Evaluation of hygienic douching on the vaginal microflora of female sex workers

Amaral, Rose Luce Gomes do; Giraldo, Paulo César; Gonçalves, Ana Katherine; Eleutério, José; Pereira, Sílvio Antônio dos Santos; Linhares, Iara M.; Passos, Mauro Romero Leal

doi:10.1258/095646207782212333

Cited by 18 publications

(27 citation statements)

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“…Excessive discharge was rare in patients with VVC. Although the vaginal discharge in CV has previously been described as cheesy or curd-like [22,23] , we found that most vaginal samples in this group appeared homogeneous, white, thin and paste-like. However, thicker white or yellowish 'cheese-like' discharge, with or without lumping, was found in the VVC samples.…”

Section: Discussioncontrasting

confidence: 62%

“…Apart from a study by Amaral et al [22] , which reported a 1.9% frequency of CV in female sex workers, studies CV reported thus far have focused largely on the frequency of women with symptoms mimicking VVC. For instance, Cerikcioglu and Beksac [13] reported that CV was diagnosed in 7.1% of 210 women with genital signs/symptoms suggestive of VVC.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Significance and Characteristic Clinical Differences of Cytolytic Vaginosis in Recurrent Vulvovaginitis

Shuhua

Zhang²,

Liu³

et al. 2016

Gynecol Obstet Invest

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Aim: The study aimed to evaluate whether cytolytic vaginosis (CV) has important clinical implications for recurrent vulvovaginitis and to identify clinical differences between CV and vulvovaginal candidosis (VVC). Methods: Medical histories, physical examinations and laboratory findings were used to diagnose and assess the prevalence rates of various vulvovaginal infections among 536 women with recurrent vulvovaginitis. Chi-square and Fisher exact tests were used to compare age, menstrual cycle phase at episode onset, symptoms/signs of infection and discharge characteristics between CV and VVC with single infection. Results: Among the 484 women with a single-infection recurrent vulvovaginitis, the prevalence of CV (n = 143; 26.7%) was second only to VVC (n = 196; 36.6%). CV symptoms occurred predominantly during the ovulatory and luteal phases. Meanwhile, VVC episodes were not concentrated premenstrually, but rather occurred throughout the menstrual cycle. Significant differences were found in the vaginal pH, discharge characteristics and frequency of inflammatory symptoms between the 2 groups. Conclusions: CV is clinically important, because it is a common cause of recurrent vulvovaginitis. To distinguish CV from VVC, gynecologists should consider the patient's medical history, physical and laboratory findings, vaginal pH and vaginal discharge characteristics.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Clinical Significance and Characteristic Clinical Differences of Cytolytic Vaginosis in Recurrent Vulvovaginitis

Shuhua

Zhang²,

Liu³

et al. 2016

Gynecol Obstet Invest

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“…Two studies reported comparison of women with abnormal flora (NS = 4–10) to normal flora (NS = 0–3) [29], [35], and one study defined BV as women with a NS = 7–10 or NS = 4–6 with ≥3 Amsel criteria [15]. Data was included as reported in the publications for these studies and did not have significant implications for the association as determined by sensitivity analyses (see below and Table S1, Table S2 and Table S3).…”

Section: Resultsmentioning

confidence: 99%

Hormonal Contraception Is Associated with a Reduced Risk of Bacterial Vaginosis: A Systematic Review and Meta-Analysis

et al. 2013

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ObjectiveTo examine the association between hormonal contraception (HC) and bacterial vaginosis (BV) by systematic review and meta-analysis.MethodsMedline, Web of Science and Embase databases were searched to 24/1/13 and duplicate references removed. Inclusion criteria 1) >20 BV cases; 2) accepted BV diagnostic method; 3) measure of HC-use either as combined oestrogen-progesterone HC (combined), progesterone-only contraception (POC) or unspecified HC (u-HC); 4) ≥10% of women using HC; 5) analysis of the association between BV and HC-use presented; 6) appropriate control group. Data extracted included: type of HC, BV diagnostic method and outcome (prevalent, incident, recurrent), and geographical and clinic-setting. Meta-analyses were conducted to calculate pooled effect sizes (ES), stratified by HC-type and BV outcome. This systematic review is registered with PROSPERO (CRD42013003699).ResultsOf 1713 unique references identified, 502 full-text articles were assessed for eligibility and 55 studies met inclusion criteria. Hormonal contraceptive use was associated with a significant reduction in the odds of prevalent BV (pooled effect size by random-effects [reES] = 0.68, 95%CI0.63–0.73), and in the relative risk (RR) of incident (reES = 0.82, 95%CI:0.72–0.92), and recurrent (reES = 0.69, 95%CI:0.59–0.91) BV. When stratified by HC-type, combined-HC and POC were both associated with decreased prevalence of BV and risk of incident BV. In the pooled analysis of the effect of HC-use on the composite outcome of prevalent/incident/recurrent BV, HC-use was associated with a reduced risk of any BV (reES = 0.78, 95%CI:0.74–0.82).ConclusionHC-use was associated with a significantly reduced risk of BV. This negative association was robust and present regardless of HC-type and evident across all three BV outcome measures. When stratified by HC-type, combined-HC and POC were both individually associated with a reduction in the prevalence and incidence of BV. This meta-analysis provides compelling evidence that HC-use influences a woman’s risk of BV, with important implications for clinicians and researchers in the field.

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“…Using a marginal structural modeling analysis to attempt to control for confounding factors, Brotman et al [25] found that the relative risk of douching versus no douching was 1.21 (1.08, 1.38) for BV. Finally, a recent cross-sectional study of douching among female sex workers in Brazil found no association between douching and BV [26]. Thus, the data remain contradictory and a defi nitive answer is pending.…”

Section: Introductionmentioning

confidence: 98%

New concepts in the etiology of bacterial vaginosis

Schwebke

2009

Curr Infect Dis Rep

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Bacterial vaginosis (BV) is the most common vaginal infection worldwide. It has been linked to serious public health consequences including preterm birth, postoperative infections, and the acquisition and transmission of sexually transmitted diseases including HIV. The etiology of BV remains unknown. In this article, controversies about sexual transmission, microbial pathogens, and heterogeneity of BV as a disease entity are discussed.

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Evaluation of hygienic douching on the vaginal microflora of female sex workers

Cited by 18 publications

References 0 publications

Clinical Significance and Characteristic Clinical Differences of Cytolytic Vaginosis in Recurrent Vulvovaginitis

Clinical Significance and Characteristic Clinical Differences of Cytolytic Vaginosis in Recurrent Vulvovaginitis

Hormonal Contraception Is Associated with a Reduced Risk of Bacterial Vaginosis: A Systematic Review and Meta-Analysis

New concepts in the etiology of bacterial vaginosis

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