Current antimicrobial therapy of infectious complications of genitourinary syndrome in perimenopausal women
DOI:
https://doi.org/10.18370/2309-4117.2019.50.43-46Keywords:
genitourinary menopausal syndrome, infectious complications, nifuratel, nystatinAbstract
Genitourinary menopausal syndrome is characterized by urogenital and sexual symptoms (vaginal dryness and itching, urinary incontinence, dyspareunia, anorgasmia). According to many experts, the symptoms of genitourinary menopausal syndrome require special attention, since women are often silent and do not complain about its manifestations.
Purpose of the study. Treatment optimization of vulvar and vaginal atrophic changes that associated with estrogen deficiency in perimenopausal women.
Materials and methods. 41 women with infectious complications of genitourinary menopausal syndrome were examined and treated. The structure of this syndrome in examined women was dominated by symptoms of vulvovaginal atrophy (itching, burning, irritation), dysuria, impaired sexual function and quality of life in general. A study of sensations state of women before and after treatment was carried out using the Barlow scale and vaginal health index. All participants were prescribed a topical preparation containing nifuratel and nystatin in vaginal cream as a mototherapy for 8 days. The choice of the nifuratel drug in perimenopausal women is associated with its wide spectrum of its antimicrobial activity and a convenient form of use (cream is the most attractive form with the prevalence of atrophic processes and irritation of the mucous membrane). Antifungal effect of nystatin has an additional therapeutic effect in women with vaginal candidiasis.
Study results. Participants showed a significant regression of pathological symptoms and a significant improvement in the life quality after treatment, as evidenced by a significant improvement in the Barlow score by 2.6 times. It should be noted that the positive therapeutic effect persisted for a month after completion of therapy.
Conclusions. Based on the study results it can be concluded that the cream containing nifuratel and nystatin is highly clinically effective for treating infectious complications of genitourinary syndrome in perimenopausal women, that makes it possible to recommend this drug in case of such pathological menopausal disorders.
References
- Antypkin, Y.G., Tatarchuk, T.F., Yefimenko, O.O.“What we know about the femininity of the future.” Reproductive endocrinology 2.40 (2018): 10–14. DOI: 10.18370/2309-4117.2018.40.10-14
- Balmer, J. “The combination of nifuratel and nystatin (Macmiror complex) in the treatment of vulvovaginitis caused by a mixed fungal, bacterial and trichomonas infection. Multicenter European research.” Medical and social problems of the family 3–4 Vol. 17 (2012).
- Vdovychenko, Y.P., Gurzhenko, E.Y. “Violation and principles of diagnosis of the sexual function of women of perimenopausal age.” Women's Health 4.63 (2017): 84–94.
- Vdovychenko, Y.P., Yefimenko, O.О., Pedachenko, N.Y., Iatsyna, O.I. “Differentiated approach to the treatment of genitourinary syndrome in perimenopausal women.” Reproductive endocrinology 2.46 (2019): 10–14. DOI: 10.18370/2309-4117.2019.46.8-18
- Grishchenko, O.V., Storchak, A.V. “Clinical and microbiological substantiation of an integrated approach to the treatment of bacterial vaginosis.” Women's Health 7 (2014).
- Instructions to the medical use of Makmiror drug. Confirmed by the order of the MoH of Ukraine No. 07 from 05.01.2017, RP No. UA/5045/01/01.
- Instructions to the medical use of Makmiror complex vaginal cream. Confirmed by the order of the MoH of Ukraine No. 685 from 26.10.2015, РС № UA/3934/01/01.
- Strachunsky, L.S., ed. A Practical Guide to Infectious Chemotherapy. Publishing house NIIAH SGMA (2010).
- Kovalenko, V.N., ed. Compendium 2018 – drugs : A Guide. Kyiv. Morion (2018).
- Kalugina, L.V., Tatarchuk, T.F., Zanko, O.V. “Genitourinary menopausal syndrome – problem for women of elegant age and not only.” Reproductive endocrinology 2.28 (2016): 68–74. DOI: 10.18370/2309-4117.2016.28.68-74
- Tatarchuk, T.F. “The evolution of diagnostic and treatment tactics for vaginal discharge syndrome.” Health of Ukraine, thematic number Gynecology. December 2017.
- Birkhaeuser, M., Genazzani, A.R., eds. Pre-Menopause, Menopause and Beyond. Volume 5: Frontiers in Gynecological Endocrinology. Springer (2018).
- Caretto, M., et al. Menopause and Ageing. Reproductive Medicine for Clinical Practice. Springer. Cham (2018): 177–89.
- De Filippo, V. “Effects of the Nifuratel-Nystatin combination in local therapy of cervico-vaginal inflammatory diseases.” Minerva Ginecology 32.1–2 (1980): 123–8.
- ESHRE Capri Workshop Group. “Perimenopausal risk factors and future health.” Human reproduction update 17.5 (2011): 706–17.
- Togni, G. “In Vitro Activity of Nifuratel on Vaginal Bacteria: Could It Be a Good Candidate for the Treatment of Bacterial Vaginosis?” Antimicrob Agents Chemother 55.5 (2011): 2490–2.
- International Union against Sexually Transmitted Infections. IUSTI European Guidline of the management of the vaginal discharge (2018).
- de Villiers, T.J., Pines, A., Panay, N., et al. “Updated 2013 International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health.” Climacteric 16.3 (2013): 316–37.
- Kingsberg, S.A., Woodard, T. “Female sexual dysfunction: focus on low desire.” Obstet Gynecol 125.2 (2015): 477–86.
- Mendling, W., Poli, A., Magnani, P. “Clinical effects of nifuratel in vulvovaginal infections. A meta-analysis of metronidazole-controlled trials.” Arzneimittelforschung 52.10 (2002): 725–30.
- Nappi, R.E., Biglia, N., Cagnacci, A., et al. “Diagnosis and management of symptoms associated with vulvovaginal atrophy: expert opinion on behalf of the Italian VVA study group.” Gynecol Endocrinol 32/8 (2016): 602–6. DOI: 10.1080/09513590.2016.1183627
- Nappi, R.E., Kokot-Kierepa, M. “Women's voices in the menopause: results from an international survey on vaginal atrophy.” Maturitas 67.3 (2010): 233–8.
- Nappi, R.E., et al. “Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey.” Climacteric 19.2 (2016): 188–97.
- Romashchenko, O.V., et al. “Determination of the frequency of genitourinary syndrome of menopause (GSM) and female sexual dysfunctions.” Urology 22.2 (2018).
- Waetjen, L.E., et al. “Association between menopausal transition stages and developing urinary incontinence.” Obstet Gynecol 114.5 (2009): 989.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 О. О. Єфіменко, В. В. Дунаєвська, І. М. Ретунська
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.