The Effect of Exogenous Sex Steroids on the Vaginal Microbiota: A Systematic Review

BackgroundExogenous sex steroids within hormonal contraception and menopausal hormone therapy (MHT) have been used for family planning and management of menopausal symptoms, without consideration of their effects on the vaginal microbiota. This is largely because their use predates our understanding of the importance of the vaginal microbiome on human health. We conducted a systematic review (PROSPERO: CRD42018107730) to determine the influence of exogenous sex steroids, stratified by oestrogen-containing or progestin-only types of contraception, and MHT on the vaginal microbiome, as measured by molecular methods.MethodsEmbase, PubMed and Medline were searched for relevant literature published through to December 1st 2020. Eligible studies reported on the effect of specific exogenous sex steroids on the vaginal microbiome using a molecular method. Data regarding the ‘positive’, ‘negative’ or ‘neutral’ effect of each type of contraceptive or MHT on the vaginal microbiome was extracted and summarised. A positive effect reflected sex steroid exposure that was associated with increased abundance of lactobacilli, a change to, or maintenance of, an optimal vaginal microbiota composition, or a decrease in bacterial diversity (specifically reflecting a low-diversity optimal microbiota state), relative to the control group. An exogenous sex steroid was designated as having a negative effect on the vaginal microbiome if it resulted in opposing effects (i.e. loss of lactobacilli, a non-optimal microbiota state). When no significant change was found, this was considered neutral/inconclusive.ResultsWe identified 29 manuscripts reporting on the effect of exogenous sex steroids on the vaginal microbiome; 25 investigating hormonal contraceptives, and 4 investigating MHT. Oestrogen-containing contraception, particularly reflecting the combined oestrogen and progestin-containing contraceptive pill, had a positive effect on the composition of the vaginal microbiota. Progestin-only contraception, particularly reflecting depo-medroxyprogesterone acetate, had mixed effects on the microbiota. Among post-menopausal women using MHT, exogenous oestrogen applied topically was associated with increased prevalence of lactobacilli.ConclusionOur findings suggest that oestrogen-containing compounds may promote an optimal vaginal microbiota, which could have clinical applications. The impact of progestin-only contraceptives on the vaginal microbiota is less clear; more data is needed to determine how progestin-only contraceptives contribute to adverse reproductive and sexual health outcomes.

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Daily Vaginal Microbiota Fluctuations Associated with Natural Hormonal Cycle, Contraceptives, Diet, and Exercise

mSphere ◽

10.1128/msphere.00593-20 ◽

2020 ◽

Vol 5 (4) ◽

Cited By ~ 3

Author(s):

Stephanie D. Song ◽

Kalpana D. Acharya ◽

Jade E. Zhu ◽

Christen M. Deveney ◽

Marina R. S. Walther-Antonio ◽

...

Keyword(s):

Reproductive Health ◽

Microbial Diversity ◽

Vegetarian Diet ◽

Vaginal Microbiota ◽

Hormonal Contraceptives ◽

High Temporal Resolution ◽

Vaginal Microbiome ◽

Microbial Composition ◽

Diet And Exercise ◽

The Impact

ABSTRACT The microorganisms of the vaginal tract are critical for vaginal and reproductive health. However, the regulation of these microorganisms is not well understood. Therefore, we investigated whether different factors regulate the vaginal microbiota of healthy college-aged women (n = 26) with high temporal resolution by collecting daily self-administered vaginal swabs and using 16S rRNA sequencing for bacterial identification. As expected, vaginal microbiota clustered into five predefined community state types. Vaginal microbial diversity, stability, and Lactobacillus abundances were associated with the menstrual cycle and hormonal contraceptive use. Vaginal microbial diversity, as measured using the Shannon index, increased during menses (P < 0.001), while Lactobacillus abundances decreased (P = 0.01). The covariance of these microbial measures with previously established estradiol levels suggests that estrogens can regulate vaginal microbiota. Moreover, the use of hormonal contraceptives may alter the temporal dynamics of the vaginal microbiota and decrease Lactobacillus abundances, depending on hormonal content and release method. Interestingly, intrasample diversity was greater in participants on a vegetarian diet (P = 0.004) and among participants who exercised more (P = 0.04). These findings indicate that ovarian hormones, diet, and exercise can regulate vaginal microbial composition and stability and may impact vaginal and reproductive health. IMPORTANCE The vaginal microbiome is a critical component of women’s sexual and reproductive health, with variations in microbial composition, particularly the loss of Lactobacillus species, being implicated in gynecologic and obstetric diseases. Given that the vaginal microbiome is so crucial, why do vaginal microbial profiles vary strikingly from person to person and even change over time within the same person? In the present study, which tracked the daily vaginal microbiomes of young healthy women through different lifestyles, we found that use of a locally released progestin contraceptive, a vegetarian diet, and intense exercise appear to lead to vaginal microbiome alterations and loss of Lactobacillus species. The impact of these vaginal microbiome changes on immediate and long-term health remain to be investigated.

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Modulation of Gut Microbiota and Oxidative Status by β-Carotene in Late Pregnant Sows

Frontiers in Nutrition ◽

10.3389/fnut.2020.612875 ◽

2020 ◽

Vol 7 ◽

Author(s):

Xupeng Yuan ◽

Jiahao Yan ◽

Ruizhi Hu ◽

Yanli Li ◽

Ying Wang ◽

...

Keyword(s):

Gut Microbiota ◽

Dietary Supplementation ◽

Basal Diet ◽

Fecal Microbiota ◽

Control Group ◽

Metabolic Activities ◽

The Impact ◽

Positive Effect ◽

Β Carotene

Recent evidences suggest that gut microbiota plays an important role in regulating physiological and metabolic activities of pregnant sows, and β-carotene has a potentially positive effect on reproduction, but the impact of β-carotene on gut microbiota in pregnant sows remains unknown. This study aimed to explore the effect and mechanisms of β-carotene on the reproductive performance of sows from the aspect of gut microbiota. A total of 48 hybrid pregnant sows (Landrace × Yorkshire) with similar parity were randomly allocated into three groups (n = 16) and fed with a basal diet or a diet containing 30 or 90 mg/kg of β-carotene from day 90 of gestation until parturition. Dietary supplementation of 30 or 90 mg/kg β-carotene increased the number of live birth to 11.82 ± 1.54 and 12.29 ± 2.09, respectively, while the control group was 11.00 ± 1.41 (P = 0.201). Moreover, β-carotene increased significantly the serum nitric oxide (NO) level and glutathione peroxidase (GSH-Px) activity (P < 0.05). Characterization of fecal microbiota revealed that 90 mg/kg β-carotene increased the diversity of the gut flora (P < 0.05). In particular, β-carotene decreased the relative abundance of Firmicutes including Lachnospiraceae AC2044 group, Lachnospiraceae NK4B4 group and Ruminococcaceae UCG-008, but enriched Proteobacteria including Bilophila and Sutterella, and Actinobacteria including Corynebacterium and Corynebacterium 1 which are related to NO synthesis. These data demonstrated that dietary supplementation of β-carotene may increase antioxidant enzyme activity and NO, an important vasodilator to promote the neonatal blood circulation, through regulating gut microbiota in sows.

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Positive and Negative Affect Changes during Gender-Affirming Hormonal Treatment: Results from the European Network for the Investigation of Gender Incongruence (ENIGI)

Journal of Clinical Medicine ◽

10.3390/jcm10020296 ◽

2021 ◽

Vol 10 (2) ◽

pp. 296

Author(s):

Imke Matthys ◽

Justine Defreyne ◽

Els Elaut ◽

Alessandra Daphne Fisher ◽

Baudewijntje P. C. Kreukels ◽

...

Keyword(s):

Negative Affect ◽

Sex Steroids ◽

Hormonal Treatment ◽

Control Group ◽

First Year ◽

Positive And Negative Affect ◽

European Network ◽

Psychological Burden ◽

The Impact

Improving transgender people’s quality of life (QoL) is the most important goal of gender-affirming care. Prospective changes in affect can influence QoL. We aim to assess the impact of initiating gender-affirming hormonal treatment (HT) on affect. In the European Network for the Investigation of Gender Incongruence (ENIGI) study, we prospectively collected data of 873 participants (451 transwomen (TW) and 422 transmen (TM)). At baseline, psychological questionnaires including the Positive and Negative Affect Schedule (PANAS) were administered. The PANAS, levels of sex steroids and physical changes were registered at each follow-up visit during a 3-year follow-up period, starting at the initiation of hormonal therapy. Data were analyzed cross-sectionally and prospectively. Over the first three months, we observed a decline in positive affect (PA) in both TM and TW. Thereafter, PA reached a steady state in TW, whereas in TM there was also a second decline at 18 months. In both TM and TW there was no persisting difference comparing baseline to the 36-months results. Concerning negative affect (NA), we observed a decline during the first year in TM, which sustained during the second year and was not different anymore at 36 months compared to baseline. In TW though, we did not find any change of NA during the entire follow-up. Even if some of these results show significant differences, they should be considered with caution, since there was no control group and the absolute differences are small. No association between affect and the level of sex steroids was observed. Baseline QoL and psychological burden are related to affect independently from gender but are not necessarily good predictors of the evolution of one’s affect during the gender-affirming process. Further research is necessary to investigate these preliminary results.

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Is the use of contraceptives associated with periodontal diseases? A systematic review and meta-analyses

BMC Women s Health ◽

10.1186/s12905-021-01180-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Micaele Maria Lopes Castro ◽

Maria Karolina Martins Ferreira ◽

Iasmin Encaua Essashika Prazeres ◽

Paula Beatriz de Oliveira Nunes ◽

Marcela Baraúna Magno ◽

...

Keyword(s):

Systematic Review ◽

Quantitative Analysis ◽

Periodontal Diseases ◽

Hormonal Contraceptive ◽

Cochrane Library ◽

Hormonal Contraceptives ◽

Clinical Parameters ◽

Significant Difference ◽

Meta Analyses ◽

The Impact

Abstract Background Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases. Methods This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters. Results 18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [− 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters. Conclusions The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.

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P080 The role of exogenous sex steroids on the vaginal microbiota: a systematic review

10.1136/sextrans-2021-sti.212 ◽

2021 ◽

Author(s):

L Ratten ◽

E Plummer ◽

C Bradshaw ◽

C Fairley ◽

S Garland ◽

...

Keyword(s):

Systematic Review ◽

Sex Steroids ◽

Vaginal Microbiota

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Influence of probiotic and prebiotic on meat quality of broiler chicken carcasses

BIO Web of Conferences ◽

10.1051/bioconf/20213204009 ◽

2021 ◽

Vol 32 ◽

pp. 04009

Author(s):

Irina Chervonova

Keyword(s):

Meat Quality ◽

Broiler Chickens ◽

Broiler Chicken ◽

First Grade ◽

Control Group ◽

Muscle Weight ◽

The Third ◽

The Impact ◽

Positive Effect

The article presents the results of studying the impact of the spore-forming probiotic “Olin” and the prebiotic “Eсofiltrum” on the meat quality of broiler chicken carcasses of the Ross-308 cross. In the course of the research, it has been found that the inclusion of these preparations in the broiler diet has a positive effect on the studied indicators: the pre-slaughter weight increased by 4.3-5.7%, the weight of the gutted carcass by 4.6-6.2%, the muscle weight 4.8-6.5%, the weight of the loin muscles by 5.7-8.2%. The ratio of edible parts to inedible parts is 4.14 in the third experimental group, 4.08-in the second, and 4.04-in the control. Based on the results of the anatomical cutting of broiler carcasses and according to the fatness indicators the poultry carcasses of the third and second experimental groups, 87.5% and 87.2%, respectively, belong to the first grade, and the yield of the first grade carcasses is 86.2% in the control group. Meat products obtained from both the control poultry and the poultry of both experimental groups has no off-aroma odor and taste, the meat is juicy, tender and aromatic. The products obtained from broiler chickens, whose ration includes the probiotic “Olin” and the prebiotic “Ecofiltrum”, do not have any deviations from the established standards and norms. During the research, it has been found that the use of the studied drugs has a positive effect on the meat quality of poultry carcasses. However, broiler chickens receiving the probiotic “Olin” has more pronounced meat qualities.

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Prevalence of ADHD in children born by mothers consuming Frankincense during pregnancy

Advances in Pharmacology and Therapeutics Journal ◽

10.18502/aptj.v1i1.7959 ◽

2021 ◽

Author(s):

Alimohammad Ranjbar ◽

Elahe Kamali Ardakani ◽

Rahele Zareshahi

Keyword(s):

Data Gathering ◽

Control Group ◽

Case Group ◽

Dsm V ◽

History Of ◽

The Difference ◽

The Impact ◽

The Relationship ◽

The Brain ◽

Positive Effect

Aims: In Iranian culture, due to some narratives from the prophet Mohammad about the use of frankincense during pregnancy for increasing IQ in children, some women consume frankincense during expectancy. This study's goal is to evaluate the relationship between frankincense used during pregnancy and the incidence of ADHD. Methods: In this study, the case group comprised children 4-17 years old referring to Shahid Chamran Pharmacy in Yazd from summer to winter 2018 for receiving Methylphenidate, those with whom a psychologist had identified ADHD based on DSM-V factors. The control group included children of the same age group but without ADHD. For data gathering, a checklist was used with some questions on smoking, family history of ADHD, presence/absence of a specific disease during pregnancy, frankincense used during pregnancy, and a chemical medication consumed during pregnancy. Results: The main result demonstrated that the children whose mothers used frankincense during pregnancy were 0.67 times less likely to be affected by ADHD than those whose mothers did not use this substance. However, the difference failed to be statistically significant (P>0.05). Conclusion: Some studies report that frankincense can bear a positive effect on the development of the brain and possibly adequate formation of dendrites trees, axons and induce proper communication between them, so the impact of frankincense on the brain may be justified by its protective effect against the hyperactive child.

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Consolidated quality improvements following benchmarking with cardiothoracic surgery registries—a systematic review

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz330 ◽

2019 ◽

Vol 57 (5) ◽

pp. 817-825

Author(s):

Theo M M H de By ◽

Rahatullah Muslem ◽

Kadir Caliskan ◽

Giacomo Bortolussi ◽

Tine Philipsen ◽

...

Keyword(s):

Systematic Review ◽

Causal Relation ◽

Cardiothoracic Surgery ◽

Quality Improvements ◽

Inclusion Criteria ◽

Scientific Publications ◽

Systematic Assessment ◽

The Impact ◽

Positive Effect ◽

Over Time

Abstract The influence of registries in medicine is large. However, there has been no systematic assessment conducted to quantify the impact of benchmarking with registries focused on cardiothoracic surgery. Numerous publications conclude that registry participation leads to improvement of outcomes for patients. A large number of registries provide evidence sub-structured by statistics that show decreases in morbidity and mortality in the participants’ clinical units. Many authors praise the benchmarking method making use of databases of registries as having a positive effect on outcome of care. However, studies proving the direct causal relation between the use of cardiothoracic surgery-oriented registries and improvement of clinical in-hospital outcomes are extremely scarce. We aimed to analyse the causal relation between the use of cardiothoracic surgery-oriented registries and improvement of clinical outcomes. In a systematic literature review, publications demonstrating the use of registry data to obtain consolidated quality improvements were selected. After analysis of 2990 scientific publications, 6 studies filled the inclusion criteria. The selected studies acknowledged that benchmarking of data against registries was used for a focused and methodologically organized improvement in cardiothoracic departments. In conjunction with the impact of the applied methods on healthcare, their results demonstrate quantifiable enhanced local outcomes over time.

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Postoperative Prophylactic Antibiotics Reduce Surgical Site Infection Rates after Ventral Hernia Repair: A Systematic Review

The American Surgeon ◽

10.1177/000313481908501128 ◽

2019 ◽

Vol 85 (11) ◽

pp. 1228-1233

Author(s):

Pablo A. Baltodano ◽

Anmol Chattha ◽

Philip K. Johnson ◽

Justin Kittredge ◽

Joseph A. Ricci ◽

...

Keyword(s):

Systematic Review ◽

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Prophylactic Antibiotics ◽

Control Group ◽

Infection Rates ◽

The Impact ◽

Independent Assessment

SSIs after ventral hernia repair (VHR) represent a significant complication. The impact of postoperative prophylactic antibiotics on the SSI rates after VHRs is unclear. A systematic review of PubMed and Web of Science databases from inception through March 2016 investigating the effect of postoperative prophylactic antibiotics after VHRs was performed. Strict inclusion and exclusion criteria were implemented, and the methodological quality of the included studies was assessed. After systematic independent assessment of 216 citations, four studies, involving 344 patients, met the inclusion criteria. Among the included studies, 164 patients received >24 hours of postoperative prophylactic antibiotics, whereas 180 patients were controls. The overall incidence of SSI among patients receiving postoperative antibiotics was 14.6 per cent (95% confidence interval [CI], 9.9 to 20.9) which compares favorably with the control group: 35.5 per cent (95% CI, 28.9 to 42.7) (odds ratio: 0.3, 95% CI: 0.2 to 0.5, P < 0.01). Among patient's receiving postoperative antibiotics, the pooled average duration of postoperative antibiotic treatment was 6.2 ± 0.4 days. Based on the available evidence, the use of postoperative prophylactic antibiotics seems to be associated with lower SSI rates after VHRs. Future prospective randomized controlled trials should be conducted to further confirm the efficacy of this prophylactic intervention.

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The Impact of a Stabilization Exercise on Neck Pain: A Systematic Review and Meta-analysis

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0039-3400953 ◽

2020 ◽

Vol 81 (04) ◽

pp. 342-347

Author(s):

Binbin Wu ◽

Hongyan Yuan ◽

Deyu Geng ◽

Liang Zhang ◽

Cheng Zhang

Keyword(s):

Systematic Review ◽

Neck Pain ◽

Meta Analysis ◽

Neck Disability Index ◽

Depression Scale ◽

Cochrane Library ◽

Control Group ◽

Stabilization Exercise ◽

Pain Scores ◽

The Impact

Abstract Introduction The efficacy of a stabilization exercise for the relief of neck pain remains controversial. We conducted a systematic review and meta-analysis to explore the effectiveness of a stabilization exercise on neck pain. Methods We searched Embase, Web of Science, EBSCO Information Services, and the Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the impact of a stabilization exercise on neck pain. This meta-analysis was performed using the random effects model. Results Six RCTs are included in the meta-analysis. Compared with the control group of patients with neck pain, a stabilization exercise can significantly reduce pain scores at 4 to 6 weeks (mean difference [MD]: −2.41; 95% confidence interval [CI], −4.46 to −0.35; p = 0.02), Neck Disability Index [NDI] at 10 to 12 weeks (MD:− 6.75; 95% CI, −11.71 to −1.79; p = 0.008), and depression scale at 4 to 6 weeks (MD: −4.65; 95% CI, −7.00 to −2.31; p = 0.02), but it has no obvious impact on pain scores at 10 to 12 weeks (MD: −1.07; 95% CI, −3.42 to 1.28; p = 0.37) or at 6 months (MD: −1.02; 95% CI, −3.43 to 1.39; p = 0.41). Conclusions A stabilization exercise can provide some benefits to control neck pain.

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