•More than 50% of menopausal women suffer from vulvo-vaginal atrophy.•Estrogen therapy has been used for the management of symptoms of vulvo-vaginal atrophy.•Meclon Idra Alfasigma is a new natural ...vaginal gel.•The new gel was shown in this study to be effective, tolerable and safe.•Study participants confirmed that the new gel reduced both symptoms of vulvo-vaginal atrophy and sexual impairment.
The aim of the present randomized placebo-controlled single-center study was to assess the efficacy and safety of a new vaginal gel (Meclon Idra - Alfasigma) in the treatment of vulvovaginal atrophy (VVA). The gel is composed of sea buckthorn (Hippophaë rhamnoides) oil, aloe vera, 18β-glycyrrhetic acid, hyaluronic acid and glycogen. The study assessed whether the gel can reduce VVA symptoms (vaginal dryness, itching, burning sensation) and improve sexual function in postmenopausal women over 12 weeks.
Postmenopausal women (n° = 60) reporting VVA symptoms were recruited and randomized in a 1:1 ratio to the gel or placebo. Active vaginal gel or placebo was applied for 14 days and then twice a week for 90 consecutive days.
The Vaginal Health Index (VHI), including vaginal pH, was used to assess changes in objective signs, whereas the self-reported Female Sexual Function Index (FSFI) was used to investigate sexual function.
Meclon Idra was effective in reducing vaginal pain, dyspareunia and vaginal pH, with the VHI showing significant improvement at day 90 (P < .0001), and in reducing each VVA symptom (vaginal dryness, vaginal itching, burning sensation) at weeks 2 and 4, and the end of the study (P < .0001). The analysis of FSFI scores showed, after the end of treatment, an improvement of sexual function in the active-treatment group, with a statistically significant increase (P < 0.001) in all domains scores and total score (P < 0.001).
The present single-center randomized clinical trial demonstrated the efficacy, tolerability and safety of 12-week treatment with a new vaginal gel in postmenopausal women with symptoms associated with VVA. Based on this trial, the gel seems to be a valid choice as a single, local agent for relieving VVA symptoms and improving sexual function, and to have good compliance.
This trial is registered prospectively with the Clinical Trials Registry – India, number CTRI/2019/05/01911.
Effective management of vasomotor symptoms (VMS) in patients undergoing treatment for breast cancer (BC) represents a critical but frequent unmet need. This review summarizes the epidemiology, ...pathophysiology, and clinical features of VMS in patients with BC and provides a synopsis of the complementary and alternative medicine (CAM) approaches in relieving VMS with a focus on purified cytoplasm of pollen (PCP).
The literature on VMS epidemiology, pathophysiology, clinical burden, and CAM treatment in healthy women and patients with BC was reviewed.
VMS are common in patients with BC undergoing hormonal treatment and negatively impact quality of life, leading to treatment discontinuation in up to 25% of patients with detrimental impact on risk of BC recurrence and overall survival. CAM approaches to treat VMS in patients with BC include vitamin E, phytoestrogens, and black cohosh, even if there is a lack of solid evidence to guide clinicians in the choice of treatment. PCP, obtained according to standards of good manufacturing practice, has a definite pharmacological mechanism of action, is devoid of estrogen activity, and has shown clinical efficacy on menopause-associated symptoms with a favorable safety profile and high compliance. As such, it appears to represent a valid management option to improve quality of life in patients with pre- and postmenopausal BC.
Physicians should actively investigate the presence and impact of VMS in patients receiving therapy for BC. Additional and appropriately sized randomized clinical trials are needed to provide clear evidence on how to best meet the needs of patients with BC suffering from menopause-associated symptoms.
The aim of this study is to summarize evidence on the effectiveness of virtual reality simulators for experienced and novice surgeons in improving their hysteroscopic skills. Three types of ...hysteroscopic simulators were evaluated: Hyst Sim VR, Virtual Reality Uterine Resectoscopic Simulator, Essure Sim TM. Virtual reality simulators have been assessed to be highly relevant to reality and all surgeons attained significant improvements between their pre-test and post-test phases, independent of their previous level of experience, demonstrating more improvement among novices than experts. Available evidence supports the effectiveness of virtual simulators in increasing the diagnostic and surgical skills of gynaecologists, independent from their starting level of expertise.
In mammals, the effects of ovarian steroids influence sexual behavior. In humans, there are a few studies that take into account if ovulation occurs.
The study aims to investigate if a woman's ...sexuality changes during the week and over the menstrual cycle, and if so, in what way.
This is a prospective cohort study; 1,957 heterosexual women were involved over the period January 2004–December 2011. Two subgroups were taken into consideration, women having a partner and singles.
Sexual interview and the Female Sexual Function Index and Female Sexual Distress Scale questionnaires were used to exclude women with sexual dysfunction. Women with ovulation confirmed by sonography were enrolled. Women were given diary cards on which to report their daily sexual activity. Serum concentrations of estradiol, progesterone, total testosterone, sex hormone binding globulin, and free androgen index were measured during the follicular, periovular, and luteal phase of the menstrual cycle.
One thousand one hundred eighty women (age range 18–40 years) were included in the analyses. Of them, 925 had a heterosexual relationship and 255 were single. Women with a partner had more sexual activity during the weekend, while the singles had a constant sexual activity over the week. The sexual activity of singles was higher during the ovulatory phase and lower during menses than that of the women with a partner. A linear correlation between sexual activity and androgenic hormonal profile during the menstrual cycle in women with and without a partner was observed.
Ovarian steroids modulate a woman's sexual activity. This aspect was more evident in singles than in women having a partner, in which a variety of nonhormonal factors can have a role. Caruso S, Agnello C, Malandrino C, Lo Presti L, Cicero C, and Cianci S. Do hormones influence women's sex? Sexual activity over the menstrual cycle. J Sex Med 2014;11:211–221.
The aim of this study was to evaluate the impact of vaginally prasterone administration on postmenopausal women with genitourinary syndrome of menopause (GSM) affected by overactive bladder syndrome ...(OAB).
A secondary aim of this study was to assess the efficacy of prasterone on VVA and quality of life (QoL).
Thirty-two postmenopausal women with GSM and referred OAB symptoms received treatment with daily intravaginal prasterone 6.5 mg. We assessed urinary symptoms through approved ICIQ-OAB and ICIQ-UI questionnaires on incontinence. Women were also screened by the Vaginal Health Index (VHI) to investigate the vulvovaginal atrophy (VVA). Quality of life (QoL) was assessed by the SF-12 Health Survey. Each questionnaire was administrated at baseline (T0) and after a 12-week treatment (T1).
Incontinence questionnaires showed improvement at T1 (from 7.8 ± 2.7 to 2.7 ± 2.2, p < 0.001). Even if women referred an improvement of daily urine although the women reported improvement in daily urine leaks, their urine leak amount did not improve statistically significant T0 (28.6%) Vs T1 (14.3%), p < 0.16. Prasterone therapy improved significantly the VHI T1(21 ± 3.7) Vs T0 (10.8 ± 4.1), p < 0.001. Finally, women had a statistically significant improvement both in Mental T1(49.9 ± 11.2) Vs T0 (42 ± 9.2), p < 0.009,) and Physical Health T1(47.1 ± 9.1) Vs T0 (38.6 ± 8.4), p < 0.006, domains of the SF-12 questionnaire. No women referred side effects.
Prasterone is an inactive precursor converted into estrogens and androgens into vaginal tissue. It leads to positive effects on VVA through the activation of the vaginal androgen and estrogen receptors. Empirical evidence in this study suggests that intravaginal 6.5 mg prasterone administration could be an effective treatment for postmenopausal women with GMS affected by OAB.
To investigate the effects of a combined oral contraceptive (COC) containing 17β-estradiol (E2) 1.5 mg and nomegestrol acetate 2.5 mg (NOMAC/E2) on the sexual health of women affected by low sexual ...desire due to COCs containing ethinylestradiol.
Eighty-three women (age range 19-32) participated in the study. Sex hormone-binding globulin (SHBG), total testosterone (TT), and free androgen index (FAI) were measured. The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) questionnaires were used to assess sexual function and distress, respectively. Hormonal levels were measured and questionnaires were administered before the women switched COC NOMAC/E2 usage (baseline) and at the 3-month (first) and 6-month (second) follow-ups.
SHBG reduction (p < 0.001), TT (p < 0.05), and FAI increases (p < 0.001) were observed during the first and second follow-ups with respect to baseline values. Sexual desire increased from baseline to the first and second follow-ups (p < 0.001). At baseline, the total FSFI score was 22 ± 1.5 and the FSDS score was 16.6 ± 1.3, both indicating sexual dysfunction with sexual distress. At the first follow-up, the total FSFI score and the FSDS score increased toward sexual health values, being 28.3 ± 1.6 and 12.1 ± 1.5, respectively (p < 0.001). At the second follow-up, the FSFI score had risen to 30.6 ± 1.3 (p < 0.001) and the FSDS score had dropped to 8.3 ± 1.4 (p < 0.001).
COCs containing E2 are an innovation that could help women to not suffer from low sexual desire during hypoandrogenic COC usage.
Sexual Behavior of Women With Diagnosed HPV Caruso, Salvatore; Bruno, Maria Teresa; Cianci, Stefano ...
Journal of sex & marital therapy,
10/2019, Letnik:
45, Številka:
7
Journal Article
Recenzirano
One hundred twenty-one women of reproductive age with suspected human papillomavirus (HPV) infection were studied. HPV-DNA testing was performed to determine HPV positivity and genotype. The Female ...Sexual Function Index was administrated before and three months after the diagnosis was communicated to the patient. Eighty-six women were HPV-positive and had a significant worsening of sexual function over the next three months. The women receiving information that they were HPV-negative did not experience a worsening of sexual function. Clinicians need to be aware of the possible adverse effects on sexual behavior of the diagnosis of HPV.
This study aims to evaluate the effects of myo-inositol supplementation on gestational diabetes mellitus (GDM) rates and body water distribution in overweight non-obese women. 223 overweight ...non-obese women pregnant were randomly assigned to the treatment group (2 g of myo-inositol plus 200 µg of folic acid) or to the placebo one (200 µg of folic acid). The treatment lasted until three weeks after delivery. A tetrapolar impedance analyser was used to study body composition. The incidence of GDM was significantly reduced in the myo-inositol group compared with the placebo group. There was a significant increase in TBW, ECW and ICW values in the placebo group compared to the myo-inositol group. We have recorded a significant reduction in the overall incidence of pregnancy-induced hypertension in the myo-inositol group compared with the placebo group. Our results demonstrate the effectiveness of myo-inositol supplementation in preventing GDM in overweight non-obese pregnant women.
To study the effects of gonadal steroids on the nongenital audiological target in surgically postmenopausal women treated with patch or gel transdermal estrogen therapy (ET).
Prospective randomized ...study.
Research Group for Sexology, University of Catania, Italy.
One hundred twenty-two surgically postmenopausal women.
Transdermal E
2 by patch or gel, and evaluation of auditory brainstem response by auditory-evoked potentials for waves I, III, and V latencies, and for interpeak I–III, I–V, and III–V intervals.
Changes in auditory wave latencies and in interpeak intervals during treatment with ET with respect to baseline levels.
One hundred two women completed the study. Forty-eight subjects used E
2 patches and 54 E
2 gel. No significant difference was observed in plasma E
2 improvement and in auditory brainstem response values with the two estrogen (E) formulations. The wave latencies and the interpeak intervals showed lower values during the E treatment than at baseline.
Auditory brainstem response seems to depend on the type of E given. Our data suggest that fluctuating E levels act on waves, even if the exact mechanism of the gonadal steroids is not clear. However, we believe that E could influence neuronal plasticity, the metabolic levels of neurotransmitters, and thus, the neuronal conduction time into the audiological system.
