Secondary dysmenorrhea and dyspareunia associated with pelvic girdle dysfunction: A case report and review of literature.

Secondary dysmenorrhea is frequently associated with dyspareunia. When the diagnostic workup is negative, its clinical management could be complex and a cause for concerned for the patient. We reported a case of a young woman who suffered from dyspareunia, dysmenorrhea and chronic pelvic pain. After symptoms progression and pharmacological therapy unresponsiveness, the gynaecologist referred the patient to an osteopath for the functional evaluation of the abdominal pevic area. The examination revealed the presence of pelvic, lumbosacral, and sacrococcygeal dysfunctions which, once treated, significatively reduced the severity of dysmenorrhea and dyspareunia. A multidisciplinary approach might be considered in case of suspected functional impairment. This should be carefully evaluated, considering the previous trauma history and the somatic dysfunctions on abdominal-pelvic fascia.

Evaluation of Gut Microbiota in Patients With Vulvovestibular Syndrome.

BACKGROUND: Vulvovestibular syndrome (VVS) or vulvodynia is a chronic, heterogeneous and multifactorial disease that dramatically affects women's health and quality of life. Despite important advancements in understanding VVS etiology have been achieved in the past decades, VVS still remains an elusive and complex condition without identifiable causes and effective treatments. In the present observational, retrospective, case-control study, we sought to investigate whether gut dysbiosis developed in patients with VVS. METHODS: To this aim, we compared both bacterial and fungal composition in VVS patients (n = 74; 34.3 ± 10.9 years old) with those of women without gynecological symptoms (n = 13 healthy control; 38.3 ± 10.4 years old). Furthermore, to assess whether gut ecology may have an impact on gut function, the degree of intestinal inflammation (calprotectin levels) and gut permeability (zonulin levels) were also evaluated. RESULTS: VVS patient developed gut dysbiosis, mainly characterized by a significant increase of Escherichia coli along with increased colonization of mold/yeast compared to healthy controls. Furthermore, fecal levels of zonulin indicated that in VVS patients gut dysbiosis translated into increased gut permeability. CONCLUSION: Our preliminary study, by demonstrating that alterations in gut microbiota and intestinal permeability are present in patients with VVS, highlights the novel notion that gut dysbiosis may be considered an important associated factor for VVS. These findings, if confirmed, may be clinically relevant and may help in choosing further diagnostic methods and more effective therapies for these patients.