Vaginal epithelium and microflora characteristics in women with premature ovarian failure under hormone therapy compared to healthy women.

PURPOSE: To evaluate some microbiological aspects of the vaginal flora and the vaginal trophism of women with premature ovarian failure (POF) in use of oral hormone therapy. METHODS: A cross-sectional study with 36 women with POF under the age of 40 years using oral hormonal therapy. They were age matched with 36 women with normal gonadal function (control group). The characteristics of the vaginal epithelium were assessed through the hormonal vaginal cytology, vaginal pH measurement and vaginal health index to identify vaginal disturbances. Vaginal microflora was evaluated by the amine test, bacterioscopy (Nugent score) and culture for fungi to identify vaginal abnormal microflora and fungi infections. RESULTS: Despite the fact that there were no statistical significant differences related to the cytological aspects and pH measurements, it was found that the vaginal health index was highly superior in the control group than in the POF group (23.4 ± 1.8 vs 20.8 ± 3.5), p < 0.0001 despite both groups had trophic scores. There were no statistical significance differences regarding to vaginal microflora types and fungi infection. CONCLUSION: Oral hormone therapy for young women with POF seems to be good enough to reestablish the epithelium cells, vaginal pH and microflora.

Aspectos microbiológicos e funcionais da mucosa vaginal e sua relação com função sexual de mulheres com falência ovariana prematura / Microbiological and functional aspects of the vaginal mucosa and its relationship with sexual function of women with premature ovarian failure

Introdução: Em mulheres com falência ovariana prematura (FOP) em uso de terapia hormonal (TH) os aspectos microbiológicos e funcionais da mucosa vaginal e sua relação com a função sexual (FS) não está clara. Não está claro também se a FS em mulheres com FOP está mais relacionada a questões emocionais ou a problemas orgânicos. Objetivo: Avaliar a função sexual em mulheres com FOP em uso de TH e correlacioná-la com algumas características da mucosa vaginal de mulheres. Identificar o escore de lubrificação e dor no ato sexual e relacioná-los com as características da mucosa vaginal. Desenho do estudo: Corte transversal com 36 mulheres com FOP em uso de TH, acompanhadas no Ambulatório de Ginecologia Endócrina do Departamento de Tocoginecologia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas, pareadas por idade (± 2 anos) com 36 mulheres com função gonadal normal; todas sexualmente ativas e referindo pelo menos uma relação sexual no último mês. Avaliou-se função sexual através do questionário Female Sexual Function Index (FSFI), o trofismo vaginal através da citologia hormonal vaginal, pH e escore vaginal e a flora vaginal através do teste de amina, bacterioscopia e cultura de fungo. Resultados: As mulheres pareadas por idade apresentaram no grupo FOP 33,8 ± 6,1 anos e controles 34,9 ±6,1 anos e tinham relacionamento conjugal estável (91,7% e 97,2% para FOP e controle, respectivamente). O FSFI mostrou escore total para o grupo FOP e controles, respectivamente, de 21,3 ± 6,3 vs. 27,9 ± 3,4 (p<0,0001), com pior desempenho sexual na presença da falência gonadal. Também se observou diferença significativa, com mais dor e pior lubrificação, no grupo com FOP do que nos controles. O escore vaginal mostrou pior trofismo da mucosa vaginal no grupo FOP (20,8 ± 3,5) em relação ao controle (23,4 ± 1,8), p<0,0001. O estudo de citologia hormonal e do pH vaginal não evidenciou diferenças...

Introduction: In women with Premature Ovarian Failure (POF) using hormonal therapy (HT) the microbiologycal and functional aspects of the vaginal mucosa and its relationship with sexual function (SF) is not clear. It is also unclear if SF in women with POF is more related to issues in emotional or physical problems. Objective: To evaluate SF in women with POF using HT and to correlate to some characteristics of the vaginal mucosa. To identify the lubrication and pain score during the intercourse and to correlate with the vaginal mucosa characteristics. Study design: Matched cross-sectional study between 36 women with POF and 36 women of the same age (± 2 years) with normal ovarian function, accompanied by the Endocrine Gynecology Clinic, Department of Obstetrics and Gynecology, School of Medical Sciences at the State University of Campinas. Women were sexually active and had at least one sexual intercourse in the last month. Sexual function was assessed using the Female Sexual Function Index questionnaire (FSFI). The trophism was determined by vaginal hormonal cytology, pH and vaginal health index. The vaginal flora was identified by amine test, bacterioscopy and culture for fungi. Results: Women showed a similar age - in the POF group were 33.8 ± 6.1 years and in the control group were 34.9 ± 6.1 (p=0.296) - and had stable marital status (91.7% and 97.2% respectively for POF and control, p = ns). The sexual function of women with POF resulted in the total score of 21.3 ± 6.3 vs. 27.9 ± 3.4 for control group (p<0.0001). The vaginal health index showed better trophism in the control group than in the POF group (23.4 ± 1.8 vs 20.8 ± 3.5, p < 0.0001), both with trophic scores. There was more pain and poorer lubrication in the group with POF than in controls...