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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 -
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 -
Evidence-based Complementary and... 2021This survey was designed and conducted with an aim to present data on sexual desire and activity in Chinese women.
OBJECTIVE
This survey was designed and conducted with an aim to present data on sexual desire and activity in Chinese women.
METHODS
Between October 2013 and December 2013, we surveyed 3000 women (aged 40-65 years) at Beijing No. 2 Hospital and the Yuetan Community Health Service Center using a questionnaire. The primary outcomes included determination of sexual desire in the past 4 weeks, reasons for stopping sexual activity, and postmenopausal syndrome. The secondary outcome was determination of factors for low sexual desire.
RESULTS
A total of 2400 women (mean age 54.33 ± 6.25 years; mean menopausal age 50.11 ± 3.31 years) returned the questionnaire, with 58% of women reporting lowered sexual desire and 39.3% reporting stoppage of sexual activity. Compared with the postmenopausal group, the incidence of anxiety, depressive, somatic, and vasomotor symptoms was higher in the perimenopausal group. Muscle and joint pain (45.8%) and vaginal pruritus (21.5%) were the most commonly reported menopausal and vulvovaginal symptoms, respectively. The odds of decrease in sexual desire were significantly higher with older age, menopause, presence of gynecological disease, menopausal depression symptoms, menopausal vasomotor symptoms, and vulvovaginal atrophy; only cesarean delivery (odds ratio = 0.887, =0.018) was associated with lesser reduction in sexual desire compared with the aforementioned factors.
CONCLUSION
This survey showed that a high proportion of Chinese middle-aged and old women have lowered sexual desire and activity. Lack of sexual desire is associated with multiple factors and affects the quality of life of women.
PubMed: 34122604
DOI: 10.1155/2021/6649242 -
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 -
Gels (Basel, Switzerland) Jan 2021Condyloma acuminata is an infectious disease caused by the human papilloma virus (HPV) and one of the most common sexually transmitted infections. It is manifested as...
Condyloma acuminata is an infectious disease caused by the human papilloma virus (HPV) and one of the most common sexually transmitted infections. It is manifested as warts that frequently cause pain, pruritus, burning, and occasional bleeding. Treatment (physical, chemical, or surgical) can result in erosion, scars, or ulcers, implying inflammatory processes causing pain. In this work, a biocompatible topical hydrogel containing 2% ketorolac tromethamine was developed to manage the painful inflammatory processes occurring upon the removal of anogenital condylomas. The hydrogel was physically, mechanically, and morphologically characterized: it showed adequate characteristics for a topical formulation. Up to 73% of ketorolac in the gel can be released following a one-phase exponential model. Upon application on human skin and vaginal mucosa, ketorolac can permeate through both of these and it can be retained within both tissues, particularly on vaginal mucosa. Another advantage is that no systemic side effects should be expected after application of the gel. The hydrogel showed itself to be well tolerated in vivo when applied on humans, and it did not cause any visible irritation. Finally, ketorolac hydrogel showed 53% anti-inflammatory activity, suggesting that it is a stable and suitable formulation for the treatment of inflammatory processes, such as those occurring upon chemical or surgical removal of anogenital warts.
PubMed: 33498627
DOI: 10.3390/gels7010008 -
Infectious Diseases in Obstetrics and... 2020A novel fixed-dose combination of 150 mg of econazole with 6 mg of benzydamine formulated in vaginal ovules was investigated in a randomised, double-blind,... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
A novel fixed-dose combination of 150 mg of econazole with 6 mg of benzydamine formulated in vaginal ovules was investigated in a randomised, double-blind, four-parallel group, tolerability, and pharmacokinetic Phase I study in healthy women.
METHODS
The fixed-dose combination was compared to econazole and benzydamine single-drug formulations and with placebo after daily applications for 3 consecutive days. Safety and tolerability were evaluated recording the adverse drug reactions, local and general tolerability scores, clinical laboratory assays, and vital signs. Econazole, benzydamine, and its metabolite benzydamine N-oxide pharmacokinetics were investigated after single and multiple applications.
RESULTS
Local reactions were generally absent. Pruritus and pain at the application site were infrequently reported. According to the subjects' evaluations, the overall tolerability of the ovules was rated as excellent or good. No significant effect of any treatment on laboratory parameters, vital signs, body weight, vaginal pH, or ECG was observed. Very low econazole, benzydamine, and benzydamine-N-oxide concentrations were measured in plasma, though quantifiable in almost all samples.
CONCLUSION
The tested fixed-dose combination showed a good safety profile consistently with the known tolerability of both active substances. In addition, the confirmed low bioavailability of the drugs excludes the possibility of any accumulation effects and limits the risk of undesired systemic effects. This trial is registered at ClinicalTrials.gov with the identifier NCT02720783 last updated on 07 February 2017.
Topics: Administration, Oral; Adult; Antifungal Agents; Area Under Curve; Benzydamine; Double-Blind Method; Drug Administration Schedule; Drug Combinations; Drug Delivery Systems; Econazole; Female; Healthy Volunteers; Humans; Middle Aged; Vagina; Young Adult
PubMed: 32410819
DOI: 10.1155/2020/7201840 -
European Review For Medical and... Jul 2020The aim of the study is to evaluate the efficacy and safety of hydroxytyrosol for the prevention of the vulvar vaginal candida infections recurrence. (Observational Study)
Observational Study
Efficacy and safety of oral administration of a product based on hydroxytyrosol as preventive therapy for recurrent vulvo-vaginal candidosis: a prospective observational pilot study.
OBJECTIVE
The aim of the study is to evaluate the efficacy and safety of hydroxytyrosol for the prevention of the vulvar vaginal candida infections recurrence.
PATIENTS AND METHODS
This study is a prospective observational pilot study. Eligible subjects were at least 18 years old, with at least 4 documented episodes of vulvovaginal candidiasis in the last 12 months. Patients were instructed to therapy (2 tabs daily for the first month and then 1 tab daily for 2 other months). Each capsule consists of hydroxytyrosol (HT) and other components: tea tree oil, tabebuia, juglans regia, and copper. Clinical and microbiological assessments took place at baseline and 12 weeks after. The impact on Quality of Life (QoL) was evaluated with the SF-36 and the Patient Global Impression of Improvement (PGI-I) after 3 months of treatment was calculated.
RESULTS
Sixty patients were enrolled in the study. In the last 1 year the mean number of previous infections was 5.83 ± 2.76. Forty-nine patients (83%) did not have candida episodes during 3 months of treatment. A significant reduction in clinical symptoms, vaginal signs, such as pruritus, burning and vulvar erythema (< 0.0001). The SF-36 showed a significant change (55.67±8.43 vs. 84.56±11.56, p < 0.0001) and the total success at PGI-I was reported in 54 patients (90%).
CONCLUSIONS
The HT-based product is effective and safe in preventing recurrent candida episodes and improves the quality of life and sexual function of treated women.
Topics: Administration, Oral; Adult; Antifungal Agents; Candidiasis, Vulvovaginal; Copper; Drug Combinations; Female; Humans; Middle Aged; Phenylethyl Alcohol; Pilot Projects; Plant Extracts; Prospective Studies; Quality of Life; Reinfection; Sexual Behavior; Time Factors; Treatment Outcome
PubMed: 32706082
DOI: 10.26355/eurrev_202007_21911 -
Contraception: X 2020The objective was to evaluate the contraceptive effectiveness, safety, and acceptability of a novel vaginal pH regulator over seven cycles of use.
OBJECTIVE
The objective was to evaluate the contraceptive effectiveness, safety, and acceptability of a novel vaginal pH regulator over seven cycles of use.
STUDY DESIGN
A single-arm, open-label, phase 3 study was conducted across 112 sites in the United States in sexually active 18-35-year-old women at risk of pregnancy. Women administered the study treatment ≤ 1 h before each episode of intercourse. Women recorded use of study drug, coital information, and any symptoms experienced in electronic diaries. The primary outcome was the seven-cycle cumulative pregnancy rate as calculated using the Kaplan-Meier methodology; secondary outcomes included safety. Overall satisfaction was assessed via written questionnaires.
RESULTS
A total of 1384 women were enrolled in the study from July 2017 to November 2018. Mean age was 27.7 ± 4.4 years; most women were white (69.0%). The seven-cycle cumulative pregnancy percentage was 13.7% [95% confidence interval (CI): 10.0%-17.5%], meeting the prespecified primary endpoint of having the upper bound 95% CI ≤ 21%. Most common adverse events (AEs) occurring in ≥ 2% of women were vulvovaginal burning sensation, vulvovaginal pruritus, urinary tract infection, vulvovaginal pain, mycotic infection, bacterial vaginosis, and nasopharyngitis. Of 1330 women who used the study drug at least once, fewer than 2% of women discontinued due to any AEs, and < 1% of women discontinued due to genitourinary symptoms. Overall, > 80% of women reported being "very satisfied" or "satisfied" with study treatment.
CONCLUSIONS
In this phase 3 study, the novel vaginal pH regulator demonstrated 86.3% contraceptive effectiveness, was safe and well tolerated, and was highly acceptable.
IMPLICATIONS
This novel vaginal pH regulator is a safe, nonhormonal, woman-controlled method of contraception that expands women's options.
PubMed: 32685920
DOI: 10.1016/j.conx.2020.100031 -
Anesthesiology and Pain Medicine Dec 2022Delivery pain is the most unbearable pain and can be relieved with intrathecal opioids. This study aimed to investigate the effect of intrathecal sufentanil for painless...
BACKGROUND
Delivery pain is the most unbearable pain and can be relieved with intrathecal opioids. This study aimed to investigate the effect of intrathecal sufentanil for painless delivery on labor progress and neonatal outcomes in pregnant women.
METHODS
This was a single-arm observational cohort study on 1055 pregnant women candidates for vaginal delivery with spinal analgesia referred to the Akbarabadi Hospital. First, 0.1 µg/kg of intrathecal sufentanil was used, and maternal blood pressure and maternal and fetal heart rates were recorded after analgesia. During delivery, the mothers were monitored for nausea, pruritus, motor block, apnea, urinary retention, or the possibility of an emergency cesarean section. The duration of the analgesia, the duration of the second stages of labor, and the mother's pain scores were recorded based on the Visual Analogue Scale (VAS). 1- and 5-minute Apgar scores and arterial blood gas (ABG) of the umbilical cord were also recorded.
RESULTS
The most common station was -3 for 723 women, followed by -2 for 229 women. Fifty-two women underwent cesarean section, and fetal distress was the most common reason for cesarean section (57.7%). The mean time for initiating analgesia was 5.93 ± 2.87 minutes, and the mean visual analog scale was 1.08 ± 0.16. The mean Apgar was 9.0 ± 0.47; the mean weight at birth was 2917.39 ± 449.90 gr; PH was 7.31 ± 2.03; HCO was 22.67 ± 3.08mEq/liter, and PaCo was 43.36 ± 7.06 mmHg. Regarding complications, the patients just developed itching (n = 78), and hypotension, bradycardia, apnea, and decreased consciousness were overlooked.
CONCLUSIONS
Intrathecal sufentanil is safe and efficient in painless delivery, resulting in normal Apgar and normal PH with no specific side-effect.
PubMed: 36938112
DOI: 10.5812/aapm-121297 -
Translational Pediatrics Apr 2023Vulvovaginitis is one of the most common pediatric gynecological diseases and easily causes the negative emotions for the parents. However, there are few studies on the...
BACKGROUND
Vulvovaginitis is one of the most common pediatric gynecological diseases and easily causes the negative emotions for the parents. However, there are few studies on the influence of parental anxiety and depression on children's disease and prognosis. This study aimed to analyze the risk factors of negative parental emotions and their effects on the prognosis of children, in order to improve life quality of children.
METHODS
We retrospectively analyzed 303 pediatric patients who developed bacterian vulvovaginitis from April 2017 to April 2022 based on our inclusion and exclusion criteria. The Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) were used to assess the negative emotions and binary logistic regression was used to analyze the independent risk factors for negative emotions among the parents of children with vulvovaginitis. The relationship between the prognosis of children and parents' negative emotions was analyzed by independent sample -test, and the relationship between the recovery rate of children within 2 weeks, clearance rate of urine, and parents' negative emotions was analyzed by chi-square test.
RESULTS
In our study, 44.6% of the parents showed anxiety and 35.0% showed depression. The binary logistics regression of the clinical characteristics of the children showed that vulvar pruritus [odds ratio (OR) =1.664, P=0.048], increased vaginal secretions (OR =2.289, P=0.001), vulvar ulcerations (OR =1.831, P=0.024), and so on were independent influences on the anxiety of the parents, whereas vulvar pruritus (OR =2.722, P=0.000), increased vaginal secretions (OR =1.758, P=0.041), dysuria, frequent urination (OR =1.761, P=0.040), and so on were independent influences on depression among the parents. Besides, it was found that parental negative emotions significantly prolonged the improvement of the child's prognosis.
CONCLUSIONS
Parents of children with vulvovaginitis are highly susceptible to have negative emotions due to the various clinical features of the child. The negative emotions of the parents significantly prolong the recovery time of the child. In clinical practice, adequate communication should be established with the parents of patients, and detailed education should be carried out to reduce the psychological burden of patients' parents, so as to improve the prognosis of children.
PubMed: 37181022
DOI: 10.21037/tp-23-183