OBJECTIVE: The aim of this study was to analize the biologic and molecular genetic characteristics of Lactobacillus spp. isolated from vagina of Korean healthy women and to perform a pilot clinical study on the treatment of vaginitis using the best Lactobacillus strain KLB 46. METHODS: Vaginal specimens were obtained from 205 Korean women with healthy vaginal ecosystems. 155 lactobacillus strains were used for catalase test, cell surface hydrophobicity (CSH) test and antimicrobial activity test. Also we identified the species prevalence by PCR-RFLP analysis of 16S rDNA gene and performed the minimal inhibitory concentrationtest using14 antibiotics to determine their patterns of antibiotic susceptibility. A pilot clinical trial of 8 bacterial vaginosis, 1 trichomonas vaginitis and 6 atrophic vaginitis using Lactobacillus crispatus KLB 46 was done by vaginal instillation (10(10)-10(11) cells/mL). RESULTS: 155 lactobacilli strains were isolated and all isolates showed high CSH and 61% of the isolates had higher CSH. L. acidophilus and L. crispatus were the most prevalent species by PCR-RFLP analysis of their 16S rDNA gene. And PCR-RFLP analysis suggested that KLB 46 was L. crispatus. The clinical study showed that the vaginal epithelial adherence rate was high as 77% for bacterial vaginosis and 33.3% for atrophic vaginitis. CONCLUSION: The predominating lactobacilli were L. crispatus and L. acidophilus in Korean women's vaginas. Although further study would be needed, L. crispatus KLB 46 is a good candidate of suitable probiotics for bacterial vaginosis.
Administration, Intravaginal ; Anti-Bacterial Agents ; Atrophic Vaginitis ; Catalase ; DNA, Ribosomal ; Ecosystem ; Female ; Humans ; Hydrophobic and Hydrophilic Interactions ; Lactobacillus* ; Molecular Biology* ; Prevalence ; Probiotics ; Trichomonas Vaginitis ; Vagina* ; Vaginitis* ; Vaginosis, Bacterial

The genitourinary syndrome of menopause (GSM) is a new term that describes various menopausal symptoms and signs including not only genital symptoms (dryness, burning, and irritation), and sexual symptoms (lack of lubrication, discomfort or pain, and impaired function, but also urinary symptoms (urgency, dysuria, and recurrent urinary tract infections). The terms vulvovaginal atrophy and atrophic vaginitis, which were generally used until recently, had a limitation because they did not cover the full spectrum of symptoms and did not imply that the symptoms are related to a decreased estrogen level in menopause. Since the GSM may have a profound negative impact on the quality of life of postmenopausal women, women should be made aware of these problems and treated with an appropriate effective therapy. Thus, in this review we introduce new terminology and discuss the importance of comprehension of GSM and the necessity of active treatment of this syndrome in postmenopausal women.
Atrophic Vaginitis ; Atrophy ; Burns ; Comprehension ; Dysuria ; Estrogens ; Female ; Humans ; Lubrication ; Menopause* ; Quality of Life ; Urinary Tract

OBJECTIVES: The present meta-analysis aimed to assess the effect of the herbal medicine on the vaginal epithelial cells (VECs) among the menopausal subjects. METHODS: The literature related to VECs exposed to various herbal medicines in menopausal women were searched on three databases, MEDLINE (1966–August 2017), Scopus (1990–August 2017) and Cochrane Library (Cochrane Central Register of Controlled Trials; 2014). RESULTS: Totally, the meta-analysis was conducted on 11 randomised controlled trials. Based on the findings, the standardized mean difference (SMD) of maturation value (MV) was observed to be elevated by 0.48% (95% interval confidence [CI], 0.108–0.871; P = 0.012), as well as the heterogeneity was high (I2 = 84%; P < 0.001). The MV revealed a significant increase in soy group (SMD, 0.358; 95% CI, 0.073–0.871; P = 0.014) compared to the control group. CONCLUSIONS: The herbal medicines exhibited a statistically significant effect on the VECs. A significant effect on the VECs was also found in the subgroup analysis of the patients, who received soy. However, further and extensive studies are required to achieve reliable outcomes.
Atrophic Vaginitis ; Epithelial Cells ; Female ; Herbal Medicine ; Humans ; Menopause ; Phytoestrogens ; Population Characteristics

OBJECTIVES: To see the effect of dietary administration of omega 3-fatty acid formula on the vaginal cells of postmenopausal rats. METHODS: Three-week-old female Wistar/ST rats were raised after one week of adjustment period. The rats were then divided into three groups, for three different kinds of diet; general diet, 1% omega-3 fatty acid diet, and 2% omega-3 fatty acid diet. After eight weeks of having assigned diet, after the oophorectomy, with the same diet previously they had Immunohistochemistry, Immunofluorescence, and Western Blot about ezrin, merlin were done. RESULTS: In immunohistochemistry, estrogen injection group revealed thicker and well differentiated features. In Immunofluorescence, Omega-3 fatty acid composition in diet did not effect expression of ezrin and merlin in rat vagina in estrogen injection group, their vaginal epithelium showed full layers (from basal to apical layer). In Western Blot analysis, Omega-3 fatty acid composition in diet did not affect expression of ezrin and merlin in rat vagina estrogen presented significant impact on expression of ezrin and merlin. CONCLUSION: Although omega-3 fatty acid composition changed in diet, vaginal epithelial morphology unchanged. Estrogen did effect on vagina cell, but omega-3 fatty acid did not effect on ezrin and merlin in vagina.
Animals ; Atrophic Vaginitis ; Blotting, Western ; Diet ; Epithelium ; Estrogens ; Female ; Fluorescent Antibody Technique ; Humans ; Immunohistochemistry ; Neurofibromin 2 ; Ovariectomy ; Rats* ; Vagina*

OBJECTIVES: Atrophic 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. METHODS: We 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. RESULTS: Meta-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. CONCLUSIONS: This 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.
Atrophic Vaginitis ; Dyspareunia ; Female ; Hand ; Hormone Replacement Therapy ; Humans ; Hydrogen-Ion Concentration ; Postmenopause ; Treatment Outcome ; Vagina ; Vaginal Creams, Foams, and Jellies

OBJECTIVES: The objective of this study was to assess the clinical characteristics of postmenopausal women who were admitted to the emergency room. METHODS: This study was conducted at a university hospital. The retrospective study of medical records comprised 26 patients who were admitted to the emergency room, between September 2010 and August 2011. RESULTS: The age of the twenty-six patients was 51-90 years. Abdominal pain and vaginal bleeding were the main complaints. The final diagnoses were 6 cases of postmenopausal atrophic vaginitis, 6 cases of ovarian cyst, 5 cases of pelvic inflammation disease, 3 cases of post-conization bleeding, 1 case of menopausal symptoms, 1 case of atrophic endometrium, 1 case of uterine prolapse, 1 case of pyometra, and acute pyeolonephritis with stone. Among the 6 cases of ovarian cyst, 5 cases performed an operation. Pathologic findings revealed 2 cases of simple cyst, 1 case of paratubal cyst, 1 case of teratoma, and 1 case of granulosa cell tumor. CONCLUSION: The incidence of post-menopausal distress in women is increasing, and the numbers of post-menopausal women being admitted to the emergency room are also increasing, so attention needs to be paid to the case of postmenopausal women in the future.
Abdominal Pain ; Atrophic Vaginitis ; Emergencies ; Endometrium ; Female ; Granulosa Cells ; Hemorrhage ; Humans ; Incidence ; Inflammation ; Medical Records ; Menopause ; Ovarian Cysts ; Parovarian Cyst ; Pyometra ; Retrospective Studies ; Teratoma ; Uterine Hemorrhage ; Uterine Prolapse

Aged ; Atrophic Vaginitis ; drug therapy ; Capsules ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Middle Aged ; Suppositories ; administration & dosage ; Treatment Outcome

Because sex hormones influence the lower urinary tract, menopause can cause several urinary diseases including overactive bladder, stress urinary incontinence and recurrent urinary tract infection. However, the results of many clinical studies have indicated that menopausal hormone replacement therapy is not effective for the treatment of previous diseases, especially via the oral route. Although estrogen vaginal cream or pessary is an effective treatment for overactive bladders and can prevent recurrent urinary tract infection, its beneficial effects only last for the duration of the treatment. If patients with previous mentioned urologic disease have other local symptoms and conditions, such as atrophic vaginitis and dyspareunia, local estrogen replacement therapy will be helpful in relieving the local symptoms. However, the potential for breast cancer or return of withdrawal of bleeding, patient's age, adverse effect of systemic administration, estrogen-progesterone combination therapy, and effectiveness among other treatment modalities must be considered before a treatment decision can be made. In this article, we will review the current issues on the relationship among urinary tract and sex hormone and menopause, and the effectiveness of menopausal hormone replacement therapy for the treatment of overactive bladders, stress urinary tract incontinence and recurrent urinary tract infection.
Atrophic Vaginitis ; Breast Neoplasms ; Dyspareunia ; Estrogen Replacement Therapy ; Estrogens ; Female ; Gonadal Steroid Hormones ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Menopause ; Pessaries ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Urologic Diseases ; Vaginal Creams, Foams, and Jellies

This study investigated the prevalence and risk factors of urinary incontinence (UI) among perimenopausal women in Wuhan. A cross-sectional survey was performed on 1067 women aged 40-65 years sampled in Wuhan urban area from April to October 2014. Information about demographic characteristics, menstruation, parity and UI symptoms was collected using a questionnaire. The data were evaluated by Chi-square test and multiple Logistic regression analysis. The prevalence rate of UI was 37.2%, with stress UI (32.2%) being more prevalent than urgency UI (21.6%) and mixed UI (16.6%). 31.2% women with UI stated that UI had negative impact on their life. Risk factors for UI included menstrual disorder, menopause, overweight, perineal laceration, atrophic vaginitis, constipation and pelvic organ prolapse. Appropriate investigation apropos the factors associated with UI should be performed to diminish its impact on women's life.
Adult ; Aged ; Atrophic Vaginitis ; epidemiology ; physiopathology ; Constipation ; epidemiology ; physiopathology ; Female ; Humans ; Lacerations ; epidemiology ; physiopathology ; Menstrual Cycle ; physiology ; Middle Aged ; Overweight ; epidemiology ; physiopathology ; Pelvic Organ Prolapse ; epidemiology ; physiopathology ; Perimenopause ; physiology ; Pregnancy ; Risk Factors ; Surveys and Questionnaires ; Urinary Incontinence ; epidemiology ; physiopathology