scholarly journals Association of Vaginal Microbiota With the Genitourinary Syndrome of Menopause Across Reproductive Stages

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 171-171
Author(s):  
Michelle Shardell ◽  
Patti Gravitt ◽  
Jacques Ravel ◽  
Anne Burke ◽  
Rebecca Brotman
Keyword(s):  
Relative Abundance ◽  
Female Genital Tract ◽  
Signs And Symptoms ◽  
Vaginal Microbiota ◽  
Genitourinary Syndrome Of Menopause ◽  
Vaginal Dryness ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Genitourinary Syndrome ◽  
Lactobacillus Spp

Abstract The genitourinary syndrome of menopause (GSM) is a collection of signs and symptoms related to estrogen decline that involves physical changes to the vulva, vagina, and lower urinary tract. GSM signs and symptoms may occur during any reproductive stage but are most common during menopause. Vaginal microbiota, particularly Lactobacillus spp., protect the female genital tract from multiple conditions; however, Lactobacillus spp. abundance declines during menopause. We aimed to determine the longitudinal association of vaginal microbiota with GSM signs and symptoms across reproductive stages. In a two-year cohort study comprising 750 women aged 35-60 years who contributed 2111 semiannual person-visits, low-Lactobacillus spp. vaginal microbiota communities were observed at 21.2% (169/798), 22.9% (137/597), and 49.7% (356/716) of person-visits among pre-, peri-, and post-menopausal women, respectively (p<.001). After covariate adjustment, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were associated with vulvovaginal atrophy relative to high-Lactobacillus spp. communities dominated by L. crispatus (OR[Odds Ratio]=3.04, 95% Confidence Interval[CI]=1.02-9.06) among post-menopausal, but not among peri- or pre-menopausal women. Also, post-menopausal women with low-Lactobacillus spp. communities reported decreased libido (OR=1.79, 95%CI=1.04-3.12) and vaginal dryness (OR=1.61, 95%CI=0.89-2.90) more frequently than their counterparts with high-Lactobacillus spp. communities, but not among peri- or pre-menopausal women (p for interaction<.05). Specifically, low-Lactobacillus spp. communities characterized by high Atopobium and Megasphaera relative abundance were related to both decreased libido (OR=2.82, 95%CI=1.11-7.14) and vaginal dryness (OR=3.50, 95%CI=1.18-10.44) compared with high-Lactobacillus spp. communities dominated by L. gasseri/L. jensenii. Vaginal microbiota, particularly Lactobacillus spp., and menopause may synergistically influence GSM.

Association of Vaginal Microbiota with Signs and Symptoms of the Genitourinary Syndrome of Menopause across Reproductive Stages

2021 ◽  
Author(s):  
Michelle Shardell ◽  
Patti E Gravitt ◽  
Anne E Burke ◽  
Jacques Ravel ◽  
Rebecca M Brotman
Keyword(s):  
Postmenopausal Women ◽  
Female Genital Tract ◽  
Premenopausal Women ◽  
Signs And Symptoms ◽  
Amplicon Sequencing ◽  
Vaginal Microbiota ◽  
Gardnerella Vaginalis ◽  
Rrna Gene ◽  
Genitourinary Syndrome Of Menopause ◽  
Genitourinary Syndrome

Abstract The genitourinary syndrome of menopause (GSM) describes signs and symptoms resulting from effects of estrogen deficiency on the female genitourinary tract, including the vagina, labia, urethra, and bladder. Signs/symptoms associated with GSM may occur during any reproductive stage from multiple etiologies but are most common during menopause due to low estrogen. Vaginal microbiota, particularly Lactobacillus spp., are beneficial to the female genital tract; however, their abundance declines during menopause. We aimed to longitudinally assess vaginal microbiota characterized by 16S rRNA gene amplicon sequencing and GSM-associated endpoints across reproductive stages. In a two-year cohort study of 750 women aged 35-60 years at enrollment and 2,111 semiannual person-visits, low-Lactobacillus vaginal microbiota communities were observed at 21.2% (169/798), 22.9% (137/597), and 49.7% (356/716) of person-visits among pre-, peri-, and postmenopausal women, respectively (p<.001). Compared to communities that have high Gardnerella vaginalis relative abundance and diverse anaerobes, the following communities were associated with a lower covariate-adjusted odds of vaginal atrophy: L. crispatus-dominated communities among postmenopausal women (odds ratio[OR]=0.25; 95% confidence interval[CI], 0.08, 0.81), L. gasseri/L. jensenii (OR=0.21; 95%CI, 0.05, 0.94) and L. iners (OR=0.21; 95%CI, 0.05, 0.85) among perimenopausal women, and L. iners-dominated communities (OR=0.18; 95%CI, 0.04, 0.76) among premenopausal women. Postmenopausal women with L. gasseri/L. jensenii-dominated communities had the lowest odds of vaginal dryness (OR=0.36; 95%CI, 0.12, 1.06) and low libido (OR=0.28; 95%CI, 0.10, 0.74). Findings for urinary incontinence were inconsistent. Associations of vaginal microbiota with GSM signs/symptoms are most evident after menopause, suggesting an avenue for treatment and prevention.

scholarly journals Involutive changes in the vulvovaginal area

2021 ◽  
Vol 20 (2) ◽  
pp. 161-174
Author(s):  
Sergei I. Surkichin ◽  
Larisa S. Kruglova ◽  
Inna A. Apolikhina ◽  
Roman Yu. Mayorov ◽  
Marika Avin
Keyword(s):  
Quality Of Life ◽  
Urinary Tract ◽  
Bacterial Infections ◽  
Signs And Symptoms ◽  
Genitourinary Syndrome Of Menopause ◽  
Vaginal Dryness ◽  
Yeast Infection ◽  
Genitourinary Syndrome ◽  
Methods Of Treatment

Involutional changes in the vulvovaginal area involve a series of transformations leading to vulvovaginal atrophy (VVA) during menopause. Signs and symptoms most often observed in this syndrome: vaginal dryness (54.4100%), dyspareunia (17.677.6%), burning (2.056.9%), itching (7.856.6%) and dysuria (5.936.1%). Other complaints include deformity of the vulva, irritation, and recurrent bacterial infections of the urinary tract or vagina, and yeast infection. Vaginal dryness, dyspareunia and irritation are the symptoms that most affect a woman's quality of life. The article analyzes modern ideas about the genitourinary syndrome of menopause. The questions of the mechanisms of occurrence are considered, a description of the clinical picture is given. The issues of treatment of atrophy of the vulvovaginal region are discussed in detail, in particular, special attention is paid to physiotherapeutic methods of treatment.

scholarly journals Efficacy and Safety of Laser Therapy for the Treatment of Genitourinary Syndrome of Menopause: A Protocol for Systematic Review and Meta-Analysis of Clinical Trials

2021 ◽  
Vol 3 ◽  
Author(s):  
Lisieux de Lourdes Martins Nóbrega Pessoa ◽  
Ayane Cristine Alves Sarmento ◽  
Kleyton Santos Medeiros ◽  
Ana Paula Ferreira Costa ◽  
Ana Katherine Gonçalves ◽  
...  
Keyword(s):  
Systematic Review ◽  
Laser Therapy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Efficacy And Safety ◽  
Bias Assessment ◽  
Genitourinary Syndrome Of Menopause ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Genitourinary Syndrome

Laser therapy has been proposed to improve the symptoms of genitourinary syndrome of menopause (GSM), especially in women who do not accept hormonal therapy or are at a high risk of complications if they undergo hormonal therapy. However, studies evaluating the effectiveness and safety of laser treatment for GSM have shown controversial results. Thus, we aimed to determine the efficacy and safety of laser therapy in post-menopausal women with GSM. We have developed a protocol according to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocol using the population, intervention, comparison, outcome, and study design (PICOS) framework for post-menopausal women who have received no treatment, laser therapy, placebo, or vaginal estrogen for GSM. As per our protocol, randomized controlled trials and quasi-randomized trials, regardless of language of publication, will be searched in PubMed, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and clinicaltrials.gov. Gray literature will be searched in Open Gray and Google Scholar. The reference lists will be scanned for additional trials, and the authors will be contacted if necessary. Outcome data reported in a trial registry, even when no published results were available, will be analyzed. The search will be performed using key terms, such as “post-menopausal women,” “menopausal genitourinary syndrome,” “vulvovaginal atrophy,” and “laser therapy.” Two review authors will independently screen the titles and abstracts, while three others will independently evaluate the full text of each study to determine its eligibility for this systematic review (SR). Any disagreement will be resolved through discussion and consensus. Data extraction will be performed independently using a standardized data collection form. Clinical outcomes, including vaginal atrophy, vaginal pH, dryness, dyspareunia, itching, burning, dysuria, urinary frequency, urinary urgency, and urinary incontinence, will be systematically evaluated. We will not perform a separate search for adverse effects; instead, we will consider the adverse effects described in the included studies. Furthermore, we will summarize the effects of dichotomous outcomes as risk ratios with 95% confidence intervals. On the other hand, continuous outcomes will be summarized by expressing treatment effects as a mean difference with standard deviation or as a standardized mean difference when different scales were used to measure the same outcome. We will use the Cochrane Risk of Bias 2 tool for bias assessment and the Grading of Recommendations Assessment, Development and Evaluation approach to rate the overall certainty of evidence. Review Manager 5.3.5 will be used for quantitative data synthesis, subgroup analysis, sensitivity analysis, meta-regression, and risk of bias assessment. The SR findings will provide highly relevant evidence through the synthesis of well-designed and robust clinical trials on the effectiveness and safety of laser therapy in GSM. The Prospective Register of Systematic Reviews (PROSPERO) registration number (2021) of the SR is CRD42021253605.

scholarly journals Effect of Menopausal Hormone Therapy on the Vaginal Microbiota and Genitourinary Syndrome of Menopause in Chinese Menopausal Women

2020 ◽  
Vol 11 ◽  
Author(s):  
Lulu Geng ◽  
Wenjun Huang ◽  
Susu Jiang ◽  
Yanwei Zheng ◽  
Yibei Zhou ◽  
...  
Keyword(s):  
Microbial Diversity ◽  
Hormone Therapy ◽  
Anaerobic Bacteria ◽  
Vaginal Microbiota ◽  
Menopausal Hormone Therapy ◽  
Rrna Gene ◽  
Genitourinary Syndrome Of Menopause ◽  
Menopausal Women ◽  
Significant Difference ◽  
Genitourinary Syndrome

Genitourinary syndrome of menopause (GSM) is a chronic and progressive condition with a series of vulvovaginal, sexual, and lower urinary tract discomforts, mainly due to hypoestrogenism. Menopausal hormone therapy (MHT) has generally been considered as the most effective treatment for GSM. In addition, vaginal microbiota is of particular significance to gynecological and reproductive illnesses and potentially has some intimate connections with GSM. Consequently, we sought to evaluate how MHT impacts the composition and structure of vaginal microbiota while alleviating GSM in Chinese menopausal women aged 45–65 years, which has not been investigated previously. 16S rRNA gene sequencing was performed to analyze microbial diversity and composition using vaginal swabs obtained from 100 menopausal women, classified as MHT women who have been taking tibolone regularly (n = 50) and non-treated women who never received any treatment (n = 50). Vaginal Health Index Score (VHIS) and GSM symptoms inquiry were also performed. We found that the vaginal microbial diversity decreased and that the abundance of Lactobacillus increased to be the dominant proportion significantly in the MHT group, in considerable contrast to vaginal microbiota of the non-treated group, which significantly comprised several anaerobic bacteria, namely, Gardnerella, Prevotella, Escherichia-Shigella, Streptococcus, Atopobium, Aerococcus, Anaerotruncus, and Anaerococcus. In this study, women without any MHT had significantly more severe GSM symptoms than those receiving tibolone, especially with regard to vulvovaginal dryness and burning, as well as decreased libido (P < 0.01). However, there was no significant difference in the severity of urological symptoms between the groups (P > 0.05). Furthermore, Lactobacillus was demonstrated to be associated with VHIS positively (r = 0.626, P < 0.001) and with GSM negatively (r = −0.347, P < 0.001). We also identified Chlamydia (r = 0.277, P < 0.01) and Streptococcus (r = 0.270, P < 0.01) as having a prominent association with more serious GSM symptoms. Our study provided an elucidation that MHT could notably alleviate GSM and conspicuously reshape the composition of the vaginal microbiota, which is of extreme importance to clinical practice for the management of GSM.

Estrogen Replacement Therapy Among Post-menopausal Women and Its Effects on Signs and Symptoms of Temporomandibular Disorders

CRANIO® ◽  
2008 ◽  
Vol 26 (3) ◽  
pp. 211-215 ◽  
Author(s):  
Aysen Nekora-Azak ◽  
Gulumser Evlioglu ◽  
Arzu Ceyhan ◽  
Haluk Keskin ◽  
Sinan Berkman ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Temporomandibular Disorders ◽  
Estrogen Replacement Therapy ◽  
Signs And Symptoms ◽  
Estrogen Replacement ◽  
Menopausal Women ◽  
Post Menopausal

Dilemmas Associated with Hormone Therapy for Post-menopausal Women

2008 ◽  
Vol 04 (01) ◽  
pp. 108
Author(s):  
Collins John
Keyword(s):  
Hormone Therapy ◽  
Sleep Disturbances ◽  
Hot Flashes ◽  
Estrogen Deficiency ◽  
Vaginal Dryness ◽  
Urogenital Atrophy ◽  
Menopausal Women ◽  
Post Menopausal

More than 50% of women going through the menopause experience hot flashes, which may cause sleep disturbances and lethargy. The symptoms are due to estrogen deficiency, which may also cause urogenital atrophy and vaginal dryness. In 25% of women, symptoms of the menopause are severe enough to seek relief. In women who do not undergo treatment, the proportion with hot flashes decreases to about 30% within three years.1

scholarly journals Safety and efficacy of a new vaginal gel, Feminilove, for the treatment of symptoms associated with vaginal dryness and vulvovaginal atrophy in women: an in vitro and in vivo study

2021 ◽  
Author(s):  
Albert Gonzalez ◽  
Robert Lee ◽  
Larry Booshehri ◽  
David Grady ◽  
Victoria Vaddi ◽  
...  
Keyword(s):  
Vaginal Mucosa ◽  
Minimal Cell ◽  
Genitourinary Syndrome Of Menopause ◽  
Vaginal Dryness ◽  
Vulvovaginal Atrophy ◽  
Vaginal Gel ◽  
The Impact ◽  
Genitourinary Syndrome

Vaginal dryness is a common condition that is particularly prevalent during and after the menopause and it is one of the most important symptoms associated with vulvovaginal atrophy/genitourinary syndrome of menopause. The impact of vaginal dryness on interpersonal relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underreported and undertreated. Personal lubricants and moisturizers are effective at relieving discomfort and pain during sexual intercourse for women with mild to moderate vaginal dryness, particularly those who have a genuine contraindication to estrogen, or who choose not to use estrogen. We evaluated the safety and beneficial effects of a new type of estrogen-free vaginal gel, Feminilove BIO-FRESH moisturizing vaginal gel, using in vitro and in vivo experimental tools. Our results suggest that; 1) Feminilove vaginal gel exhibits minimal cell cytotoxicity on various human vaginal cells; 2) Feminilove vaginal gel exhibits minimal side-effects on the structure of vaginal mucosa stratum of experimental animals; 3) Feminiove vaginal gel inhibits the growth of pathogenic vaginal bacteria (E. coli) while promotes the growth of beneficial vaginal bacteria (Lactobacillus spp); 4) Feminilove vaginal gel elicits an anti-inflammatory response on vaginal epithelial cells; and 5) Feminilove vaginal gel promotes the production of tropoelastin and collagen on cultural vaginal smooth muscle and may restore loose vaginal wall (i.e., tightening effects). In summary, our results indicate that Feminilove BIO-FRESH moisturizing vaginal gel is a safe and effective remedy for the treatment of symptoms associated with vaginal dryness and vulvovaginal atrophy in women. Keyword: vaginal dryness, vulvovaginal atrophy, genitourinary syndrome of menopause, sexual dysfunction, vaginal lubrication, vaginal moisturizer

scholarly journals Ospemifene for the treatment of menopausal vaginal dryness, a symptom of the genitourinary syndrome of menopause

2019 ◽  
Vol 14 (5) ◽  
pp. 301-314 ◽  
Author(s):  
David F. Archer ◽  
James A. Simon ◽  
David J. Portman ◽  
Steven R. Goldstein ◽  
Irwin Goldstein
Keyword(s):  
Genitourinary Syndrome Of Menopause ◽  
Vaginal Dryness ◽  
Genitourinary Syndrome
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