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

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

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

OBJECTIVES: The aim of this study was to assess atrophic symptoms, the vaginal maturation index (VMI), and vaginal pH in postmenopausal women after use of estriol vaginal tablets for the treatment of vaginal atrophy. METHODS: In a randomized prospective study, 67 postmenopausal women were treated with 500microg estriol tablets 3 times a week for 1 week in the 1-week treatment group (n = 40) and for 2 weeks in the 2-week treatment group (n = 27). The primary endpoints were changes in the VMI, vaginal pH, and improvement in participant-reported most bothersome symptom (MBS; vaginal dryness, irritation/itching, or dyspareunia). We compared three endpoints before and after treatment in each group and between the two treatment groups. The correlation between the vaginal pH and maturation value (MV) was assessed. RESULTS: A statistically significant increase in the MV, decrease in pH, and improvement in the MBS occurred for women treated with estriol vaginal tablets in the 1- (P = 0.000, P = 0.002, and P = 0.000, respectively) and 2-week treatment groups (P = 0.000, P = 0.000, and P = 0.000, respectively). There were no significant differences between the 1- and 2-week treatment groups with respect to improvement in the VMI, vaginal pH, or MBS. The correlation between the vaginal pH and MV showed a negative linear correlation at 0, 1, and 2 weeks (P = 0.000, P = 0.000, and P = 0.011, respectively). CONCLUSION: Treatment with 500microg estriol vaginal tablets thrice-weekly for 1 week was effective in improving. It is thought that the three primary endpoints (VMI, vaginal pH, and MBS) improved at the same time during treatment.
Estriol ; Estrogens ; Female ; Humans ; Hydrogen-Ion Concentration ; Prospective Studies ; Tablets ; Vaginal Creams, Foams, and Jellies

OBJECTIVE: The purpose of this study is to evaluate the effect of Vitamin-C vaginal tablets on vaginal pH and vaginitis symptoms of pregnant women. METHODS: Ninety pregnant women who visited the antenatal clinic were included in this study after giving their informed consent. The treatment regimen of the vitamin-C vaginal tablets (250 mg, Vagi-C(R), Taurus Pharma GmbH, Germany) was one tablet given once a day for 6 consecutive days. Vaginal pH was measured the day before and the day after the Vit-C vaginal treatment. Ninety women of initial, ten failed to follow-up (participate). After routine screening using microscopic analysis of the vaginal smears, 31 of the 80 participating women fell into one of 3 pathologic groups (15 monilial infection, 10 bacterial vaginosis, 6 trichomonial infection) and leaving 49 pathogen-free pregnant women. 10 of the pathogen-free pregnant women were excluded during the study because they did not complete the treatment period due to vaginal irritation such as itching or burning sensations. The diagnosis of each vaginal infection was made by specific pathologic findings. RESULT: Mean vaginal pH values for the pathology group decreased significantly from 4.9 to 4.2. Pathologic findings of each infection were also improved without specific treatment. Bacterial vaginosis disappeared in 80.0% (8/10) of patients. The specific pathogens of the remained two vaginitis types were not detected in 33.3% (5/15) of monilial infection and 33.3% (2/6) trichomonial infection 1 week after discontinuation of Vitamin-C vaginal tablets. Although it is not significant, mean vaginal pH values decreased from 4.4 to 4.2 in the pathogen-free pregnant women. CONCLUSION: Vitamin-C, when vaginally applied, is effective in lowering vaginal pH and in the treatment of vaginitis in pregnant women.
Burns ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hydrogen-Ion Concentration ; Informed Consent ; Mass Screening ; Pathology ; Pregnancy* ; Pregnant Women* ; Pruritus ; Sensation ; Vaginal Creams, Foams, and Jellies* ; Vaginal Smears ; Vaginitis* ; Vaginosis, Bacterial

Inflammation; Genital Diseases, Female ;Vaginal Creams, Foams, and Jellies; drugs; CTK vaginal tablet’s antibacterial effect was evaluated in vitro through the determination of minimal inhibition effect of this tablet in various strains of E.coli and S.aureus subchronical toxicity and effect of this medicament on the tissue were investigated. Results showed that CTK in 1/150 solution is capable to inhibite completely the growth of S.aureus, and in 1/100 solution to E.coli. In applying into rabbit vagina CTK made vaginal pH decreased. CTK dose of 0.05-0.06 g/kg did not influence on blood white cell counts, red cell counts, platelet counts and Hb level in rabbit. CTK did not influence on SGOT, SGPT enzyme activity, improving the content of albumin and of cholesterol of the rabbit
Inflammation ; Genital Diseases, Female ; Vaginal Creams, Foams, and Jellies ; drugs

BACKGROUND: To the best of our knowledge, there has been no any report on the antibiotic susceptibility profile of Gardnerella vaginalis, determined in domestic area by the agar dilution method. Therefore, we studied on 49 strains of G. vaginalis by the agar dilution method. METHODS: One standard strain (ATCC 14018) and Forty-eight strains isolated from patients with increased vaginal discharge were included in this study. Columbia agar base containing 1% proteose peptone No. 3 was supplemented with horse serum (5%) and human erythrocyte lysate (5%) which was prepared by a new method, and this medium was used for the antibiotic susceptibility test. RESULTS: The MICs90 of clindamycin and ciprofloxacin were 0.3 g/mL and 0.6 g/mL, respectively. Amoxicillin, cefazolin, doxycycline, and erythromycin were hardly effective against most strains of G. vaginalis (NCCLS, U.S.A., 2001). Especially, MICs90 of both metronidazole and tinidazole were 80 g/ mL under micro-aerobic condition of 5% O2. CONCLUSION: For the treatment of Bacterial vaginosis, it is suggested that clindamycin or ciprofloxacin should be combined with vaginal tablet or gel of metronidazole rather than single administration of metrondazole or tinidazole.
Agar* ; Amoxicillin ; Cefazolin ; Ciprofloxacin ; Clindamycin ; Doxycycline ; Drug Resistance ; Erythrocytes* ; Erythromycin ; Gardnerella vaginalis* ; Gardnerella* ; Horses* ; Humans* ; Metronidazole ; Peptones ; Tinidazole ; Vaginal Creams, Foams, and Jellies ; Vaginal Discharge ; Vaginosis, Bacterial

BACKGROUND: To the best of our knowledge, there has been no any report on the antibiotic susceptibility profile of Gardnerella vaginalis, determined in domestic area by the agar dilution method. Therefore, we studied on 49 strains of G. vaginalis by the agar dilution method. METHODS: One standard strain (ATCC 14018) and Forty-eight strains isolated from patients with increased vaginal discharge were included in this study. Columbia agar base containing 1% proteose peptone No. 3 was supplemented with horse serum (5%) and human erythrocyte lysate (5%) which was prepared by a new method, and this medium was used for the antibiotic susceptibility test. RESULTS: The MICs90 of clindamycin and ciprofloxacin were 0.3 g/mL and 0.6 g/mL, respectively. Amoxicillin, cefazolin, doxycycline, and erythromycin were hardly effective against most strains of G. vaginalis (NCCLS, U.S.A., 2001). Especially, MICs90 of both metronidazole and tinidazole were 80 g/ mL under micro-aerobic condition of 5% O2. CONCLUSION: For the treatment of Bacterial vaginosis, it is suggested that clindamycin or ciprofloxacin should be combined with vaginal tablet or gel of metronidazole rather than single administration of metrondazole or tinidazole.
Agar* ; Amoxicillin ; Cefazolin ; Ciprofloxacin ; Clindamycin ; Doxycycline ; Drug Resistance ; Erythrocytes* ; Erythromycin ; Gardnerella vaginalis* ; Gardnerella* ; Horses* ; Humans* ; Metronidazole ; Peptones ; Tinidazole ; Vaginal Creams, Foams, and Jellies ; Vaginal Discharge ; Vaginosis, Bacterial

OBJECTIVE: To compsre the efficiency, success rate, and abortion time of applications of intravaginal misoprostol versus prostaglandin E2 vaginal tablet for mid-trimester pregnancy termination Subjects and methods: Eighty four patients between 17-29 weeks of gestation with medical, obstetric, or genetic reasons far termination were randomized to receive either 50 ug tablets of misoprostol placed in the posterior vaginal fornix or prostaglandin E2 3mg in tables placed into the endocervix. RESULTS: Among eighty four patients recruited, fourty five patients received misoprostol and thirty nine patients received prostaglandin E2 vaginal tablets. The average interval hom start of induction to vaginal delivery was 13.35 +/- 3.34 hours in misoprostol poup and 19.14 +/- 10.64 hours in the prostaglandin E2 group. The success rate of complete termination within 12 and 24 hours in misopr-ostol group were 57.7%, 93.3%, respectively, while in prostaglandin E2 group were 20.5%, 82.1% repectively. Oxytocin augumentation was 6.7% in misoprostol group and 17.9% in the prostaglardin E2 group. No serious complication occumd. CONCLUSION: Intracervicovaginal misoprostol appears to be acceptably safe and effective agents for second trimester pregnancy termination. The abortion time is less in misoprostol group than those in the prostaglandin E2 group. Misoprostol has the advantage of being expensive, easily stored and readily available. We used 50 ug tablets of misoprostol every four hours. But, we suspect that the regimen of 100ug misopostol inserted intracervico-vaginally every eight hours will beis the proper and optimal method for pregnancy termination.
Dinoprostone* ; Female ; Humans ; Misoprostol* ; Oxytocin ; Pregnancy Trimester, Second ; Pregnancy* ; Tablets ; Vaginal Creams, Foams, and Jellies*