Safety, efficacy, and tolerability of differential treatment to prevent and treat vaginal dryness and vulvovaginitis in diabetic women.

BACKGROUND: Problems affecting the vaginal tract in diabetic women are very often neglected. The efficacy and safety of three gynecological treatments in diabetic women have been assessed. MATERIALS AND METHODS: A single-blind randomized progressive trial on 48 diabetic women affected by vaginal dryness, dyspareunia, and recurrent Candida infections was carried out. The ICIQ Vaginal Symptoms (ICIQ-VS) questionnaire was administered. RESULTS: The analysis of the parameters of ICIQ-VS questionnaire among the three groups showed significant difference only for "dragging pain" (p = 0.0 19) and "soreness" (p = 0.028). In all groups and for all parameters of the questionnaire, improvement of symptoms was observed. In particular, in Group 1 for all symptoms a highly significant difference was observed, to support the already known benefits of the products and of the proposed combination. Significant improvement was also observed in Group 2. CONCLUSIONS: The proposed treatment with DermoXEN® Ultracalming Special for diabetics and DermoXEN® Vitexyl vaginal gel exert effective moisturizing and soothing action. Indeed, the aforementioned products have been proven effective for the main gynecological problems of diabetic women.

A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study.

OBJECTIVE: This pilot study aimed to assess the efficacy and feasibility of fractional CO2 laser in the treatment of vulvovaginal atrophy (VVA) in postmenopausal women. METHODS: VVA symptoms were assessed before and after three applications of laser over 12 weeks in 50 women (age 59.6 ± 5.8 years) dissatisfied with previous local estrogen therapies. Subjective (visual analog scale) and objective (Vaginal Health Index Score, VHIS) measures were used during the study period to assess VVA. Quality of life was measured by using the SF-12. A subjective scale to evaluate the degree of pain related to the laser application and the degree of difficulty to perform the laser procedure was used. RESULTS: Fractional CO2 laser treatment was effective to improve VVA symptoms (vaginal dryness, vaginal burning, vaginal itching, dyspareunia, dysuria; p < 0.001) at 12-week follow-up, as well as the VHIS (13.1 ± 2.5 at baseline vs. 23.1 ± 1.9; p < 0.001). Both physical and mental scores of quality of life were significantly improved in comparison with baseline (p < 0.001). Satisfaction with the laser procedure was reported by 42 women (84%) and a minimal discomfort was experienced at the first laser application, mainly because of the insertion and the movements of the probe. Finally, the technique was very easy to perform in all women starting from the second application at week 4 and no adverse events were recorded during the study period. CONCLUSIONS: A 12-week treatment with the fractional CO2 laser was feasible and induced a significant improvement of VVA symptoms by ameliorating vaginal health in postmenopausal women. Further controlled studies should be performed to confirm the present data and to assess the long-term effects of the laser procedure on vaginal tissues.

Vulvovaginal atrophy: current and future therapies (CME).

INTRODUCTION: Vulvovaginal atrophy results from estrogen deficiency and affects a large number of postmenopausal women. Symptoms include vaginal dryness, itching, irritation, and dyspareunia. AIM: The purpose of this review is to evaluate the efficacy, safety and acceptability of current treatment methods for vulvovaginal atrophy, as well as highlight evolving new treatment methods. Method. We conducted a review of the literature concerning treatment of vulvovaginal atrophy. RESULTS: All currently available low-dose local estrogen formulations are effective and yield few side effects. Fears sparked by the Women's Health Initiative, as well as recommendations by the FDA, have generated interest in the development of new treatment methods. Lower doses of existing formulations have proven to be efficacious. The use of estrogen agonists/antagonists and intravaginal dehydroepiandrosterone (DHEA) have both been shown to positively affect vaginal atrophy symptoms without inducing endometrial proliferation. CONCLUSION: Potential new treatment methods show promise to provide efficacy in treatment while avoiding unwanted side effects. Further research is needed to establish optimal treatment formulations.

Women's attitudes to hormone replacement therapy, alternative therapy and sexual health: a web-based survey.

OBJECTIVE: To survey women's views on hormone replacement therapy (HRT), alternative therapies and sexual health using the Internet. Study design and main outcome measures. Three questionnaires were offered on a UK, patient-tailored, independent, clinician-led dedicated menopause website. They covered HRT, alternative therapies and sexual health. The anonymous responses of the users of the website were analysed. RESULTS: There were 1026, 1072 and 1002 responses for the HRT, alternative therapies and sexual health questionnaires, respectively. On the first, 75% of respondents were in favour of HRT; 36% felt media reports of the risks of HRT had been exaggerated and 73% of women did not know enough about HRT to make informed choices. In relation to alternative therapies, 85% of respondents felt they did not know enough to make informed choices, 71% received no advice before starting an alternative therapy and 69% were unaware of possible interactions. Ninety-five per cent would try alternative therapies before HRT in the belief that they were more natural and 68% were prepared to pay more than pound10 a month for such therapies. On the questionnaire on sexual health, 88% of respondents indicated that they believed an active sex life was important. Fifty-three per cent recorded that they experienced dyspareunia, but 51% of women hid their symptoms and 31% made excuses to avoid intercourse; 54% felt their confidence had been adversely affected. Only 20% had discussed their symptoms with health professionals and only 12% were using prescribed treatment. CONCLUSIONS: Online questionnaires are a useful means to obtain data. Our surveys raised several issues, including the observations that the majority of women said they did not know enough about HRT and alternative therapies to make informed choices. There appeared to be many women with vaginal symptoms who had not spoken with a health professional and therefore were untreated.