Menstrual toxic shock syndrome (TSS) is a severe, fatal, superantigen toxin‑mediated illness, which leads to multiorgan system failure early in its course. At the time of writing, there are no local data available on menstrual cup‑associated TSS. Reported is a 30‑year‑old healthy Filipino, diagnosed as a case of menstrual cup‑associated TSS. Diagnosis was confirmed by case definition criteria and supported by vaginal discharge culture of methicillin‑resistant Staphylococcus aureus. The patient was treated empirically with antibiotics that led to successful treatment outcomes with no recurrence. At present, when women empowerment is of utmost importance, we support women’s decisions pertaining to their health, including their choice of menstrual hygiene products. This case is reported to raise awareness, promote wellness and safety among menstrual cup users and to educate clinicians on the course and management of menstrual cup associated toxic shock syndrome to prevent its catastrophic sequelae.
Menstrual Hygiene Products ; Shock, Septic

The majority of South Korean females use sanitary pads, which contain various organic solvents which could be excreted before and during their menstruation. However, they are not provided with findings from studies about the health effects of sanitary pads. Therefore, this study aims to establish a list of potential health hazards of sanitary pads and address the need for further extensive research by pointing out the limitations of the previous literature. A systematic review was adopted to conduct quantitative and qualitative reviews based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses). Studies from electronic databases such as PubMed, RISS, and Google Scholar were retrieved for the final analyses. In accordance with our findings, we proposed a set of limitations of the previous studies. A systematic review revealed that there were effects of sanitary pads on vaginal or vulvar skin, endometriosis, and vaginal microflora. The review also revealed that organic solvents, which sanitary pads are composed of, bring potential harmful effects on pregnancy, autoimmune disease, cardiovascular disease, and neurological development. Social environments such as hygiene use or puberty education also turned out to affect female health. It was inferred that a lack of non-occupational and domestic studies reflecting the distinguishing features of sanitary pads with a reliable sample size remains as an important limitation. This study suggests that organic solvents in sanitary pads may increase some health risks bringing reproductive, autoimmune, cardiovascular, and neurological effects. Due to a lack of studies, a more extensive study can contribute to the public health of South Korean females.
Adolescent ; Autoimmune Diseases ; Cardiovascular Diseases ; Education ; Endometriosis ; Female ; Humans ; Hygiene ; Menstrual Hygiene Products ; Menstruation ; Pregnancy ; Puberty ; Public Health ; Sample Size ; Skin ; Social Environment ; Solvents

OBJECTIVES: Although vaginal estrogen is highly effective in alleviating genitourinary symptoms of menopause (GSM), some women are reluctant to use hormonal treatment. Our aim was to evaluate the effect of a zinc-containing vaginal moisturizer gel on GSM. METHODS: Women with GSM were enrolled. Patients were asked to use the vaginal gel daily for 2 weeks. Vaginal Health Index (VHI) was calculated. Visual analogue scale (VAS) was obtained on vaginal pain, dryness, burning, itching, dyspareunia and dysuria before and 2 weeks after the completion of treatment. Vaginal cytology was obtained. Vulvovaginal symptom questionnaire (VSQ-21) was used to assess subjective symptoms. RESULTS: Thirty-seven women with GSM participated in the study. The VHI improved significantly (mean ± standard deviation, 13 ± 4 before vs. 17 ± 4 after treatment, P < 0.01). The patient reported VAS combined score was significantly lower after the treatment (18 ± 14 before vs. 7 ± 12 after treatment, P < 0.01). The largest improvement occurred in vaginal dryness. The maturation value did not change significantly. There were no signs of inflammation on vaginal cytology. VSQ-21 combined scores also improved significantly (7.9 ± 5.5 before vs. 2.7 ± 3.6 after the intervention, P < 0.01). Side effects were rare and minor. CONCLUSIONS: Novel zinc-containing vaginal moisturizer gel significantly improves postmenopausal vulvovaginal symptoms without serious side effects.
Burns ; Dyspareunia ; Dysuria ; Estrogens ; Female ; Humans ; Inflammation ; Menopause ; Pilot Projects ; Pruritus ; Vagina ; Vaginal Creams, Foams, and Jellies ; Zinc

PURPOSE: The purpose of this study was to investigate the status of use of menstrual hygiene products and genital organ hygiene management in unmarried women. METHODS: Data from 161 unmarried women were used for analysis. The instruments consisted of self-reported questionnaires that included 40 items: 20 on General Characteristics & Sexual Health Related Characteristics, 8 on Using Status of Menstrual Hygiene Products, 12 on Genital Organ Hygiene Management. RESULTS: The subjects used disposable sanitary napkin as the most frequently but the satisfaction was low, while the use of reusable sanitary napkin and tampons were few, but satisfaction was high. Sixty-seven percent of the unmarried women had sex experience, and more than 60% experienced abnormal symptoms in the genital organ. There was a significant difference in genital organ hygiene management according to sex experience. Among subjects of this study, 44.1% wanted to use menstrual cup, and 98.8% wanted to have education for their menstrual hygiene products. CONCLUSION: Based on results of this study, a nationwide survey of the demand for menstrual hygiene products used by Korean women is needed, it is necessary to educate about the proper use of menstrual hygiene products and genital organ hygiene management.
Education ; Female ; Genitalia* ; Humans ; Hygiene* ; Menstrual Hygiene Products* ; Menstruation ; Reproductive Health ; Single Person*

OBJECTIVE: To determine whether four (4) feminine hygiene wash products maintain normal vaginal pH and are acceptable among reproductive and menopausal age women.

METHODS: A randomized, double blind, three-period, three-way crossover trial on 90 reproductive age women and 30 menopausal women measuring external and internal vaginal pH levels and product acceptability after using different feminine wash for 3 weeks.

RESULTS: There were significant differences in mean change in internal vaginal pH values among the three feminine wash products (p=0.0392) in the reproductive age group. Majority of the subjects expressed 'extreme satisfaction' on the different features of the products. In the menopausal age group, there was a statistically significant difference in mean pH change in the external genitalia (p=0.0279). Feminine Wash 4 appeared to be most acceptable.

CONCLUSION: Using feminine wash may help maintain vaginal pH levels within the physiologic range thus prevents vaginal infections. Good acceptability of use among the subjects implies good compliance and therefore, a practice that can be adopted on a long-term basis as part of a woman's good hygienic practice.

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

Preterm birth (PTB) is one of the most common complications during pregnancy and it primarily accounts for neonatal mortality and numerous morbidities including long-term sequelae including cerebral palsy and developmental disability. The most effective treatment of PTB is prediction and prevention of its risks. Risk factors of PTB include history of PTB, short cervical length (CL), multiple pregnancies, ethnicity, smoking, uterine anomaly and history of curettage or cervical conization. Among these risk factors, history of PTB, and short CL are the most important predictive factors. Progesterone supplement therapy is one of the few proven effective methods to prevent PTB in women with history of spontaneous PTB and in women with short CL. There are 2 types of progesterone therapy currently used for prevention of PTB: weekly intramuscular injection of 17-alpha hydroxyprogesterone caproate and daily administration of natural micronized progesterone vaginal gel, vaginal suppository, or oral capsule. However, the efficacy of progesterone therapy to prevent PTB may vary depending on the administration route, form, dose of progesterone and indications for the treatment. This review aims to summarize the efficacy and safety of progesterone supplement therapy on prevention of PTB according to different indication, type, route, and dose of progesterone, based on the results of recent randomized trials and meta-analysis.
Cerebral Palsy ; Conization ; Curettage ; Developmental Disabilities ; Female ; Humans ; Infant ; Infant Mortality ; Injections, Intramuscular ; Pregnancy ; Pregnancy, Multiple ; Premature Birth* ; Progesterone* ; Risk Factors ; Smoke ; Smoking ; Suppositories ; Vaginal Creams, Foams, and Jellies

OBJECTIVE: The objective of this study is to estimate the effects of Inclear, a feminine cleanser, on sperm motility. METHODS: Semen samples were obtained from infertile male patients. Following liquefaction, the raw semen samples were diluted with Ham's F-10 nutrient mixture medium containing 0.4% human serum albumin solution at a ratio of 1:3. The semen samples were subsequently centrifuged to separate the seminal plasma from the serum. The supernatant was discarded, and the pellet was resuspended. The sample was again centrifuged to remove cell debris, and the supernatant was removed. The final pellet was gently loosened by resuspension and incubated in medium alone as a control, and in a 10% solution of the medium plus Inclear. A sampling time of 30 minutes was selected on the basis of sperm transport studies. Sperm motility was evaluated with computer-assisted sperm analysis. RESULTS: A total of 20 samples were analyzed. The mean age of patients was 34.40+/-2.96 years. There was no difference in sperm concentration and motility in the two samples at 0 minute and 30 minutes of incubation. In both semen samples, the sperm concentration and motility decreased after an incubation period of 30 minutes. However, there was no statistical difference between the samples. Sperm concentration and motility were not significantly different between the control and Inclear samples after 0 minute and 30 minutes of incubation. CONCLUSION: Inclear has no negative effects on sperm motility. This product can be recommended to pregnancy planners for vaginal hygiene and as a vaginal lubricant.
Feminine Hygiene Products ; Humans ; Hygiene ; Lubricants ; Male ; Pregnancy ; Prospective Studies* ; Semen ; Serum Albumin ; Sperm Motility* ; Sperm Transport ; Spermatozoa

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

PURPOSE: In this study the impact of pro-environmental behavior, well-being oriented behavior, and use of cloth menstrual pads on dysmenorrhea in Korean female adults was examined according to the theory of reasoned action. METHODS: A cross-sectional study was conducted with 195 Korean female adults. Data were collected from June to August, 2010 using self-report questionnaires. Data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficients, multiple regression, and logit regression with STATA 10.0. RESULTS: Pro-environmental behavior explained 48% of well-being oriented behavior. Well-being oriented behavior explained 10% of cloth pad use. Use of cloth pad explained 4% of dysmenorrhea and 5% of menstrual pain. The path through well-being oriented behavior had a significant effect from pro-environmental behavior to cloth pad use. CONCLUSION: Use of cloth pad was significantly related with well-being oriented behavior, pro-environmental behavior, social influence, dysmenorrhea, and menstrual pain. The results of this study suggest that pro-environmental strategies can help health care providers diminish clients' menstrual symptoms. Nursing intervention can support pro-environmental behavioral strategies.
Adult ; Age Factors ; Cross-Sectional Studies ; Dysmenorrhea/*psychology ; Environment ; Female ; Humans ; Menstrual Hygiene Products ; Middle Aged ; Questionnaires ; Socioeconomic Factors