Review of current guidelines for the management of women with vaginal discharge


Cite item

Full Text

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

Abstract

The paper reviews current Russian and foreign guidelines for the management of women complaining of vaginal discharge, which deal with the diagnosis of recurrent discharge and algorithms for its laboratory examination, treatment, and prevention in women of reproductive and postmenopausal ages. It presents an algorithm for examining women with complaints of vaginal discharge. Anti-adhesive agents that block the adhesion of pathogenic microorganisms to the vaginal epithelium are shown to be effective in preventing dysbiotic and inflammatory diseases. There is evidence that it is necessary to regularly use gel moisturizers that exert protective and regenerative effects on the vaginal mucosa, which is a necessary condition for the restoration and preservation of vaginal biocenosis.

Full Text

Restricted Access

About the authors

Olga A. Pustotina

Private Educational Institution of Additional Postgraduate Education F.I. Inozemtsev Academy of Medical Education

Email: pustotina@gmail.com
MD, professor of the Department of Obstetrics and Gynecology with a course of reproductive medicine

Vladimir V. Ostromensky

Private Educational Institution of Additional Postgraduate Education F.I. Inozemtsev Academy of Medical Education

Email: academy-medical@cmtmad.com
PhD, head of the Department of Obstetrics and Gynecology with a course of reproductive medicine

References

  1. Роговская С.И., Липова Е.В., ред. Шейка матки, влагалище, вульва. Физиология, патология, кольпоскопия, эстетическая коррекция. Руководство для практикующих врачей. М.: StatusPraesens; 2014: 34-43
  2. Klebanoff M.A., Nansel T.R., Brotman R.M., Zhang J., Yu K.F., Schwebke J.R., Andrews W.W. Personal hygienic behaviors and bacterial vaginosis. Sex. Transm. Dis. 2010; 37(2): 94-9
  3. Workowski K.A., Bolan G.A., Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep 2015; 64(3): 69-72.
  4. Sherrard J., Wilson J., Donders G., Mendling W., Jensen J.S. European (IUSTI/ WHO) Guideline on the management of vaginal discharge. Int. J. STD AIDS. 2018; 29(13): 1258-72.
  5. Клинические рекомендации по диагностике и лечению заболеваний, сопровождающихся патологическими выделениями из половых путей женщин. М.: Российское общество акушеров-гинекологов; 2019. 56 с.
  6. Donders G.G., Ruban K., Bellen G. Selecting anti-microbial treatment of aerobic vaginitis. Curr. Infect. Dis. Rep. 2015; 17(5): 477.
  7. Donders G.G., Zodzika J., Rezeberga D. Treatment of bacterial vaginosis: what we have and what we miss. Expert Opin. Pharmacother. 2014; 15(5): 645-57.
  8. Verstraelen H., Swidsinski A. The biofilm in bacterial vaginosis: implications for epidemiology, diagnosis and treatment. Curr. Opin. Infect. Dis. 2013; 26: 86-9.
  9. Kelly C.G., Younson J.S. Anti-adhesive strategies in the prevention of infectious disease at mucosal surfaces. Expert Opin. Investig. Drugs. 2009; 9(8): 1711-21.
  10. Asadi A., Razavi S., Talebi M., Gholami M. A review on anti-adhesion therapies of bacterial diseases. Infection. 2019; 47: 25-6.
  11. Van Dijk W. Further characterization of negatively charged polysaccharides isolated from concentrated Aloe vera gel with regard to antibacterial properties and molecular structure. Phytomedicine. 2006; 16(9): 856-63. Dermatological report on human patch test with 2QR-complex (batch 2011002374). World J. Gastroenterol. 2012; 18: 2026-34.
  12. Eurofins. Cytotoxicity-Direct contact on 2QR-complex 0.8 mg/g report 2012/545-1. Curr. Med. Chem. 2012; 17: 129-38.
  13. Bojovic T., Bojovic D., Boyer de La Tour F.-X., Lamers B. First line treatment and relief of bacterial vaginosis-related vaginal complaints with metronidazole and Multi-Gyn® ActiGel. Eur. Obstet. Gynaecol. 2012; 7(2): 103-6.
  14. Балан В.Е., Тихомирова Е.В., Овчинникова В.В. Рецидивирующий бактериальный вагиноз - возможность увеличения продолжительности ремиссии. Акушерство и гинекология. 2017; 1: 83-8.
  15. Dols J.A.M., Boon M.E. An in vitro study of the effects of self care Gels on desirable and undesirable vaginal microbiota. Eur. Obstet. Gynaecol. 2012; 7(2): 107-10.
  16. Palacios S., Nappi R.E., Bruyniks N., Particco M., Panay N. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal atrophy of menopause. Climacteric. 2018; 21(3): 286-91. Gliniewicz K., Schneider G.M., Ridenhour B.J., Williams C.J., Song Y., Farage M.A. et al. Comparison of the vaginal microbiomes of premenopausal and postmenopausal women. J. Front. Microbiol. 2019; 10: Article 193.
  17. Mason M.J., Winter A.J. How to diagnose and treat aerobic and desquamative inflammatory vaginitis. Sex. Transm. Infect. 2017; 93: 8-10.
  18. Bruyniks N., Biglia N., Palacios S., Mueck A.O. Systematic indirect comparison of ospemifene versus local estrogens for vulvar and vaginal atrophy. Climacteric. 2017; 20(3): 195-204.
  19. Gaspar A., Brandi H., Gomez V., Luque D. Efficacy of Erbium:YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause. Lasers Surg. Med. 2017; 49(2): 160-8.
  20. Gambacciani M., Palacios S. Laser therapy for the restoration of vaginal function. Maturitas. 2017; 99: 10-5.
  21. Балан В.Е. Урогенитальные расстройства в климактерии (клиника, диагностика, заместительная гормонотерапия): дисс. д-ра мед. наук. М.; 295 с.
  22. Edwards D., Panay N. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? Climateric. 2016; 19(2): 151-61.
  23. Chatsiproios D., Schmidts-Winkler I.M., Konig L., Masur C., Abels C. Topical treatment of vaginal dryness with a non-hormonal cream in women undergoing breast cancer treatment - An open prospective multicenter study. PLoS One. 2019; 14(1): e0210967.
  24. Kim Y.H., Park S., Lee M., Hahn S., Jeon M.J. Effect of a pH-balanced vaginal gel on dyspareunia and sexual function in breast cancer survivors who were premenopausal at diagnosis: a randomized controlled trial. Obstet. Gynecol. 2017; 129(5): 870-6.
  25. Vermani K., Garg S., Zaneveld L.J. Assemblies for in vitro measurement of bioadhesive strength and retention characteristics in simulated vaginal environment. Drug Dev. Ind. Pharm. 2002; 28(9): 1133-46.

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

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

About Cookies