Foods to help when you have BV
Vaginal complaints are a common reason for women of all ages to visit their physician, with an estimated 3.2 million initial visits to physicians offices for this population in 1997 (8). Decreased estrogen production in the postmenopausal woman causes a number of changes in the vagina, which can lead to a variety of symptoms (21). The amount of glycogen in the epithelial cells diminishes, leading to a reduction in the lactobacilli population that help to protect the vagina from other bacteria by their production of lactic acid and hydrogen peroxide. The resulting increase in pH facilitates colonization of the vagina with coliform bacteria, streptococci, and staphylococci. The lack of estrogen also leads to thinning of the vaginal mucosa, loss of rugae, and a progressive loss of elasticity and vascularity. The vaginal vault shortens and narrows, and the vaginal introitus may also become contracted. These changes often lead to dyspareunia, vaginal dryness, itching, burning or pruritis,...
Mannan is found in the cell wall as large N-linked and shorter O-linked mannooligosaccharides associated with mannoproteins. Anti-mannan antibodies are prevalent in human sera, including patients and normal population (Domer, 1989 Lopez-Ribot et al., 2004 Martinez et al., 1998 Reiss and Morrison, 1993). The antigenic specificity of serotypes A and B of C. albicans is determined by structural peculiarities of the carbohydrate moiety of mannans (Hasenclever and Mitchell, 1964). The mannan component is also involved in adhesive interactions (Chaffin et al., 1998). Han and Cutler immunized mice with a mannan fraction (previously encapsulated into liposomes) to induce protective antibody responses. In the same study, these authors tested two monoclonal antibodies specific for different mannan epitopes in the adhesin fraction. Both antibodies agglutinated Candida cells but only one of them protected mice against disseminated candidiasis. The protective antibody recognized the acid-labile...
Estrogens may be administered orally, IM, IV, or intravaginally. Oral estrogens are administered with food or immediately after eating to reduce gastrointestinal upset. When estrogens are given vaginally for atrophic vaginitis, the nurse gives the patient instructions on proper use.
Vaginitis and vaginal discharge are common complaints prompting women to visit their health care providers. The differential diagnosis is extensive and should include physiologic discharge, chemical or irritant vaginitis, atrophic vaginitis, and vaginitis due to the infectious agents discussed in the following sections. Many over-the-counter products, such as topical antifungals, are widely available and allow women to self treat, often inappropriately. This makes diagnosis even more difficult and confusing when patients present with partially treated disease. Patients with vaginitis should undergo a speculum examination with careful examination of the cervix for discharge and acquisition of cultures (2). If no cervical discharge is present, then the vaginal mucosa should be inspected and material obtained for pH as well as microscopic examination with normal saline and potassium hydroxide solutions. These simple bedside procedures should aid in determining whether or not a patient...
The protozoa that parasitize the human intestinal and urogenital systems belong to five major groups amebae, flagellates, ciliates, coccidia, and microsporidia. With the exception of the flagellate Trichomonas vaginalis (an important cause of vaginitis, see colorplate 49) and microsporidia of the genera Pleistophora, Nosema, and Encephalitozoon, all of these organisms live in and may cause disease of the intestinal tract.
C. trachomatis and N. gonorrhea are well-documented causes of PID. One recent randomized, controlled trial found that identifying and treating women with chlamy-dial cervical infections reduced the incidence of PID (65). PID is frequently a polymicrobial infection with bacteria such as M. hominis, H. influenzae, G. vaginalis, staphylococci, Group B streptococci, E. coli, and anaerobes (66). Thus, the consensus is that PID necessitates broad-spectrum antibiotic therapy. Anaerobes are particularly frequent in women with TOA and with PID in the presence of HIV infection or bacterial vaginosis (64,66). There is an association between bacterial vaginosis and PID, but its significance is controversial.
Guidelines for management of women with abnormal cervical cytology have been established by the National Cancer Institute (9). Currently women with ASCUS undergo repeat cytology every 4-6 mo for 2 yr until there have been three consecutive normal smears. If ASCUS is found in conjunction with an inflammatory process, then diagnostic measures to identify and treat concurrent vaginal infections should be initiated before the cytology is repeated. Most clinicians would perform colposcopy if a second ASCUS cytology is found within that 2-yr period. If LSIL is diagnosed on cytology, a similar follow-up plan may be initiated, but referral for colposcopy is recommended for women who may not return for follow-up. All women with HSIL on cytology should be referred for colposcopy.
The vaginal infection model of rhesus macaques with SIV has been useful in studies of immunity to SIV in the female reproductive tract (121,122). Recent studies in this model have provided direct evidence that pCTLs occur in female macaque repro ductive tissues and that infection with SIV induces CTL responses (123). This important finding has now been extended to vaginal infection with an SIV HIV-1 chimeric virus (SHIV) containing HIV-1 89.6 env gene (124). Interestingly, all macaques resisted two challenges with virulent SIV, and functional, gag-specific CTLs were present in the peripheral blood (124). Again, it should be emphasized that vaginal Abs were also induced however, these results clearly indicate that mucosal CTL responses may be of importance in immunity to SIV infection. Recent work has shown that intranasal immunization with SIV HIV components induces antibody responses in vaginal secretions (reviewed in ref. 125). It should be noted that intranasal immunization of mice...
Chlamydia trachomatis is a common cause of sexually transmitted diseases and a leading cause of preventable blindness worldwide (57). Host defense against chlamydial infection is mediated by both cellular and humoral immune responses (58). Ex vivo DCs pulsed with killed or live chlamydiae and reinfused into mice have been reported to induce strong protective immunity to vaginal infection (59,60). Similar protective effects have been observed for Borrelia bergdorfei, lymphocytic choriomenin-gitis, Toxoplasma, Leishmania major, and equine herpesvirus.
Candida organisms are yeasts, and several species cause human disease. Candida albicans accounts for the majority of human disease, and is responsible for mucocuta-neous disease (thrush, vaginitis), as well as invasive disease. However, other Candida species are being recognized as important pathogens. Candida tropicalis is responsible for up to one fourth of systemic candidiasis and may be more virulent than C. albicans in immunocompromised patients. Candida krusei and Candida glabrata (formerly
Estrogen is most commonly used in combination with progesterones as contraceptives or as hormone replacement therapy in postmenopausal women. The estrogens are used to relieve moderate to severe vasomotor symptoms of menopause (flushing, sweating), female hypo-gonadism, atrophic vaginitis (orally and intravaginally), osteoporosis in women past menopause, palliative treatment for advanced prostatic carcinoma, and in selected cases of inoperable breast carcinoma. The estradiol transdermal system is used as estrogen replacement therapy (ERT) for moderate to severe vasomotor symptoms associated with menopause, female hypogonadism, after removal of the ovaries in premenopausal women (female castration), primary ovarian failure, and in the prevention of osteoporosis. Estrogen is given IM or intravenously (IV) to treat uterine bleeding caused by hormonal imbalance. When estrogen is used to treat menopausal symptoms in a woman with an intact uterus, concurrent use of progestin is recommended...
Many agents are available for the treatment of Candida vaginitis. A single dose of fluconazole is often effective. Because concerns about resistance are much lower in the situation in which short-term therapy is needed, this practice has been widely adopted. However, in some patient populations in which fluconazole prophylaxis has been used, especially HIV patients, vaginitis resistant to azoles has been recognized. itraconazole if refractory esophagitis fluconazole, amphotericin if severe vaginitis fluconazole topical preparations such as nystatin, miconazole Amphotericin B fluconazole effective for most C. albicans
Rupture of the membranes, premature onset of labor, or pregnancy complications requiring premature delivery. Maternal hypertension and diabetes as well as abruptio placenta are risk factors. Maternal infections, including bacterial vaginosis, are also associated with an increased risk.
Candida vaginitis is an extremely common condition up to 70 of women will experience a yeast infection at some time in their lives (see Chapter 11, this volume). Severe and or recurrent disease may signal underlying diabetes mellitus or HIV Other emerging infections are being recognized in severely immunocompromised patients. M. furfur is a lipophilic fungus that causes dermatophytosis in the normal host. However, as a result of its lipophilic nature, it can grow in lipid-rich solutions, including parenteral hyperalimentation supplemented with fatty acids. Immunocom-promised, especially neutropenic patients receiving such therapy, may develop Malassezia infection, manifested by follicular skin lesions or disseminated disease in the lungs and other organs. T. beigelii has also emerged as a feared fungal infection in neutropenic patients. Skin, lung, or sinus involvement can progress to disseminated disease with multifocal infection. Reversal of the neutropenia is critical to survival....
Regarding vaginal infections, studies by Fidel's group illustrated a lack of a protective role of T cells against C. albicans vaginitis. This assertion was due to the evidence that most T cell-immunodeficient or knockout mice had a vaginal fungal burden similar to that of wild-type strains (Wormley et al., 2003). In support of the missing T cell involvement at vaginal level, they demonstrated that following intravaginal challenge with Candida Ag in adult women, there was no evidence of local immune stimulation, including changes in Th (Fidel et al., 2003).
A fungus that infects the vulva and vagina is Candida albicans, causing candidiasis. There is vaginitis, a thick, white, cheesy discharge, and itching. Pregnancy, diabetes mellitus, and use of antibiotics, steroids, or birth control pills predispose to infection. If the infection is recurrent, the patient's partner should be treated to prevent reinfections. Antifungal agents (mycostatics) are used in treatment.
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Bacterial Vaginosis Facts
This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.