The Vaginal Flora after Natural or Surgical Menopause

Abstract

A study was made of the cervical and upper vaginal flora in menopausal women, in an attempt to determine whether such women are predisposed to infections when undergoing gynecologic operations. The series comprised 72 women (age range, 44-80 years) classified as follows: a) 35 with a natural menopause, b) 18 with a surgical menopause induced by abdominal panhysterectomy, and c) 19 postmenopausal women after vaginal hysterectomy performed for genital prolapse. The vaginal flora of these menopausal women consisted predominantly of Gram-positive bacteria which, together with the Gram-negative bacteria, conformed to the normal pattern of microorganisms in the vagina. Such bacteria also are found in women of child-bearing age, but occasionally they can be pathogenic. Despite the inherent biohormonal changes of the memopause, expressed especially by the low estrogen level, 26.4 percent of the cultures in our study were sterile, even after major vaginal operations. Thus, the pattern of the vaginal flora, even though occasionally pathogen, should not be a contraindication to gynecologic surgical procedures in postmenopausal women. Even when vaginal cultures show the presence of these bacteria, it does not seem necessary to use prophylactic antibiotic and hormonal therapy routinely. Rather, it should be given selectively, depending upon the local state of the tissues and upon the postoperative course.

Infectious complications and managements for surgical site infections in genital Paget's disease

“…Previous investigators have identified the following organisms on the surface of the genitalia: Staphylococcus epidermidis , viridans streptococci, peptostreptococci, corynebacteria, mycobacteria, various Enterobacteriaceae , Bacteroides spp., Prevotella spp., C. albicans and other yeasts 14 . In addition, the vaginal flora of menopausal women consist predominantly of Gram‐positive bacteria, which are found together with gram‐negative bacteria 15 . In the present study, we found that colonized organisms in GPD were Enterobacteriaceae , CNS, Corynebaterium spp.…”

“…14 In addition, the vaginal flora of menopausal women consist predominantly of Gram-positive bacteria, which are found together with gram-negative bacteria. 15 In the present study, we found that colonized organisms in GPD were Enterobacteriaceae , CNS, Corynebaterium spp. or MSSA .…”

Lactational Amenorrhea as a Risk Factor for Group A Streptococcal Vaginitis

“…The condition is called senile vaginal atrophy in postmenopausal women and postpartum vaginal atrophy in postpartum women. Both conditions are characterized by dyspareunia, vaginal stinging and tightness, dysuria, vaginal color change, an increase in parabasal cells, a decrease in Lactobacillus species, and an increase in vaginal pH [16][17][18][19][20]. The association of breast-feeding with vaginal atrophy and the resultant absence of Lactobacillus species, along with its potential risks, may be underappreciated.…”