Aim — to investigate receptivity of the vaginal epithelium in women with the female sexual dysfunction and hypoandrogenism.Materials and methods. The immunohistochemical investigation has been performed to define the density of androgen receptors (AR) and estrogen receptors (ER) in the distal part of the vaginal tract of women of reproductive age with hypoandrogenic provision of their hormonal background. For immunohistological examination, a biopsy of the lower third of the vaginal mucosa was taken using a dermopunch with a diameter of 3 mm in 20 women with female sexual dysfunction (FSD) and hypoandrogenism. The control group consisted of 20 women of reproductive age without FSDmanifestations and disturbances in their hormonal levels. The survey was carried out at the stage of pre-conceptional preparation. Location: Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine.Results. Immunoreactivity of ERα in the epithelium in the main and control groupswas 47.2 ± 22.2 and 86.1 ± 8.0 (p < 0.001), in the stroma — respectively 13.9 ± 16.8 and 86.1 ± 8.3 (p < 0.001), that is, immunoreactivity in the epithelium was significantly higher thanin the stroma (p < 0,01). The ERα locationin the vaginal epithelium was the samein both groups: cellsof the basal-intermediate layer along the basement membrane and the intermediate layer. No cells, expressing ERα, were detected in the surface layer. In stromal cells, ERαcontained in fibroblasts and smooth muscle cells. ERβ was found in cellsof thebasal — parabasal layer, the intermediate layer, occasionally —on the surface layerof vaginal epithelium, as well as in fibroblasts, vascular endothelium, where both nuclear andcytoplasmic staining was revealed. According to the results of immunohistochemical study of AR invagina, the proportion of AR-positive cells in healthy women was negligible (3.8 ± 2.2), that is considerably less than in patients with androgen deficiency (18.8 ± 8.3) and compared withother receptors. AR were localized mainly in the basal layer alongbasement membrane. Single AR-positive fibroblasts occurred in the stroma.Conclusions. Estrogen receptors α (ERα) are involved in the regulation of the processes of proliferation and differentiation of the vaginal epithelium under the influence of estrogen, as evidenced by a 1.8-fold increase in the density of stained ERα in women of the control group. The absence of correlations between ЕRα and ЕRβ receptors (r = 0.24; p < 0.05) may indicate the ability to change in the same tissue depending on the strength of estrogen effects on the body of a woman. Topical localization of androgen receptors in the basal layer testifies in favour of the safe use of local formsof androgensto overcome the reduced lubrication.
The Effectiveness of Psycho-Educational and Cognitive-Behavioral Counseling on Female Sexual Dysfunction
