Phytoprogestins: Unexplored Food Compounds with Potential Preventive and Therapeutic Effects in Female Diseases.

In recent years, there has been an increasing interest in natural therapies to prevent or treat female diseases. In particular, many studies have focused on searching natural compounds with less side effects than standard hormonal therapies. While phytoestrogen-based therapies have been extensively studied, treatments with phytoprogestins reported in the literature are very rare. In this review, we focused on compounds of natural origin, which have progestin effects and that could be good candidates for preventing and treating female diseases. We identified the following phytoprogestins: kaempferol, apigenin, luteolin, and naringenin. In vitro studies showed promising results such as the antitumoral effects of kaempferol, apigenin and luteolin, and the anti-fibrotic effects of naringenin. Although limited data are available, it seems that phytoprogestins could be a promising tool for preventing and treating hormone-dependent diseases.

Update on the treatment of genital warts.

This review summarizes new treatments from the last seven years employed for the treatment of genital warts caused by human papillomavirus (HPV). Imquimod 3.75% is a new agent with fewer side effects and perhaps a better dosing schedule than imquimod 5%, but is not more effective. Sinecatechins/Polyphenon E 15%, a novel extract from green tea can be effective against genital warts but requires three times a day dosing and is not more effective than existing treatments; the treatment course is 12-16 weeks. Photodynamic therapy combined with other destructive modalities might increase the cure rate for genital warts. The quadrivalent vaccine against HPV 6, 11, 16, 18 is decreasing the incidence of warts in the western world but the evidence does not support vaccination as a treatment for those already infected by HPV. Hyperthermia and immunomodulators might be positive additions to the armamentarium of clinicians. In sum, there are new tools that physicians can use but none is really a great advance over what was available a decade ago.

Female genital mutilation in Sierra Leone: who are the decision makers?

The objectives of this study were to identify decision makers for FGM and determine whether medicalization takes place in Sierra Leone. Structured interviews were conducted with 310 randomly selected girls between 10 and 20 years in Bombali and Port Loko Districts in Northern Sierra Leone. The average age of the girls in this sample was 14 years, 61% had undergone FGM at an average age of 7.7 years (range 1-18). Generally, decisions to perform FGM were made by women, but father was mentioned as the one who decided by 28% of the respondents. The traditional excisors (Soweis) performed 80% of all operations, health professionals 13%, and traditional birth attendants 6%. Men may play a more important role in the decision making process in relation to FGM than previously known. Authorities and health professionals' associations need to consider how to prevent further medicalization of the practice.

Integrating cervical cancer and genital tract infection screening into mother, child health and family planning clinics in Eldoret, Kenya.

BACKGROUND: Visual inspection, with acetic acid (VIA) and with Lugol's iodine (VILI), has been demonstrated to have test characteristics comparable to those of Pap smear but are more affordable and easier implement. It also presents an opportunity for management of female genital tract infection. OBJECTIVES: Pilot test integration of cervical cancer screening using visual inspection with genital tract infection identification into an existing MCH-FP in MTRH. METHODS: Cross sectional, descriptive study in which consecutive women were screened for genital tract inflammatory morbidity and cervical cancer through visual inspection. RESULTS: Two hundred and nineteen women with a mean age of 31-3 years, parity of 3.1 were screened. About 54% of study participants had multiple sex partners, 62% had sexual debut earlier than 20 years, while use of tobacco was reported by 4%. The test positivity rate was 13.9% and 16.9% for VIA and VILI respectively. Positive test finding was significantly related to contraceptive never-use after controlling for previous screening (p=0.006).Symptoms of genital tract infections were reported by 38% of the participants with features of cervicitis being reported by nearly 24%. CONCLUSION: Integration of cervical cancer screening and genital tract infection identification and treatment into the existing MCH-FP appears feasible.

Genital Chlamydia trachomatis infection in Australia: epidemiology and clinical implications.

Over the last decade, notification rates for genital Chlamydia trachomatis infection in Australia have been rising progressively. While chlamydia is common and possibly increasing in the general population, heterosexual adolescents, indigenous Australians in remote settings, and homosexually active men are at particular risk of infection. Few studies are available on the extent of morbidity from chlamydia-associated diseases. Australia urgently needs a national strategy to control chlamydia, with widespread, selective screening as a key component. As general practitioners have an important role to play, we proffer guidelines for selective testing in primary care.

Should we offer antibiotic prophylaxis post sexual assault?

Our objective was to assess whether antibiotic prophylaxis should be offered to women post sexual assault by considering acceptability of prophylaxis, follow up attendance rates and the prevalence of sexually transmitted infections (STIs) in these women. Retrospective case notes review of female survivors of rape or sexual assault attending the Rose Clinic, Ambrose King Centre, Royal London Hospital between 1 January 1997 and 31 May 1999 was carried out. The following selection criteria were applied: age greater than 16 years; attending within two weeks of assault; having experienced vaginal and/or anal penetration. All women were screened for STI using standard investigation methods detailed below. Antibiotic prophylaxis was offered within two weeks of the assault, the antibiotic regimens used as recommended. The women were invited to attend for results at two weeks and offered a further screen at three months post assault. Bacterial vaginosis was present in 32% of the women screened, Chlamydia trachomatis was identified in 8%, none tested positive for Neisseria gonorrhoeae. Of the 25 women who were offered antibiotic prophylaxis, 88% accepted. Follow up attendances were 57% at two weeks and 30% at three months. Antibiotic prophylaxis was acceptable to women. Among recent rape victims, follow-up rates are low confirmed by our study. These factors support the use of antibiotic prophylaxis post sexual assault. There was an apparently high prevalence of STIs amongst women in this study. More research is required with respect to this aspect of the work and to consider the cost-benefit analysis of antibiotic prophylaxis.

Cultural and personal behavioral factors and women's reproductive tract infections.

OBJECTIVE: To review the relationship between personal behavior and cultural factors and reproductive tract infections (RTIs). METHODS: An English-language literature search using MEDLINE (1994-1998), Social Science Index (1994-1998), and informal discovery. Any original researches and reviews related to RTIs' epidemiology, behavior and culture were selected. RESULTS: RTIs have become a silent epidemic that is devastating women's lives each year. CONCLUSION: The influencing factors include sexual behavior, health related behavior (preventive health behavior, health-seeking behavior, reproductive behavior etc.) and culture, belief, etc. A holistic point of view should be taken.

Promoting gynecologic health in young and middle-age women.

A holistic approach to gynecologic health addresses more than the physical problems associated with the reproductive organs and breasts. The article presents information about selected gynecologic health issues for young and middle-age women (17 to 60 years) in a context that considers other aspects of the client, such as the woman's age, life style, health behaviors, culture and ethnicity, and education. Strategies to promote gynecologic health are discussed in relation to these aspects.

The 'other' sexually transmitted diseases: a case for public health education.

Generally, people tend to associate the phrase 'sexually transmitted diseases' (STDs) with only gonorrhoea and syphilis. This paper highlights the prevalence of other diseases such as herpes simplex, trichomoniasis and candidiasis which are also sexually transmitted. It is shown that, although they are rarely discussed and reported, various estimates, particularly in the developed countries where statistics are available, indicate that their incidence rates are rapidly rising to epidemic proportions and, in certain instances, have surpassed the annual cases of syphilis and gonorrhoea. Their causative organisms, mode of spread, signs and symptoms, complications, prevention and control are presented. Although knowledge of the above are important, it is emphasised that it is much more desirable to focus on prevention through public health education. Health education strategies such as avoiding sexual exposure with infectees, personal hygiene, simulation, role-play and unemotional discussion in schools and the use of mass media in disseminating information to the public regarding prevention, control and how to seek for treatment are elaborated upon.

Noncontraceptive benefits of oral contraceptives.

The noncontraceptive health benefits of oral contraceptives were initially summarized a decade ago. Studies conducted in the last decade confirmed the findings of earlier studies with high-dose oral contraceptives and extended them to low-dose formulations. Among the noncontraceptive health benefits first cited were reductions in menorrhagia, irregular menses, endometrial cancer, ovarian cancer, functional ovarian cysts, benign breast disease, dysmenorrhea, premenstrual tension and iron-deficiency anemia. In addition, women who used oral contraceptives were less likely to develop rheumatoid arthritis or acute salpingitis, particularly moderate or severe forms, than were women using no method of contraception. Despite the fact that such benefits were identified more than 10 years ago and despite their inclusion in oral contraceptive labeling, women today are largely unaware of the noncontraceptive health benefits associated with oral contraceptive use.

Liv-52 protection against beryllium toxicity in female albino rats.

Toxic effects of beryllium salts on the reproductive organs of cyclic adult female albino rats have been studied. An attempt was made to overcome these effects using an Ayurvedic medicine Liv-52 (Himalaya Drug Co., Bombay). Liv-52-primed rats (1 mL/rat/day for 15 days) were exposed to beryllium nitrate intravenously and were sacrificed at different time intervals. At autopsy ovary, uterus, cervix, and vagina were processed for biochemical and histopathologic examination. Histoarchitecture of the ovary, uterus, cervix, and vagina revealed severe necrotic changes with beryllium nitrate treatment. Tissue glycogen content and the activity of alkaline phosphatase were inhibited significantly after beryllium treatment. Total and esterified cholesterol levels increased significantly in these organs when exposed to beryllium salts. However, a significant improvement was observed in the biochemical parameters and histoarchitecture of these organs when beryllium was injected into Liv-52-primed animals.

Clinical study of mezlocillin for the treatment and prevention of postoperative obstetric and gynecological infections.

Twenty-one women were given mezlocillin for the treatment or prevention of infections after obstetric and gynecological surgery. Ten women had active infections caused by Escherichia coli, Klebsiella species, Proteus mirabilis, Pseudomonas aeruginosa, or Streptococcus faecalis. They had a 90% rate of recovery after an average of seven days of treatment with 6 to 15 gm/day of mezlocillin. The other 11 women were given mezlocillin prophylactically, 2 gm every 12 hours for seven days. All had good postoperative courses without complications caused by infections. Among both groups only three adverse reactions occurred, two instances of rash and one case of moderate diarrhea. All resolved spontaneously without discontinuation of treatment.