Relationship between the symptoms of vulvovaginal epithelial atrophy and the vaginal microbiota in postmenopausal women
- Authors: Eprikyan E.G1, Yureneva S.V1, Donnikov A.E1, Ezhova L.S1
-
Affiliations:
- Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
- Issue: No 11 (2019)
- Pages: 152-159
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/248677
- DOI: https://doi.org/10.18565/aig.2019.11.152-159
- ID: 248677
Cite item
Abstract
Objective. To investigate the vaginal microbiota in postmenopausal women and its relationship to the symptoms of vulvovaginal atrophy (VVA). Subjects and methods. A total of 187 women, who had been postmenopausal for 1-20years, were examined. All the patients signed informed consent forms. The inclusion criteria were the absence of menopausal hormone therapy for 6 months and systemic or local antibacterial therapy for 1 month before starting the study. The studies included cytological examination of vaginal wall smears, followed by estimation of the vaginal epithelium maturation index, vaginal pH value, and polymerase chain reaction for estimating the vaginal microcenosis. Results. Bacterial community Type IV (BC-IV) is associated with the absence of lactobacilli. Vaginal dryness is not a specific symptom for atrophic changes in the vaginal mucosa. The presence or absence of this symptom seems to also depend on the composition of the vaginal microbiota in the postmenopausal period and to be associated with BC-IV. Conclusion. Presentation of the relationship of vaginal symptoms not only to atrophy of the vaginal mucosa, but also to the specific features of its microflora will be able to personalize the management of postmenopausal women: those with BC-IV without atrophic changes in the vaginal mucosa from the standpoint of therapy for bacterial vaginosis, but if there are atrophic changes, local hormone therapy with estriol is the first-line treatment of choice.
Full Text
![Restricted Access](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
About the authors
E. G Eprikyan
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: eldo989@rambler.ru
S. V Yureneva
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: syureneva@gmail.ru
A. E Donnikov
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: a_donnikov@oparina4.ru
L. S Ezhova
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: l.s.ezhova@yandex.ru
References
- Sinha A., Ewies A. A. Non-hormonal topical treatment of vulvovaginal atrophy: an up-to date overview. Climacteric. 2013; 16(3): 305-12. doi: 10.3109/13697137.2012.756466
- Балан В.Е. Урогенитальные расстройства в климактерии (клиника, диагностика, заместительная гормональная терапия): дис. д-ра мед. наук. М., 1998. 305 c.
- Ворошилина Е.С., Тумбинская Л.В., Донников А.Е., Плотко Е.Э., Хаютин Л.В. Биоценоз влагалища с точки зрения количественной полилимеразной цепной реакции: что есть норма? Акушерство и гинеколо гия. 2011; 1: 57-65.
- Sturdee D.W. Recommindations for the magement of postmenopausal vaginal atrophy. International menopause Society Writing Group. Climacteric. 2010; 13(6): 509-31. doi: 10.3109/13697137.2010.522875
- Сметник В.П., Юренева С.В., Ермакова Е.И., Глазунова А.В. Генитоуринарный менопаузальный синдром. Клинические рекомендации (проект). Менопауза. 2015; 1:18.
- Бурменская О.В. Молекулярно-генетические маркеры иммунного ответа при воспалительных заболеваниях органов женской репродуктивной системы: дис. д-ра биол.наук. М., 2014. 249 c.
- Балан В.Е., Ковалева Л.А., Амирова Ж.С., Рафаэлян И.В. Возможности гормональной терапии урогенитальной атрофии у женщин. Акушерство и гинекология. 2011; 6: 113-116.
- Есефидзе Ж.Т. Клиника, диагностика и лечение атрофического вагинита в постменопаузе. РМЖ; 9: 370.
- Ravel J., Gajer P., Abdo Z., Schneider G.M., Koenig S.S., McCulle S.L., Karlebach S., Gorle R., Russell J., Tacket C.O., Brotman R.M., Davis C.C., Ault K., Peralta L., Forney L.J. Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci U. S. A. 2011;108 Suppl 1: 4680-7. doi: 10.1073/ pnas.1002611107
- Brotman R.M., Shardell M.D., Gajer P., Fadrosh D., Chang K., Silver M.I., Viscidi R.P. Burke A.E., Ravel J., Gravitt P.E. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. 2014; 21(5): 450-8. doi: 10.1097/GME.0b013e3182a4690b
- Hummelen R., Macklaim J.M., Bisanz J.E., Hammond J.A., McMillan A., Vongsa R., Koenig D., Gloor G.B., Reid G. Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness. PLoS One. 2011; 6(11): e26602. doi: 10.1371/journal.pone.0026602
Supplementary files
![](/img/style/loading.gif)