Endocrine aspects of management of patients with vaginal infections


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The paper reviews of literature on the relationship between endocrine diseases and vulvovaginal infections, on the characteristics of the vaginal microbiota and on the impact of hormonal fluctuations on it. It discusses the pathogenesis of vulvar and vaginal inflammatory processes in diabetes mellitus and impaired microbiocenosis in the genital organs in stress, hypercorticism, and obesity, as well as alternative treatment modalities for chronic recurrent infectious diseases. The paper reflects the main points of the clinical guidelines of the International Union against Sexually Transmitted Infections (IUSTI)/World Health Organization (WHO), 2018 for the management of patients with abnormal discharge from the genital tract.

Full Text

Restricted Access

About the authors

Elena N. Andreeva

Endocrinology Research Center; Moscow State University of Medicine and Dentistry

Email: endogin@mail.ru
MD, professor, deputy director of the Center - director of the Institute of Reproductive Medicine; professor of the Department of Reproductive Medicine and Surgery

Yulia S. Absatarova

Endocrinology Research Center

Email: korsil2008@yandex.ru
researcher of the Medical and Diagnostic Department of Endocrine Gynecology

References

  1. Schooley R.T. The human microbiome: implications for health and disease, including HIV infection. Top. Antivir. Med. 2018; 26(3): 75-78.
  2. Smith S.B., Ravel J. The vaginal microbiota, host defence and reproductive physiology. J. Physiol. 2017; 595(2): 451-63.
  3. Wagner R.D., Johnson S.J. Probiotic lactobacillus and estrogen effects on vaginal epithelial gene expression responses to Candida albicans. J. Biomed. Sci. 2012; 19: 58.
  4. Wira C.R., Rodriguez-Garcia M., Patel M.V. The role of sex hormones in immune protection of the female reproductive tract. Nat. Rev. Immunol. 2015; 15(4): 217-30. https://dx.doi.org/10.1038/nri3819.
  5. Borgdoff H., Armstrong S.D., Tytgat H.L., Xia D., Ndayisaba G.F., Wastling J.M., van de Wijgert J.H. Unique insights in the cervicovaginal Lactobacillus iners and L. crispatus proteomes and their associations with microbiota dysbiosis. PLoS One. 2016; 11(3): e0150767. https://dx.doi.org/10.1371/journal.pone.0150767.
  6. Witkin S., Linhares I. Why do lactobacilli dominate the human vaginal microbiota? BJOG. 2016; 124(4): 606-11. https://dx.doi.org/10.1111/1471-0528.14390.
  7. Bautista C.T., Wurapa E., Sateren W.B., Morris S., Hollingsworth B., Sanchez J.L. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil. Med. Res. 2016; 3: 4.
  8. Малова И.О., Афанасьева И.Г. Бактериальный вагиноз: есть ли альтернатива традиционным препаратам? Медицинский совет. 2019; 7: 34-44. [Malova I.O., Afanasyeva I.G. Bacterial vaginosis: is there an alternative to traditional drugs? Medical advice. 2019; 7: 34-44. (in Russian)].
  9. Vodstrcil L.A., Hocking J.S., Law M., Walker S., Tabrizi S.N., Fairley C.K. et al. Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis. PLoS One. 2013; 8(9): e73055. https://dx.doi.org/10.1371/journal.pone.0073055.
  10. Špacek J., Kestránek J., Jílek P., Leško D., Plucnarovâ S., Buchta V. Comparison of two long-term gestagen regimens in the management of recurrent vulvovaginal candidiasis: A pilot study. Mycoses. 2017; 60(4): 260-5. https://dx.doi.org/10.1111/myc.12593.
  11. Li D., Wang T., Shen S., Fang Z., Dong Y., Tang H. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes. Metab. 2017; 19(3): 348-55.
  12. Liu J., Li L., Li S., Jia P., Deng K., Chen W., Sun X. Effects of SGLT2 inhibitors on UTIs and genital infections in type 2 diabetes mellitus: a systematic review and meta-analysis. Sci. Rep. 2017; 7(1): 2824. https://dx.doi.org/10.1038/s41598-017-02733-w.
  13. Dave C.V., Schneeweiss S., Patorno E. Comparative risk of genital infections associated with sodium-glucose co-transporter-2 inhibitors. Diabetes Obes. Metab. 2019; 21(2): 434-8. https://dx.doi.org/10.1111/dom.13531.
  14. Sacks D.A., Black M.H., LiX., Montoro M.N., Lawrence J.M. Adverse pregnancy outcomes using the international association of the diabetes and pregnancy study groups criteria: glycemic thresholds and associated risks. Obstet. Gynecol. 2015; 126(1): 67-73.
  15. Zhang X., Liao Q., Wang F., Li D. Association of gestational diabetes mellitus and abnormal vaginal flora with adverse pregnancy outcomes. Medicine (Baltimore). 2018; 97(34): e11891. https://dx.doi.org/10.1097/MD.0000000000011891.
  16. Seo D., Rabinowitz A.G., Douglas R.J., Sinha R. Limbic response to stress linking life trauma and hypothalamus-pituitary-adrenal axis function. Psychoneuroendocrinology. 2019; 99: 38-46. https://dx.doi.org/10.1016/j.psyneuen.2018.08.023.
  17. Amabebe E., Anumba D.O.C. The vaginal microenvironment: the physiologic role of Lactobacilli. Front. Med. (Lausanne). 2018; 5: 181. https://dx.doi.org/10.3389/fmed.2018.00181.
  18. Amabebe E., Anumba D.O.C. Psychosocial stress, cortisol levels, and maintenance of vaginal health. Front. Endocrinol. (Lausanne). 2018; 9: 568. https://dx.doi.org/10.3389/fendo.2018.00568.
  19. Ventolini G., Khandelwal N., Hutton K., Lugo J., Gygax S.E. et al. Obesity and recurrent vulvovaginal bacterial infections in women of reproductive age. Postgrad. Med. J. 2017; 93(1099): 297. https://dx.doi.org/10.1136/postgrad-medj-2016-134638.
  20. Oh H.Y., Seo S.S., Kong J.S., Lee J.K., Kim M.K. Association between obesity and cervical microflora dominated by Lactobacillus iners in Korean women. J. Clin. Microbiol. 2015; 53(10): 3304-9. https://dx.doi.org/10.1128/JCM.01387-15.
  21. Sherrard J., Wilson J., Donders G., Mendling W., Jensen J.S. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int. J. STD AIDS. 2018; 29(13): 1258-72. https://dx.doi.org/10.1177/0956462418785451.
  22. Российское общество дерматовенерологов и косметологов, Российское общество акушеров-гинекологов. Федеральные клинические рекомендации по ведению больных бактериальным вагинозом. Акушерство и гинекология. 2016; Приложение № 4: 42-8.
  23. Lamont R.F., Nhan-Chang C.L., Sobel J.D., Workowski K., Conde-Agudelo A., Romero R. Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and metaanalysis. Am. J. Obstet. Gynecol. 2011; 205(3): 177-90. https://dx.doi.org/10.1016/j.ajog.2011.03.047.
  24. Gaspar C., Donders G.G., Palmeira-de-Oliveira R., Queiroz J.A., Tomaz C., Martinez-de-Oliveira J., Palmeira-de-Oliveira A. Bacteriocin production of the probiotic Lactobacillus acidophilus KS400. AMB Express. 2018; 8(1): 153. https://dx.doi.org/10.1186/s13568-018-0679-z.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies