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Minerva Ginecologica Dec 2019The aim of this pilot registry study was to use a standardized supplement (Lady Prelox®, Horphag Research) - including Pycnogenol®, l-arginine, L-citrulline and rose...
BACKGROUND
The aim of this pilot registry study was to use a standardized supplement (Lady Prelox®, Horphag Research) - including Pycnogenol®, l-arginine, L-citrulline and rose hip extract - to improve signs and symptoms associated with vaginal dryness in pre and post-menopausal healthy women. A group of women used only a standard management (SM) and a second group added Lady Prelox®.
METHODS
Four groups of women were included in the study. 34 pre-menopausal and 38 post-menopausal women took Lady Prelox®, four tablets daily for 8 weeks and 33 pre-menopausal women and 35 post-menopausal women served as controls.
RESULTS
No safety problems were observed with the supplement that was well tolerated. The subgroups of controls and supplemented subjects were comparable in both the pre- and post-menopausal groups. Among pre-menopausal women, results of the female sexual function index (FSFI) were significantly improved with the supplement in comparison with the control subjects' group (P<0.05). The results of the FSFI questionnaire for post-menopausal women indicated a significant improvement at 8 weeks with Lady Prelox® (P<0.05) in comparison with controls. Preclinical items (vaginal dryness, pain/discomfort during intercourse, mucus, minimal infections, presence of candida and oxidative stress) were significantly improved (P<0.05) with Lady Prelox®) in comparison to minimal changes with the SM group. These measurements included all women.
CONCLUSIONS
The effects of the supplementation with Lady Prelox® on vaginal dryness were significant. The supplement was well accepted and revealed no side effects or tolerability problems. Further studies are evaluating the effects of Lady Prelox® on other aspects of the menopausal transition that may alter the quality of life of most women in advanced age. A gentle approach with suitable dietary supplementation, represents a promising option for addressing common challenges that women experience in such conditions.
Topics: Adult; Arginine; Citrulline; Dietary Supplements; Female; Flavonoids; Humans; Middle Aged; Pilot Projects; Postmenopause; Premenopause; Quality of Life; Sexual Dysfunction, Physiological; Surveys and Questionnaires; Vagina
PubMed: 32064827
DOI: 10.23736/S0026-4784.19.04466-6 -
La Revue Du Praticien Jan 2001Vaginal dryness is one of the "little problems" that are too often, ignored. The disorder essentially manifests at the time of menopause, but can occur at other times,...
Vaginal dryness is one of the "little problems" that are too often, ignored. The disorder essentially manifests at the time of menopause, but can occur at other times, such as with oral contraception, following vaginal infection, after treatment for infection, etc. Screening for the disorder should become routine. Management should have precise objectives: cure of the infection and restablishment of the vaginal flora in order to reconstitute a natural balance. Treatment can be adapted for each patient to obtain effective and lasting results.
Topics: Contraceptives, Oral; Female; Humans; Mass Screening; Menopause; Risk Factors; Vagina; Vaginal Discharge; Vaginal Smears
PubMed: 11252940
DOI: No ID Found -
Archives of Gynecology and Obstetrics Dec 2013In a multicenter, randomized, controlled, open-label, parallel- group trial hyaluronic acid vaginal gel (Hyalofemme) was compared to estriol vaginal cream (Ovestin) in...
In a multicenter, randomized, controlled, open-label, parallel- group trial hyaluronic acid vaginal gel (Hyalofemme) was compared to estriol vaginal cream (Ovestin) in women with vaginal dryness due to various causes. A total of 144 supposedly postmenopausal women below age 70 years were randomized in a 1:1 ratio to either receive hyaluronic acid vaginal gel (5 g per application) or estriol vaginal cream (0.5 g cream per application = 0.5 mg estriol) every 3 days for a total of ten applications, respectively. Exclusion criteria included vaginal infections, conventional contraindications to estrogens, use of vaginal products other than the investigational compounds, being unmarried, pregnant, or breastfeeding. The aim of the study was to test for non-inferiority of hyaluronic acid vaginal gel compared to estriol vaginal cream. The primary efficacy end point was the percentage (%) improvement in vaginal dryness, with the secondary end points being the percentage (%) improvements in vaginal itching, burning, and dyspareunia. Efficacy was assessed by using a visual analog scale (VAS) (0-10; 0 = absent, 10 = intolerable) at baseline (V0), during telephone contact after the third administration (V1), and at the final visit after the tenth administration (V2). Safety parameters included vaginal pH, endometrial thickness, and a vaginal smear for vaginal microecosystem assessment. Adverse events were recorded according to international guidelines. 133 women completed the study. At baseline, participants' characteristics did not differ significantly. Mean age was 54 years, time since menopause was 5 years on average, and cause of menopause was mostly natural. However, mean menstrual cycle days were also reported, although according to inclusion criteria only postmenopausal women were eligible for the study. At V1, an improvement in vaginal dryness was reported by about 49 % of women using hyaluronic acid vaginal gel, and by 53 % of women using estriol vaginal cream (p = 0.31). At V2, the percentage improvement rates were 84 and 89 % (p = 0.13), respectively. Improvement rates for vaginal itching, burning, and dyspareunia at V2 were about 86, 85, and 57 % for hyaluronic acid vaginal gel, and 82, 87, and 62 % for estriol vaginal cream (p[0.05), respectively. After treatment, vaginal pH was significantly lower in estriol-treated women compared to those having received hyaluronic acid. Endometrial thickness did not differ between groups. In the majority of women, the vaginal microenvironment remained unaffected by treatment. However, the proportion of women whose abnormal vaginal microecological results became normal was higher in women using estriol vaginal cream. Adverse events (suspected to be) related to the investigational compounds were minor and included vaginal infection and genital itching. The authors concluded that hyaluronic acid vaginal gel was not inferior to estriol vaginal cream in women presenting with vaginal dryness. They suggest using hyaluronic acid vaginal gel not only as an alternative treatment to vaginal estrogens, but also to consider its general use in women presenting with vaginal dryness of any cause.
Topics: Administration, Intravaginal; Adult; Aged; Dyspareunia; Estriol; Female; Humans; Hyaluronic Acid; Middle Aged; Postmenopause; Time Factors; Treatment Outcome; Vagina; Vaginal Creams, Foams, and Jellies; Vaginal Diseases
PubMed: 24178484
DOI: 10.1007/s00404-013-3068-5 -
Dermatologic Therapy 2010With the loss of estrogen that occurs with menopause, physiologic and structural changes occur within the vulvovaginal mucosa that lead to a condition commonly called...
With the loss of estrogen that occurs with menopause, physiologic and structural changes occur within the vulvovaginal mucosa that lead to a condition commonly called atrophic vaginitis. Although mild genital changes occur in most women, 10-47% of postmenopausal women will develop one or more debilitating symptoms that include vulvovaginal dryness, dyspareunia, vulvar itching or pain, recurrent urinary tract infections, as well as abnormal vaginal discharge. Topical estrogen replacement therapies reverse these mucosal changes and are effective treatments for the symptoms of atrophic vaginitis. Vaginal moisturizers and lubricants also provide symptomatic relief for vaginal dryness and dyspareunia, respectively.
Topics: Antineoplastic Agents, Hormonal; Atrophy; Breast Neoplasms; Epithelial Cells; Epithelium; Estrogen Replacement Therapy; Estrogens; Female; Gynecological Examination; Humans; Lipids; Menopause; Selective Estrogen Receptor Modulators; Vagina; Vaginal Creams, Foams, and Jellies; Vaginitis
PubMed: 20868405
DOI: 10.1111/j.1529-8019.2010.01354.x -
Women's Health (London, England) Mar 2014Vaginal or vulvovaginal atrophy is a widespread but poorly recognized condition of peri- and post-menopausal women. It causes urogenital symptoms of dryness, reduced... (Review)
Review
Vaginal or vulvovaginal atrophy is a widespread but poorly recognized condition of peri- and post-menopausal women. It causes urogenital symptoms of dryness, reduced lubrication, itching, burning, irritable bladder symptoms and painful intercourse. This impacts quality of life and sexual health, but increases with time rather than reduces, as with most other menopausal symptoms. With early identification, treatments can improve these symptoms and reverse the physical changes. However, when embedded, bladder and sexual changes have occurred and these may be more difficult to remedy. Therefore, it is important to educate both healthcare professionals and women about these symptoms and advise on the range of interventions available.
Topics: Administration, Cutaneous; Administration, Intravaginal; Administration, Oral; Androgens; Atrophic Vaginitis; Atrophy; Dehydroepiandrosterone; Estrogen Replacement Therapy; Female; Humans; Hyaluronic Acid; Lubricants; Oxytocics; Oxytocin; Postmenopause; Selective Estrogen Receptor Modulators; Testosterone; Vulvar Diseases
PubMed: 24601810
DOI: 10.2217/whe.14.9 -
Journal of Clinical Medicine Jul 2023Hormonal vaginal therapy is an effective treatment option for women who experience vaginal symptoms related to hormonal changes. Estrogen and prasterone are widely used... (Review)
Review
Hormonal vaginal therapy is an effective treatment option for women who experience vaginal symptoms related to hormonal changes. Estrogen and prasterone are widely used as vaginal treatments, particularly for urogenital atrophy. These symptoms may include vaginal dryness, itching, burning, and pain during sexual intercourse, all of which can significantly affect a woman's quality of life. Previous studies have indicated that such treatment improves tissue elasticity, moisturizes the vagina, and can have a substantial impact on urine incontinence and vaginal microflora and decreases dyspareunia. Hormonal therapy is also useful and commonly used before vaginal surgical treatment. Prasterone is quite a new option for vaginal therapy in Poland and is mainly recommended for dyspareunia in menopausal women. The study related to prasterone therapy emphasizes its effectiveness and safety, making it advantageous to explore its beneficial impact. This paperwork aims to summarize the mechanism of action as well as the effects of both drugs and their beneficial action during vaginal treatment.
PubMed: 37510854
DOI: 10.3390/jcm12144740 -
Clinics in Dermatology 2022Female genitourinary treatments in aesthetics utilize energy-based treatments and other noninvasive modalities. These include CO and Erbium YAG lasers, radiofrequency,... (Review)
Review
Female genitourinary treatments in aesthetics utilize energy-based treatments and other noninvasive modalities. These include CO and Erbium YAG lasers, radiofrequency, high-intensity focused electromagnetic energy, hyaluronic acid injection, platelet-rich plasma, and silicone thread treatments with an objective to treat sexual dysfunction and symptoms of genitourinary syndrome associated with menopause, which include atrophic vaginitis, urinary incontinence, and vulvovaginal laxity that is characterized by vaginal dryness, thinning of the epithelium, laxity, prolapse, incontinence, dyspareunia, and increased bacterial infections. The body of evidence is growing for the use of these modalities to improve signs and symptoms of the genitourinary syndrome associated with menopause and sexual function, as well as for rejuvenating the appearance of the external female genitalia. We reviewed the currently available modalities in this rapidly advancing area of expertise.
Topics: Atrophy; Dyspareunia; Esthetics; Female; Humans; Lasers, Gas; Menopause; Syndrome; Vagina; Vaginal Diseases
PubMed: 34838658
DOI: 10.1016/j.clindermatol.2021.11.009 -
Nutrients Aug 2023Recent years have witnessed the emergence of growing evidence concerning vitamin D's potential role in women's health, specifically in postmenopausal women. This... (Review)
Review
Recent years have witnessed the emergence of growing evidence concerning vitamin D's potential role in women's health, specifically in postmenopausal women. This evidence also includes its connection to various genitourinary disorders and symptoms. Numerous clinical studies have observed improvements in vulvovaginal symptoms linked to the genitourinary syndrome of menopause (GSM) with vitamin D supplementation. These studies have reported positive effects on various aspects, such as vaginal pH, dryness, sexual functioning, reduced libido, and decreased urinary tract infections. Many mechanisms underlying these pharmacological effects have since been proposed. Vitamin D receptors (VDRs) have been identified as a major contributor to its effects. It is now well known that VDRs are expressed in the superficial layers of the urogenital organs. Additionally, vitamin D plays a crucial role in supporting immune function and modulating the body's defense mechanisms. However, the characterization of these effects requires more investigation. Reviewing existing evidence regarding vitamin D's impact on postmenopausal women's vaginal, sexual, and urological health is the purpose of this article. As research in this area continues, there is a potential for vitamin D to support women's urogenital and sexual health during the menopausal transition and postmenopausal periods.
Topics: Female; Humans; Vitamin D; Postmenopause; Vitamins; Sexual Behavior; Receptors, Calcitriol
PubMed: 37686835
DOI: 10.3390/nu15173804 -
Annals of the Rheumatic Diseases May 2019
Topics: Adult; Case-Control Studies; Female; Humans; Microbiota; Middle Aged; Premenopause; Sjogren's Syndrome; Vagina; Vaginal Diseases
PubMed: 30487150
DOI: 10.1136/annrheumdis-2018-214404 -
American Journal of Obstetrics and... Sep 2023Postmenopausal vaginal symptoms affect over 60% of women and may substantially impact a woman's quality of life. Since 2012, fractional CO laser has been suggested as a... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Postmenopausal vaginal symptoms affect over 60% of women and may substantially impact a woman's quality of life. Since 2012, fractional CO laser has been suggested as a treatment for this indication. Structural assessment of vaginal epithelium using microscopic biopsy examination has been used as a primary outcome measure and surrogate determinant of success of vaginal laser in previous clinical studies.
OBJECTIVE
This study aimed to report the effects of laser compared with sham treatment on human vaginal epithelium from postmenopausal women using microscopic examination of tissue biopsies.
STUDY DESIGN
This single-center double-blind, sham-controlled randomized controlled trial was performed in a tertiary hospital in Sydney, Australia. A total of 49 postmenopausal women who were symptomatic of at least 1 vaginal symptom (vaginal dryness, burning, itching; dyspareunia; or dryness) were randomized to either laser or sham treatment. For this nested histologic study, participants had a pre- and post-treatment vaginal wall biopsy collected. Biopsy samples were analyzed by 3 independent specialist gynecologic pathologists and categorized as Type 1 (well-estrogenized), 2 (poorly estrogenized), or 3 (combination) mucosae. Other outcomes assessed included symptom severity (visual analog scale for symptoms including most bothersome symptom, and Vulvovaginal Symptom Questionnaire) and Vaginal Health Index. Prespecified secondary analyses of data were performed. Categorical data were analyzed using the Pearson chi-square test (or Fisher exact test if <5 in any category) or related-samples McNemar test for paired nonparametric data. Nonparametric, continuous variables were assessed using Wilcoxon signed-rank test or Mann-Whitney U test, and parametric variables with t test or 1-way analysis of variance as appropriate. All analyses were performed using SPSS software version 26.0 (IBM Corp, Armonk, NY).
RESULTS
There was no significant difference in microscopic features of vaginal epithelium following laser or sham treatment (P=.20). Further subgroup analyses of age, menopause type, duration of reproductive life, time since menopause and BMI, still demonstrated no significant difference between laser and sham groups in histological category of vaginal epithelium. Microscopic features at pre-treatment vaginal biopsy were Type 1 in 27% (13/49). There was no significant difference in VAS score for overall vaginal symptom between those classified as Type 1 vs. Type 2/3 (VAS score overall: Type 1 vs. Type 2/3, (48.1 [95% CI 27.0, 69.2] vs. 61.5 [95% CI 49.8, 73.3]; P=.166).
CONCLUSION
Data from this double-blind, sham-controlled randomized controlled trial demonstrate that fractional CO laser and sham treatment have a comparable histologic effect on vaginal tissue that is not significantly different. Fractional CO laser is not significantly different from sham treatment and should not be recommended for clinical use for postmenopausal vaginal symptoms.
Topics: Female; Humans; Postmenopause; Carbon Dioxide; Quality of Life; Vagina; Vaginal Diseases; Lasers, Gas; Treatment Outcome
PubMed: 37192705
DOI: 10.1016/j.ajog.2023.05.005