), and antibiotic use (COR: 1.731, 95% CI: 1.066-2.811) were more likely to have BV. Multivariable analysis identified pruritus (AOR: 2.861, 95% CI: 1.684-4.863) as the only independent predictor for VVC.
CONCLUSION
Results indicate a high prevalence of infection among these women; therefore regular screening and treatment is recommended to curb the high rate of infection. More studies on risk factors of infection are recommended.
Topics: Pregnancy; Female; Humans; Adult; Reproductive Health; Cross-Sectional Studies; Uganda; Trichomonas Vaginitis; Vaginosis, Bacterial; Candidiasis, Vulvovaginal; Reproductive Health Services; Prevalence; Health Facilities; Anti-Bacterial Agents; Pruritus
PubMed: 38114988
DOI: 10.1186/s12905-023-02835-w