1.  Peer Reviewed Title: Female genital schistosomiasis--a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross-sectional study in endemic rural Zimbabwe. Author: Kjetland EF; Kurewa EN; Ndhlovu PD; Midzi N; Gwanzura L; Mason PR; Gomo E; Sandvik L; Mduluza T; Friis H; Gundersen SG Source: Tropical Medicine and International Health. 2008 Dec;13(12):1509-17. Abstract: OBJECTIVE: To examine the association between schistosomiasis and reproductive tract symptoms. METHOD: A cross-sectional study was conducted in a Schistosoma haematobium-endemic area of rural Zimbabwe. A total of 483 permanently resident adult women of Mupfure Ward aged 20-49 were interviewed and examined clinically, each providing three consecutive urine samples. Logistic regression analysis was used to control for sexually transmitted diseases (STDs). RESULTS: Women with genital sandy patches had significantly more genital itch (P = 0.009) and perceived their discharge as abnormal (P = 0.003). Eighty percent of the women who had genital itch, yellow discharge, and childhood or current waterbody contact had sandy patches. Fifty-two percent of the women with genital sandy patches did not have detectable S. haematobium ova in urine. Genital schistosomiasis was associated with stress incontinence and pollakisuria, but not with menstrual irregularities, current or previous ulcers, or tumours. CONCLUSION: Genital schistosomiasis may be a differential diagnosis to the STDs in women who have been exposed to fresh water in endemic areas. Because of the chronic nature of the disease in adults, we suggest to pay special attention to the prevention of morbidity. Language: English Keywords: ZIMBABWE | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | STATISTICAL REGRESSION | WOMEN IN DEVELOPMENT | RURAL POPULATION | SCHISTOSOMIASIS | SEXUALLY TRANSMITTED DISEASES | VAGINAL DESQUAMATE EFFECTS | SIGNS AND SYMPTOMS | MENSTRUATION DISORDERS | PHYSICAL EXAMINATIONS AND DIAGNOSES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Analysis | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Reproductive Tract Infections | Infections | Vaginitis | Vaginal Abnormalities | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330045 |
2.  Title: Vaginal discharge: its causes and associated symptoms as perceived by rural north Indian women. Author: Singh AJ Source: Indian Journal of Community Medicine. 2007 Jan-Mar;32(1):[11] p. Abstract: Reproductive health is closely associated with culture of a country. Its sign and symptoms can be best understood within the ethnomedical contest rather then biomedical theories. The objective was to ascertain the views of the respondents regarding vaginal discharge. Three roadside villages of Panchkula, Haryana was purposively selected. A house to house survey was done and a total of 236 married women 15-45 years were interviewed by a female social worker on various aspect on vaginal discharge. Six FGDs and five case studies were also done. Prevalence of vaginal discharge was 28.7%. Weakness, backache and poor vision were told as the main health effects of vaginal discharge. Heat, melting of bones, sexual promiscuity, poor hygiene and diet were told as the major causes of vaginal discharge. Consultation rate for vaginal discharge was 59%. The views of the rural north Indian women regarding vaginal discharge reflected the Ayurvedic system of thinking of the Indian masses. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | RURAL POPULATION | WOMEN | WOMEN'S HEALTH | REPRODUCTIVE HEALTH | VAGINAL DESQUAMATE EFFECTS | SIGNS AND SYMPTOMS | Developing Countries | Asia, Southern | Asia | Population Characteristics | Demographic Factors | Population | Health | Vaginitis | Vaginal Abnormalities | Diseases Document Number: 315288 |
| 3. Title: IUDs: old thinking versus new thinking. Author: Shelton J Source: [Baltimore, Maryland], Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Information and Knowledge for Optimal Health [INFO], 2005. 2 p. (IUD Toolkit. Up-to-date Evidence and Best Practices Related to the Intrauterine DeviceUSAID Cooperative Agreement No. GPH-A-00-02-00003-00USAID Development Experience Clearinghouse DocID / Order No. PN-ADI-069) Brought to you by members of USAID's Maximizing Access and Quality Initiative [MAQ]. Abstract: STIs and Pelvic Inflammatory Disease (PID): Old Think: IUDs pose substantial risk of PID and infertility in the face of STIs. New Think: Risk of PID related to IUD is far lower than commonly thought. Relates to gonorrhea or chlamydia in the cervix, specifically at time of insertion. IUDs have no or negligible effect on infertility. STI Risk and IUD Eligibility: Old Think: Women who might be at any increased risk of STI shouldn't get IUDs-including women in populations where STIs are "common" and whose partners' behavior might be suspect. New Think: STI only disqualifies women with a "very high individual risk of exposure to gonorrhea or chlamydia." (excerpt) Language: English Keywords: GLOBAL | MANUAL | INSTRUCTION | IUD | CONTRACEPTIVE USAGE | SEXUALLY TRANSMITTED DISEASE PREVENTION | PELVIC INFLAMMATORY DISEASE | VAGINAL DESQUAMATE EFFECTS | HIV INFECTIONS | INSERTION | SAFETY | ANEMIA | PREGNANCY, ECTOPIC | TRAINING ACTIVITIES | Education | Contraceptive Methods | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Vaginitis | Vaginal Abnormalities | Viral Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Pregnancy Complications | Training Programs Document Number: 315318 |
| 4. Peer Reviewed Title: Changing patterns in sexually transmitted disease syndromes in Kenya after the introduction of a syndromic management program. Author: Cheluget B; Joesoef MR; Marum LH; Wandera C; Ryan CA Source: Sexually Transmitted Diseases. 2004 Sep;31(9):522-525. Abstract: The objective of this study was to evaluate patterns in sexually transmitted disease (STD) syndromes after the introduction of an STD syndromic management program. We used the HIV sentinel surveillance in patients with STDs (1990 –2001) to compute the proportions of STD syndromes (as a proportion of all patients with STDs) before and after the introduction of the syndromic management program. A decline in the proportion of genital ulcer disease (GUD), urethral discharge (UD), and vaginal discharge (VD) was observed from the baseline (1990 –1994) to the year 2000 (P <0.0001). GUD declined from 27.6% at baseline to 11.0% in 2000; UD from 31.8% at baseline to 22.2% in 2000; and VD from 36.7% at baseline to 20.1% in 2000. Similar declines for these syndromes were also observed in sex and age groups. The proportions of GUD, UD, and UV increased again in 2001. These changing patterns of STD syndromes were coincident with the introduction of the STD syndromic management program in 1995 and the termination of free STD medication in 2001. (author's) Language: English Keywords: KENYA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | MEN | SEXUALLY TRANSMITTED DISEASES | TREATMENT | MORBIDITY | GENITAL EFFECTS, FEMALE | GENITAL EFFECTS, MALE | UROGENITAL EFFECTS | VAGINAL DESQUAMATE EFFECTS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Genitalia, Male | Vaginitis | Vaginal Abnormalities Document Number: 274898 |
| 5. Peer Reviewed Title: Risk for invasive and borderline epithelial ovarian neoplasias following use of hormonal contraceptives: the Norwegian-Swedish Women's Lifestyle and Health Cohort Study. Author: Kumle M; Weiderpass E; Braaten T; Adami HO; Lund E Source: British Journal of Cancer. 2004 Apr 5;90(7):1386-1391. Abstract: The risk of ovarian epithelial neoplasia following use of hormonal contraceptives (HC) was examined in data from the Norwegian-Swedish Women's Lifestyle and Health cohort including 103551 women aged 30-49 years in 1991-92. Follow-up through 2000 produced 214 incident cases of histologically confirmed epithelial ovarian neoplasias (135 invasive and 79 borderline cases). Using the Cox proportional hazard models, ever having used HC was associated with a decreased relative risk of epithelial ovarian cancer of 0.6 (95% CI 0.5-0.8). The effect of duration of HC use was convincing (P for trend <0.0001), and more important than age at start of use or time since first or last use. There was no significant difference between the effects of combined oral contraceptives and progestins-only contraceptives on risk (P = 0.98). Similarly, there was no significant difference between the effects of ever use of HC on invasive and borderline ovarian neoplasia (P = 0.37). In this cohort, use of HC seems to reduce the risk of epithelial ovarian neoplasia markedly and persistently in relation to the duration of use. (author's) Language: English Keywords: UNITED KINGDOM | SWEDEN | COHORT ANALYSIS | WOMEN | LIFE STYLE | HEALTH | ORAL CONTRACEPTIVES | VAGINAL DESQUAMATE EFFECTS | Developed Countries | Europe, Western | Europe | Europe, Northern | Research Methodology | Demographic Factors | Population | Behavior | Contraceptive Methods | Contraception | Family Planning | Vaginitis | Vaginal Abnormalities | Diseases Document Number: 277883 |
| 6. Title: [Papillomavirus-induced lesions in partners of women with intraepthelial neoplasia of the lower genital tract] Lesões induzidas por papilomavírus humano em parceiros de mulheres com neoplasia intra-epitelial do trato genital inferior. Author: Teixeira JC; dos Santos CC; Derchain SF; Zeferino LC Source: RBGO. Revista Brasileira de Ginecologia e Obstetrícia. 1999 Sep;21(8):431-437. Abstract: Objectives: researching the presence of lesions induced by papillomavirus (HPV) and the associated factors in partners of women with genital intra-epithelial neoplasia. Methods: 337 women were evaluated by urethral and peniscopic cytology and biopsy when necessary. The presence of the HPV-induced lesion was analyzed, correlating it to age, level of education, use of tobacco, marital stability, beginning of sexual activity, number of partners, history of sexually transmitted disease (STD), postectomy, peniscopic images and degree of lesions in the women. Results: the peniscopy was positive in 144 women (42.7%) and 105 (31.2%) showed HPV-induced lesions. Only tobacco use, marital stability for six months or less and the history of more than one sexual partner were associated with the presence of HPV induced lesion (p<.05). The urethral cytology was suspected for HPV in 4.2% of the cases, this being found to be significantly associated with a high degree of lesion. Of the 229 biopsies performed, 72.1% were positive for HPV, independent of the pensicopic image and degree of lesion in the woman. Conclusions: the HPV-induced lesions were diagnosed in 31.2% of the cases and were associated with tobacco use, time of marital union being six months or less and more than one sexual partner. The degree of lesion in the woman, level of education, history of STD, postectomy and peniscopic image were not shown to be correlated with the presence of the HPV-induced lesion. (author's) Language: Portuguese Keywords: RESEARCH REPORT | CORRELATION STUDIES | WOMEN | SEXUAL PARTNERS | HPV | VAGINAL DESQUAMATE EFFECTS | INCIDENCE | AGE FACTORS | FIRST INTERCOURSE | TOBACCO USE | EDUCATIONAL STATUS | MARITAL STATUS | MULTIPLE PARTNERS | Statistical Studies | Studies | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Viral Diseases | Diseases | Vaginitis | Vaginal Abnormalities | Measurement | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Nuptiality Document Number: 183656 |
| 7. Peer Reviewed Title: A phase I comparative study of contraceptive vaginal films containing benzalkonium chloride and nonoxynol-9. Postcoital testing and colposcopy. Author: Mauck CK; Baker JM; Barr SP; Abercrombie TJ; Archer DF Source: CONTRACEPTION. 1997 Aug;56(2):89-96. Abstract: Both in vitro and in vivo studies have confirmed the capability of benzalkonium chloride (BZK) to immobilize sperm, protect against sexually transmitted pathogens, and penetrate and thicken cervical mucus. In this Phase I study, 10 US women underwent 2 baseline cycles followed by 3 experimental cycles in which either a new contraceptive vaginal film containing 19 or 25 mg of BZK or a currently marketed film containing 70 mg of nonoxynol-9 (N-9) was used. After a midcycle cervical mucus specimen was analyzed, each woman had intercourse using either no film or a test film and was evaluated 2-3 hours later. The average number of progressively motile sperm seen per high power field was as follows: first baseline cycle, 22.2; second baseline cycle, 22.1; test cycle with film containing 19 mg BZK, 0.2; test cycle with film containing 25 mg BZK, 0.0; and test cycle with film containing 70 mg N-9, 0.0. Colposcopy revealed superficial de-epithelialization without underlying inflammation in 15-20% of baseline cycles, 50% of BZK test cycles, and 69% of cycles in which the N-9 film was used. Women rated both films as neutral or pleasant in terms of appearance, smell, and feel. These findings suggest that contraceptive vaginal films containing either 19 or 25 mg of BZK are as effective as N-9 containing films and may be somewhat less disruptive to the vaginal epithelium. However, since each woman used each BZK film only once, the effects of multiple use on the vaginal epithelium and microflora require further study. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | VAGINAL SPERMICIDES | NONOXYNOL-9 | CERVICAL MUCUS | VAGINAL DESQUAMATE EFFECTS | CONTRACEPTIVE EFFECTIVENESS | ADMINISTRATION AND DOSAGE | Developed Countries | North America | Americas | Clinical Research | Research Methodology | Studies | Contraceptive Methods | Contraception | Family Planning | Spermicidal Contraceptive Agents | Contraceptive Agents | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Vaginitis | Vaginal Abnormalities | Diseases | Drugs | Treatment Document Number: 127978 |
| 8. Peer Reviewed Title: A phase I comparative study of three contraceptive vaginal films containing nonoxynol-9. Postcoital testing and colposcopy. Author: Mauck CK; Baker JM; Barr SP; Johanson WM; Archer DF Source: CONTRACEPTION. 1997 Aug;56(2):97-102. Abstract: In this Phase I study, 10 US women underwent sequential testing of 3 contraceptive vaginal films containing nonoxynol-9 (N-9): a new Allendale-N-9 film containing either 100 or 130 mg of the spermicide or the commercially available VCF product containing 70 mg of N-9. After a midcycle cervical mucus specimen was collected, women had intercourse using either no film (2 baseline cycles) or a test film and returned 2-3 hours later for further testing. The average number of progressively motile sperm seen per high power field were as follows: average of the 2 baseline cycles, 19.3; test cycle with Allendale-N-9 film containing 100 mg N-9, 0.6; test cycle with Allendale-N-9 film containing 130 mg N-9, 0.9; and test cycle with VCF, 0.5. In 1 baseline and 8 test cycles, colposcopy revealed superficial de-epithelialization. De-epithelialization occurred least often when the 100 mg Allendale film was used. None of the women who experienced de-epithelialization reported symptomatic irritation. These findings indicate that the new contraceptive product containing either 100 or 130 mg of N-9 is safe and comparable to the VCF product in terms of preventing sperm from entering midcycle cervical mucus. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | VAGINAL SPERMICIDES | NONOXYNOL-9 | CERVICAL MUCUS | CONTRACEPTIVE EFFECTIVENESS | VAGINAL DESQUAMATE EFFECTS | ADMINISTRATION AND DOSAGE | Developed Countries | North America | Americas | Clinical Research | Research Methodology | Studies | Contraceptive Methods | Contraception | Family Planning | Spermicidal Contraceptive Agents | Contraceptive Agents | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Vaginitis | Vaginal Abnormalities | Diseases | Drugs | Treatment Document Number: 127979 |
| 9. Title: Bacterial vaginosis associated with G vaginallis / Mobiluncus sp: ultrastructural parameters. Author: Villegas-Castrejon H; Villanueva-Diaz C; Arredondo-Garcia JL; Narcio-Reyes L; Karchmer-Krivitzky S Source: ARCHIVES OF STD / HIV RESEARCH. 1992;6(3):177-82. Abstract: Physicians at the National Institute of Perinatology in Mexico City, Mexico used a Carl-Zeiss EM 10C electron microscope to examine genital secretion samples from 10 pregnant women (15-38 weeks' gestation) who had been diagnosed with Mobiluncus species and Gardnerella vaginalis infections to illustrate the form and structure of bacteria responsible for bacterial vaginosis. They were concerned that these bacteria induce preterm labor and premature rupture of membranes (PL/PROM). These bacteria have been present in the genital tract of 30% of pregnant women with a thick whitish discharge who have attended the Institute's prenatal outpatient clinic. Physicians noted on the microscope slides that bacteria surrounded vaginal squamous epithelial cells (clue cells). Numerous gardnerella-like bacteria surrounded elongated squamous epithelial cells with many plasma projections. An extensive area of lysis existed around the bacteria in the cytoplasm of many squamous epithelial cells with intact membrane and nonexistent microfilaments. This finding indicated that the bacteria invade and destroy the cells. Plasma membrane projections almost completely surrounded the gardnerella-like bacteria in certain areas. Since this study strengthened the theory that G. vaginalis enters the vaginal squamous epithelial cells, researchers should conduct more studies to determine its role in PL/PROM. Language: English Keywords: MEXICO | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | LABORATORY EXAMINATIONS AND DIAGNOSES | VAGINAL DESQUAMATE EFFECTS | BACTERIAL AND FUNGAL DISEASES | SEXUALLY TRANSMITTED DISEASES | PREGNANCY, SECOND TRIMESTER | PREGNANCY, THIRD TRIMESTER | CYTOLOGIC EFFECTS | CONGENITAL ABNORMALITIES | PREMATURE BIRTH | FETAL MEMBRANES | North America | Latin America | Americas | Developing Countries | Research Methodology | Examinations and Diagnoses | Vaginitis | Vaginal Abnormalities | Diseases | Infections | Reproductive Tract Infections | Pregnancy | Reproduction | Physiology | Biology | Neonatal Diseases and Abnormalities | Pregnancy Outcomes | Fetus Document Number: 075284 |
| 10. Title: The effects of frequent nonoxynol-9 use on the vaginal and cervical mucosa. Author: Niruthisard S; Roddy RE; Chutivongse S Source: Sexually Transmitted Diseases. 1991 Jul-Sep;18(3):176-9. Abstract: A Phase I type clinical trial was conducted to study the local toxic effects of nonoxynol-9 (N-9) on the vaginal and cervical mucosa of women, to see whether a Phase II trial is needed, since women may use the spermicide frequently to prevent sexually transmitted diseases. 14 women inserted suppositories containing 150 mg N-9 every hour for 4 doses for 14 days. They were checked before the trail and for 2 or 3 weeks, with pelvic exam, smears for trichomonas and monilia, and colposcopy. 5 women inserted placebos to blind the trial. 43$ of the subjects had physical findings including sloughing of the cervical epithelium in 4, cervical erythema in 4, cervical bleeding in 1, vaginal erythema in 3, vaginal sloughing and bleeding in 1, vaginal dryness in 3, dryness in 2 and itching in 2. The cervical sloughing did not cross the transformation zone. 1 woman had edema and bleeding of the cervix resembling severe strawberry cervix. All symptoms resolved in 1 week. No effects were seen on the vulva, perineum or anus. The dose and frequency of use of N-9 in this trail are larger than women would normally be expected to use, but the data do justify a Phase II study. Language: English Keywords: THAILAND | RESEARCH REPORT | DOUBLE-BLIND STUDIES | VAGINAL SPERMICIDES | VAGINAL SUPPOSITORY | NONOXYNOL-9 | CERVICAL EFFECTS | VAGINA | DERMATITIS | PRURITUS | BLEEDING | EDEMA | VAGINAL ABNORMALITIES | VAGINAL DESQUAMATE EFFECTS | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Spermicidal Contraceptive Agents | Contraceptive Agents | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Diseases | Signs and Symptoms | Vaginitis Document Number: 070541 |
| 11. Title: Presence of HIV in cervical and vaginal secretions. Author: Bernstein GS Source: In: Heterosexual transmission of AIDS: proceedings of the Second Contraceptive Research and Development (CONRAD) Program International Workshop, held in Norfolk, Virginia, February 1-3, 1989, edited by Nancy J. Alexander, Henry L. Gabelnick, and Jeffery M. Spieler. New York, New York, Wiley-Liss, 1990. :213-24. Abstract: People infected with the human immunodeficiency virus (HIV) have the virus in their blood, genital secretions, saliva, tears, cerebral spinal fluid, and milk. This chapter discusses research findings on the existence of HIV in cervical and vaginal secretions. The findings support the concept that HIV enters the fluids of the lower genital tract by infected cervical cells. An inflamed cervix with infiltrates of infected cells can enhance heterosexual transmission of HIV by increasing the infectiousness of seropositive women or the susceptibility to infection of seronegative women. The studies indicate that since vagina and cervix contribute most of the secretions in the lower female genital tract, HIV is cell-associated and that infected cells in a certain region can be a source of virus separate from blood lymphocytes. Several factors influencing viral shedding in the vagina and cervix are: 1) the stage of the disease; 2) phase of the menstrual cycle; 3) other endocrine factors; and 4) inflammation. (Author's modified). Language: English Keywords: HIV TRANSMISSION | CERVICAL MUCUS | GENITALIA, FEMALE | GENITAL EFFECTS, FEMALE | CERVICAL EFFECTS | VAGINAL DESQUAMATE EFFECTS | CYTOLOGY | LITERATURE REVIEW | CYTOLOGIC EFFECTS | HIV Infections | Viral Diseases | Diseases | Cervix | Uterus | Genitalia | Urogenital System | Physiology | Biology | Vaginitis | Vaginal Abnormalities Document Number: 272153 |
| 12. Title: Protective effect of the contraceptive sponge against STDs in Thailand. Author: Feldblum PJ Source: In: International Health in the 1990s: Directions in Research and Development, NCIH Southern Regional Conference, Chapel Hill, North Carolina, October 29-31, 1987, selected proceedings, coordinated by Maureen Heffernan. Washington, D.C., National Council for International Health, 1988 Spring. :73-6. Paper prepared at a conference co-sponsored by The National Council for International Health, and the School of Public Health, University of North Carolina at Chapel Hill, Kenan Center Abstract: Family Health International conducted a study of the contraceptive sponge in a high-risk population in order to investigate the association between a nonoxynol-9 spermicidal product and the incidence of endocervical infections caused by chlamydia or gonorrhea, and vaginal infections caused by candida. The randomized clinical trial was conducted among high-risk women in Bangkok, Thailand, between June and August, 1986. Women were recruited from 4 massage parlors selected for their large and stable staffs of at least 60 women each and their cooperative management. After the needed preliminary communications, study participants were randomly assigned to either the sponge-user group or non-user group. 149 women received sponges at admission, and there were 163 women in the non-user group. They were young, poorly educated, and predominantly single and nulligravid. Chlamydial infection proved to be the most frequent outcome studied, with a total of 99 infections. The risk of infection was lower among sponge users. There were 44 cases of gonorrhea. Sponge users had a 6 week cumulative life-table estimate of infection of 8%, compared with 40% among women not using the sponge. The study indicated that women using the contraceptive sponge are partially protected against gonorrhea and chlamydia, but have an increased risk of contracting candidiasis. Chlamydial infection is now the most common STD in the US with an estimated 4 million cases annually. Candidiasis is not associated with the same potentially severe health consequences as either chlamydia or gonorrhea and is not generally sexually transmitted, but women using the sponge should be aware of the possible increased risk of the condition. In conclusion, there is unassailable scientific evidence that spermicides reduce the risk of contracting bacterial STDs. Although this benefit must be weighed against the risk of pregnancy and the possible increased risk of candidiasis with the sponge, concern with diseases transmitted through sexual contact points to more widespread use of spermicides. Language: English Keywords: CHLAMYDIA | GONORRHEA | SPERMICIDAL CONTRACEPTIVE AGENTS | THAILAND | VAGINAL SPONGE | CONTRACEPTION | SEXUALLY TRANSMITTED DISEASES | COMPARATIVE STUDIES | SEX WORKERS | SEX BEHAVIOR | POPULATION AT RISK | VAGINAL DESQUAMATE EFFECTS | CLINICAL RESEARCH | NONOXYNOL | ALCOHOLS | RESEARCH REPORT | WOMEN | Reproductive Tract Infections | Infections | Diseases | Contraceptive Agents | Family Planning | Developing Countries | Asia, Southeastern | Asia | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Studies | Research Methodology | Behavior | Vaginitis | Vaginal Abnormalities | Organic Chemicals | Ingredients and Chemicals | Demographic Factors | Population Document Number: 270820 |
| 13. Title: Vaginal cytology in women using oral contraceptives. Author: Katira V; Dayal SS Source: JOURNAL OF THE ANATOMICAL SOCIETY OF INDIA. 1987 Aug;36(2):94-100. Abstract: The present study was undertaken to assess the effect of a known synthetic steroid on vaginal epithelium as a diagnostic and prognostic tool. Biweekly vaginal smears from 10 multiparous, normally menstruating Indian females ages 21-40 were studied for 3 consecutive cycles, during which time they received Voldy's 21 oral contraceptive which contained both estrogen and progesterone. 7 of these cases acted as controls for themselves since their daily smears had been studied prior to the medication. In general, all smears had present a large number of leukocytes and Doderlein bacilli. There was a loss of cyclic pattern normally seen by midzonal maturation index, low karyopyknotic index, and the appearance of navicular cells with marked curling and folding of cells. The appearance of occasional cells having larger than a 5 micron-sized nucleus during the 2nd and 3rd cycles of medication may be suggestive of some significant effect with regard to the prolonged use of this oral contraceptive. (author's) Language: English Keywords: CYTOLOGIC EFFECTS | VAGINAL DESQUAMATE EFFECTS | DATA COLLECTION | LABORATORY EXAMINATIONS AND DIAGNOSES | MENSTRUAL CYCLE | ORAL CONTRACEPTIVES, COMBINED | CONTROL GROUPS | CHANGES | SIDE EFFECTS | ORAL CONTRACEPTIVES, SIDE EFFECTS | Physiology | Biology | Vaginitis | Vaginal Abnormalities | Diseases | Research Methodology | Examinations and Diagnoses | Menstruation | Reproduction | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Social Change | Treatment | Contraceptive Safety | Safety | Public Health | Health Document Number: 063014 |
| 14. Title: Vaginal infections and sexually transmitted diseases. Author: Institute for Development Training Source: Chapel Hill, North Carolina, Institute for Development Training, 1986. 78 p. (Training Course in Women's Health Module 4U.S.A.I.D. Project Agreement No. NEB-0048-A-00-4120-00) Also available in French or Arabic. The material was designed and developed by the International Women's Health Coalition, and has been adapted for self-instructional use by the Institute for Development Training Abstract: This manual was developed for health clinicians by the International Women's Health Coalition and then formatted by the Institute for Development Training to be a prototype self-instruction course on the recognition, evaluation, and treatment of vaginal infections and sexually transmitted diseases in women. This module is the 4th of a series developed to train clinicians in women's health. Other modules on: the female reproductive system; the anatomy, function, and common disorders of the female urinary system; and basic examination procedures are prerequisites before using this module. This module focuses on the most common infectious disorders of the female reproductive system (e.g. syphilis, gonorrhea, chlamydia trachomatis, lymphogranuloma venereum, granuloma inguinale, chancroid, genital warts, genital herpes, infestations, and Pelvic Inflammatory Disease or PID). This module discusses the causes, signs and symptoms, specific diagnostic procedures, and recommended treatments for 5 common vaginal infections and 10 types of sexually transmitted diseases and infections. Follow-up recommendations for Pap test results for cervical cancer are also discussed. To facilitate the self-instruction aspect of this module, it is divided into short information sections followed by a series of questions and answers. A pretest is provided to initially highlight the areas the user is weakest in, and a post-test is provided to help the user pull all of the manual's information together. Language: English Keywords: MANUAL | EXAMINATIONS AND DIAGNOSES | TREATMENT | VAGINA | SEXUALLY TRANSMITTED DISEASES | VAGINAL ABNORMALITIES | VAGINAL DESQUAMATE EFFECTS | VAGINITIS | GENITAL EFFECTS, FEMALE | GONORRHEA | SYPHILIS | PROGRAMMED INSTRUCTION | CHLAMYDIA | CERVICAL EFFECTS | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Reproductive Tract Infections | Infections | Diseases | Educational Methods | Educational Activities | Education | Cervix | Uterus Document Number: 193826 |
| 15. Title: [Vaginitis due to Gardnerella vaginalis in a university medical service] Vaginitis por Gardnerella vaginalis en un servicio medico universitario. Author: Diaz F; Vasquez ME; Escobar S; Galeano A; Londono M; Pelaez M; Villa M; Montoya F Source: ACTA MEDICA COLOMBIANA. 1985 Sep-Oct;10(5):197-203. Abstract: Between August 1983 and June 1984, a total of 363 women were studied who had been referred to the medical service of the School of Bacteriology and Laboratory Clinic of the University of Antioquia, Medellin, Colombia, for obtaining vaginal cytology. They either had or did not have vaginal discharge. The smears were tested for Gardnerella vaginalis and Trichomonas vaginalis. The majority of the patients were in the third, fourth, and fifth decades of their lives: 51%, 24.5%, and 14%, respectively. 104 (28.7%) patients had discharge as ascertained both subjectively and objectively. 74 (20.4%) complained of discharge, but it could not be confirmed objectively; 38 (10.5%) did not have discharge by objective findings; and 147 (40.5%) neither complained of, nor were found to have, discharge. 223 (61.4%) women did not use contraceptives. 56 (15.4%) women used hormonal contraceptives and 45 (12.4%) used IUDs; 20 (5.5%) had undergone tubal ligation; 8 (2.2%) used spermicides and 10 (2.8%) had undergone hysterectomy; and 1 woman used various combinations of methods. 70 (21.8%) had vaginitis caused by Gardnerella, 28 (7.7%) had candidiasis, and 10 (2.8%) had trichomoniasis; 4 cases were associated with Gardnerella and Candida and 2 cases had mixed infection (both Candida and Trichomonas); and 240 (66.1%) patients did not show any kind of bacteria. The following variables were associated with Gardnerella vaginitis (p < 0.0001) as opposed to other forms of vaginitis: Gram compatibility with Gardnerella; the pH of the vaginal secretion was 4.51 or higher; the homogeneous aspect of the discharge; the presence of cells and odor; the absence of lactobacilli and Corynebacteria; the positivity of Gardnerella culture; and the absence or low count of leukocytes (p < 0.02). 20 (25.3%) of the 79 patients with Gardnerella vaginitis, 3 (10.7%) of the 28 patients with candidiasis, and 2 (20%) of 10 patients with trichomoniasis neither had discharge nor could that be confirmed by speculum examination. On the other hand, 62 (25.8%) of the 240 patients without the etiologic agents of vaginitis did have discharge as ascertained objectively. Of these, 22 (35.5%) displayed congestion and erosion of the cervix. Language: Spanish Keywords: COLOMBIA | RESEARCH REPORT | CLINIC VISITS | BACTERIAL AND FUNGAL DISEASES | SIGNS AND SYMPTOMS | VAGINAL DESQUAMATE EFFECTS | VAGINITIS | CERVICAL EFFECTS | CANDIDIASIS | South America, Northern | South America | Latin America | Americas | Developing Countries | Service Statistics | Program Activities | Programs | Organization and Administration | Infections | Diseases | Vaginal Abnormalities | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 083510 |
| 16. Title: [Frequency of Trichomonas vaginalis infection in apparently healthy women in western Santiago] Frecuencia de infeccion por Trichomonas vaginalis en mujeres aparentemente sanas del area occidente de Santiago. Author: Mercado R; Basaldua J; Madariaga A Source: BOLETIN DEL HOSPITAL SAN JUAN DE DIOS. 1985;32:85-7. Abstract: The incidence of infection by Trichomonas vaginalis in apparently healthy women was surveyed in the western area of Santiago, Chile, which comprised both urban and rural areas with medium- or low-income people. A retrospective review of the data of the cytopathology laboratory of San Juan de Dios Hospital was conducted. The data contained all annual Pap smears and epidemiological information about the presenting patients. During 1983, a total of 29,501 women had Pap smears taken to detect signs of early cervical and uterine cancer. 10,491 of these women came from rural areas of the western health district and sought medical care in hospitals located there. The rest of the women (19,010) were urban inhabitants who attended consultation rooms and polyclinics in the peripheries. It was found that, among 29,501 smears of cervical secretions examined, 3365 contained Trichomonas vaginalis (11.4% of the studied group). The age range of those affected was 20-49 years. There was no difference in infection rate between rural and urban inhabitants. The presence of T. vaginalis was 9.1% in the 10-19 age group; 12.3% in the 20-29 age group; 11.5% in the 30-39 age group; and 11.6% in the 40-49 age group. The 20-49 age group had the highest incidence, because their sexual activity also was the highest. A previous (1975) investigation in Santiago indicated a 7.9% rate of infection by T. vaginalis; therefore, it can be concluded that infection maintains a fairly stable incidence in this female population. Language: Spanish Keywords: CHILE | RESEARCH REPORT | RETROSPECTIVE STUDIES | BACTERIAL AND FUNGAL DISEASES | HOSPITALS | LABORATORY EXAMINATIONS AND DIAGNOSES | VAGINAL DESQUAMATE EFFECTS | VAGINITIS | AGE FACTORS | South America, Southern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Infections | Diseases | Health Facilities | Delivery of Health Care | Health | Examinations and Diagnoses | Vaginal Abnormalities | Population Characteristics | Demographic Factors | Population Document Number: 083359 |
| 17. Title: Management of recurrent and refractory vaginitis. Author: Kaufman RH; Safro IL; Gardner HL Source: In: Zuspan FP, Christian CD, ed. Reid's controversies in obstetrics and gynecology. Vol. 3. Philadelphia, W.B. Saunders, 1983. :413-27. Abstract: This review of management of recurrent and refractory vaginitis provides a general discussion of the epidemiology and diagnosis of such disorders and a more detailed treatment of problems encountered in treating 6 specific infections: Trichomonas vaginalis, Gardnerella vaginalis vaginitis, candidiasis, herpes genitalis, Torulopsis (Candida) glabrata vulvovaginitis, and desquamitive inflammatory vaginitis. Many problems related to persistent vaginal infections are also related to reinfection. The 1st step in treatment is an accurate diagnosis, but many women with persistent or recurrent vaginitis pose serious diagnostic and therapeutic problems; patients with successfully treated conditions often continue to have symptoms and are repeatedly treated, or vaginal organisms are treated that were probably unrelated to the clinical vaginitis. Examinations should be done when the patient is experiencing symptoms and has not douched or used vaginal medications or contraceptive cream or gel for several days. Laboratory tests are valuable in diagnosis, with the physiologic saline wet mount probably the most useful. The 3 most common organisms causing vaginitis can usually be identified by finding motile trichomonads, the clue cells of G. vaginalis, or spores and filaments of Candida. The KOH (10-20%) wet mount is highly accurate in diagnosing candidiasis. Stained smears of vaginal secretions are only occasionally required for differential diagnosis of vaginitis and discharge. Cultures are required primarily for investigation protocols or to confirm gonorrhea, Chlamydia, or herpes genitalis. Vaginal bacterial cultures are seldom informative. Determing the pH of vaginal secretions is extremely informative. Appropriate therapy can be instituted on the basis of accurate diagnosis, but each of the vaginal infections presents specific problems relative to permanent cure. The treatment, epidemiology, clinical appearance, risk factors, and prevention of the 6 specific forms of vaginitis are discussed. Language: English Keywords: VAGINITIS | GENITAL EFFECTS, FEMALE | INFECTIONS | TREATMENT | DRUGS | VAGINA | GENITALIA, FEMALE | VAGINAL DESQUAMATE EFFECTS | EXAMINATIONS AND DIAGNOSES | LABORATORY EXAMINATIONS AND DIAGNOSES | PHYSICAL EXAMINATIONS AND DIAGNOSES | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | Vaginal Abnormalities | Diseases | Genitalia | Urogenital System | Physiology | Biology | Reproductive Tract Infections | Behavior Document Number: 021041 |
| 18. Title: The association of bacterial vaginitis and pelvic infection among contracepting women. Author: Cassidy JE Source: Baltimore, Maryland, Johns Hopkins Univ, 1982. 195 p. Doctoral dissertation, Johns Hopkins University School of Hygiene and Public Health, 1982 Abstract: Researchers have demonstrated that there are 2 types of pelvic inflammatory disease (PID): gonorrheal and nongonorrheal. The nongonorrheal is polymicrobial in origin, and is an ascending infection caused by the normally innocuous flora of the female reproductive tract. The incidence of nongonorrheal pelvic infection has risen in the last 10 years. Initially this rise was attributed to the popularity of the IUD. However, further investigation revealed that only 1/4 of the rise in this incidence can be attributed to the IUD, and that other factors must be considered. Along with the rise of nongonorrheal PID, bacterial vaginitis has also shown an increased incidence. Although this vaginitis is a mild infection, it causes a rise in the pH of the vagina. It is this investigator's premise that the rise in pH triggers a response in the normal flora of the vagina, which in turn permits an ascending infection of the reproductive tract to develop. Accordingly, the major hypothesis of this study is that women with nongonorrheal PID are more likely to have had a prior episode of bacterial vaginitis than women without nongonorrheal PID. To investigate this hypothesis, a matched pair, case-control study was designed. The sample population of 171 cases and controls was selected from women who had been clients of the Baltimore Clinic of Planned Parenthood of Maryland for at least a year. The cases had nongonorrheal pelvic infection and the controls did not. Cases were defined by specific diagnostic criteria and had a negative culture for the Neisseria gonorrhoeae at the time PID was diagnosed. Controls were defined as the next woman to come to the clinic after each case, who matched the case on age, marital status, and method of contraception. To be eligible for the study, a woman must have made a return visit to the clinic between December 1, 1978 and May 31, 1979, and must have been using the same method of contraception for at least a year. In addition, at the time of entry into the study, eligible women had no pelvic infection, and no therapeutic abortion, delivery, or gynecological surgery within the past 2 months. Data were collected by record review. Information on the records was reviewed for a year prior to entrance into the study. Data were collected on the incidence of bacterial vaginitis at 2 defined time periods as well as other variables known to have effect on the incidence of nongonorrheal PID. The 2 time periods were defined as the time of entry, or the index visit, and during the year prior to entry, the study year. Analysis of the data involved standard matched pair analysis of 2x2 tables, the Mantel-Haenzel adjustment procedure, and a logistic regression technique developed for matched pairs. Preliminary results indicated that the major risk factor for the total study population was a previous pelvic infection. Accordingly, it was decided to investigate a subsample of women who were having their 1st case of pelvic infection at the time they entered the study. This group consisted of 99 cases with their 1st episode of pelvic infection pair matched to 99 controls without pelvic infection. Further results indicated that when the 2 time period variables of bacterial vaginitis; i.e., at the index visit and during the study year were compared, the risk of nongonorrheal pelvic infection given bacterial vaginitis differed between these 2 time periods. For the group that was having their 1st case of pelvic infection, the risk of nongonorrheal pelvic infection is greatest for those women who have had bacterial vaginitis during the study year. When the women with a history of prior pelvic infections both before and during the study were added to the 1st case population, the risk of a nongonorrheal pelvic infection is the highest for those women with bacterial vaginitis at the index visit. However, the highest risk of pelvic infection for the total group is for women who had had prior pelvic infections. Results such as these lead to the conclusion that the risk of nongonorrheal pelvic infection given bacterial vaginitis is dependent upon 2 components: the time of the episode of bacterial vaginitis, and whether the case of pelvic infection is a 1st case. (author's modified) Language: English Keywords: MARYLAND | ADNEXITIS | PELVIC INFECTIONS | VAGINITIS | VAGINAL DESQUAMATE EFFECTS | DATA COLLECTION | VOLUNTARY HEALTH AGENCIES | INCIDENCE | DATA ANALYSIS | UNITED STATES OF AMERICA | IPPF | MARITAL STATUS | CONTRACEPTIVE USAGE | PARITY | ETHNIC GROUPS | ABORTION | IUD | SEXUALLY TRANSMITTED DISEASES | EDUCATIONAL STATUS | TREATMENT | AGE DISTRIBUTION | Developed Countries | North America | Americas | Pelvic Inflammatory Disease | Reproductive Tract Infections | Infections | Diseases | Vaginal Abnormalities | Research Methodology | Organizations | Measurement | International Agencies | Nuptiality | Contraception | Family Planning | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Cultural Background | Population Characteristics | Fertility Control, Postconception | Contraceptive Methods | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Age Factors Document Number: 011900 Notification |
| 19. Title: Haemophilus vaginalis (Corynebacterium vaginale, Gardnerella vaginalis) in a family planning clinic population. Author: Bramley HM; Dixon RA; Jones BM Source: British Journal of Venereal Diseases. 1981 Feb;57(1):62-6. Abstract: This study examines the prevalence of H vaginalis, with and without other infections, in healthy women attending a family planning clinic. Vaginal specimens were obtained at 902 attendances from 522 women requiring vaginal examination at a family planning clinic. Culture methods used were similar to those devised by Dunkelberg with some modification. Patients were followed up after a year, and clinical examination was repeated in 380 women. Haemophilus vaginalis was found in 8% of specimens either by culture or by at least two out of three microscopic tests; lactobacilli were seldom found in the presence of the organism. Increased signs and symptoms, especially an offensive odor, were found only when H vaginalis and staphylococci were isolated together. The organism was found less often in patients using contraceptive methods which protected the vagina, thus suggesting sexual transmission. Treatment is advisable when H vaginalis is in contact with a vascular bed. (Author's modified) Language: English Keywords: CLINICAL RESEARCH | VAGINITIS | UROGENITAL EFFECTS | PREVALENCE | FAMILY PLANNING CENTERS | VAGINAL DESQUAMATE EFFECTS | AGE FACTORS | Research Methodology | Vaginal Abnormalities | Diseases | Urogenital System | Physiology | Biology | Measurement | Health Facilities | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population Document Number: 001556 |
| 20. Title: Actinomyces in the vaginas of women with and without intrauterine contraceptive devices. Author: Curtis EM; Pine L Source: American Journal of Obstetrics and Gynecology. 1981 Aug 15;140(8):880-4. Abstract: This study compares the presence of Actinomyces in the vaginas of women with and without IUDs. Mucus samples were collected from the external cervical os of 50 randomly selected women. The smears were air-dried, heat-fixed, and stained directly with fluorescent antibody conjugates for A. israelii, A. naeslundii, and Arachnia propionica (Actinomyces species with clinical significance in human beings). A fluorescent microscope with oil immersion magnification of about 400x was used, and identification of the specific organisms depended upon both cellular morphologic features and the brilliant greenish yellow fluorescence of the cell membrane. Either 1 of 3 A. species was positively identified in 18 of 50 patients (36%). 1 or more species were found in 8 of 30 patients with no internal devices (27%). Of 18 IUD wearers, 8 were positive for Actinomyces (44%). 1 patient with a retained vaginal tampon and another 1 with a pessary also had positive smears. A. israelii and Arachnia propionica were the most commonly identified species. If the organism was found, average duration of continuous IUD use was 5.3 years (range, 1 to 15 years). Where these organisms do not exist, average continuous use was 2.1 years. Age of patients positive for Actinomyces ranged from 18 to 52 years. These findings do not show the true incidence of these organisms in either the general population or IUD wearers. However, they suggest the presence of such organisms in asymptomatic women, with or without intravaginal devices. Papanicolaou staining is not sufficient in identifying the presence of the organisms. Further studies must be done. The immunofluorescence technique is a simple, rapid and universally available technique for identifying the organism. Further studies should be done to determine whether these organisms lie dormant until some pathogens or trauma precipitate disease. Also, the disease actinomycosis should be carefully distinguished from the mere presence of Actinomycetaceae in the vagina. Language: English Keywords: CLINICAL RESEARCH | VAGINAL DESQUAMATE EFFECTS | IUD | CERVICAL MUCUS | AGE FACTORS | Research Methodology | Vaginitis | Vaginal Abnormalities | Diseases | Contraceptive Methods | Contraception | Family Planning | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Population Characteristics | Demographic Factors | Population Document Number: 003421 |
| 21. Title: The current status of the DES-exposed population. Author: Herbst AL Source: Obstetrics and Gynecology Annual. 1981;10:267-78. Abstract: This chapter discusses current knowledge concerning clear cell adenocarcinoma of the vagina and cervix as well as nonmalignant genital alterations in both female and male diethylstilbestrol (DES)-exposed offspring. A special registry on clear cell adenocarcinoma in young women established in 1971 has so far accessioned 400 cases as of December 1979. Analysis of maternal drug histories for 347 cases revealed that 61% had exposure to DES or chemically related dienestrol or hexestrol (nonsteroidal synthetic estrogens), 10% had been treated with unidentified medication for high-risk pregnancy, in slightly more than 25% there was evidence of maternal hormone usage and in about 2.5%, a non-DES type hormone had been used. DES patients ranged in age from 7-29 at time of diagnosis. 95% of the tumors were found in those aged 14 years or older; median age was 18.9 years. It is estimated that the risk of developing clear cell adenocarcinoma of the vagina and cervix in an exposed female up to age 24 is between 0.14 and 1.4 in a thousand. The national cooperative DES adenosis study estimates the risk to be less than 1 in a thousand. These estimates are supported by the observation that the number of DES-associated cancer cases occurring in various birth cohorts in the U.S. (1950 and earlier, 1951-53, 1954-56) closely parallel the sales of 25 mg DES tablets of a major U.S. drug manufacturer. This suggests that occurrence of cancer is related to the frequency of DES use during pregnancy. Overall, the 5-year survival for patients with adenocarcinoma is 78%, which is higher than usually reported for squamous cell carcinoma of the cervix (55%) or of the vagina (35%). Widespread screening evaluation of the DES-exposed female population undoubtedly contributes to the diagnosis of the tumor at an early stage and thus, greater chance for survival. Nonmalignant changes of the DES-exposed female genital tract include vaginal adenosis, cervical ectropion or eversion, squamous metaplasia, metaplastic epithelium, and transverse vaginal and cervical ridges. DES daughters should have a thorough screening examination and close follow-up when they begin to menstruate or by the time they are aged 14 years. The status of DES-exposed mothers and sons is briefly discussed. Language: English Keywords: DIETHYLSTILBESTROL | CONTRACEPTIVE AGENTS, ESTROGEN | GENITAL EFFECTS, FEMALE | VAGINAL CANCER | CANCER | VAGINAL DESQUAMATE EFFECTS | CERVICAL EFFECTS | AGE FACTORS | POPULATION CHARACTERISTICS | INCIDENCE | PREGNANCY | UNITED STATES OF AMERICA | Estrogens | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Genitalia, Female | Genitalia | Urogenital System | Neoplasms | Diseases | Vaginitis | Vaginal Abnormalities | Cervix | Uterus | Demographic Factors | Population | Measurement | Research Methodology | Reproduction | Developed Countries | North America | Americas Document Number: 006395 |
| 22. Title: Stage of gestation of intrauterine exposure to diethylstilbestrol. Author: Kirkhope TG Source: Ohio State Medical Journal. 1981 Apr;77(4):247-50. Abstract: In Toledo, Ohio, a final sample of 33 out of 159 patients with a history of intrauterine exposure to DES (diethylstilbestrol) were interviewed by the authors, and their drug histories reviewed. 28 of 33 patients with accurate documentation had objective colposcopic findings related to DES effect; 4 had colposcopically normal-appearing vagina and cervices; and in 1, the findings were unequivocal. Total drug dosage given in patients with positive findings ranged from 840 mg to 44,800 mg and averaged 7444.8 mg (mean, 7444.8; median 21,140; mode, 2500). Total drug dosage given in patients with negative findings ranged from 420 mg to 1500 mg and averaged 830 mg. 27 mothers used the drug during the 16th through the 20th week of gestation, the period when differentiation of the vaginal plate occurs in embryonic life. Of 5 patients with negative or equivocal colposcopic findings, none had exposure to DES during the 16th to 20th weeks of gestation. As the exact amount of the drug given to mothers, as well as duration and stage of gestation, are not known even with the availability of physician records, the answers to these questions are yet to be determined. Language: English Keywords: DIETHYLSTILBESTROL | PREGNANCY | VAGINAL CANCER | SIDE EFFECTS | CONTRACEPTIVE AGENTS, ESTROGEN | ORAL CONTRACEPTIVES | VAGINAL DESQUAMATE EFFECTS | Estrogens | Hormones | Endocrine System | Physiology | Biology | Reproduction | Cancer | Neoplasms | Diseases | Treatment | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | Vaginitis | Vaginal Abnormalities Document Number: 002270 |
| 23. Title: Diagnostic evaluation of patients with DES exposure in-utero: a prospective study. Author: Spangler S; Bibro MC; Schwartz PE Source: Connecticut Medicine. 1981 Apr;45(4):215-9. Abstract: Between October 1975 and May 1978, 192 patients were referred to Yale-New Haven Hospital for colposcopic evaluation secondary to a positive history of in utero exposure to DES (diethylstilbestrol) or to observation of cervical or vaginal changes during routine pelvic examination. The role of cytology, colposcopy, and iodine staining in the evaluation of the lower genital tract is discussed. Patient characteristics were ascertained. Maternal indications for DES therapy plus maternal medical and surgical histories are tabulated. No cases of clear cell adenocarcinoma of the vagina were detected. Benign anatomical alterations were noted on gross inspection of the vagina and cervix in almost 40% of the patients. The colscopic inspection revealed vaginal adenosis in 18% while histologic examination showed the rate to be 23%. These incidence rates are lower than previous studies have found, perhaps due to differences in the timing of in utero exposure to DES. It was found that cytology and Schiller's stain were considerably less helpful than colposcopy and histologic examinations in detecting vaginal adenosis. The prevalence of squamous cell carcinoma-in-situ was 2%, considerably higher than in a normal population. It is recommended that routine screening of girls exposed to DES in utero begin by age 14 or within a year of the start of menstruation. Language: English Keywords: PROSPECTIVE STUDIES | LONGTERM EFFECTS | PREVALENCE | DIETHYLSTILBESTROL | CERVICAL EFFECTS | VAGINAL DESQUAMATE EFFECTS | SIDE EFFECTS | EPIDEMIOLOGIC METHODS | CANCER | HISTOLOGY | COLPOSCOPY | Studies | Research Methodology | Time Factors | Population Dynamics | Demographic Factors | Population | Measurement | Estrogens | Hormones | Endocrine System | Physiology | Biology | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Vaginitis | Vaginal Abnormalities | Diseases | Treatment | Neoplasms | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses Document Number: 001271 |
| 24. Title: Common gynaecological problems. Author: Ball K Source: In: Porter J, ed. The control of human fertility: a text for pharmacists. Canberra, Australia, Pharmaceutical Society of Australia, 1980. :90-5. Abstract: In this very brief review, common gynecological complaints are defined and their etiologies briefly explained. The common complaints covered in this chapter include: 1) amenorrhea, both primary and secondary; menorrhagia (often associated with such conditions as fibroids, chronic pelvic inflammatory disease, endometriosis and adenomyosis, prolapse, ovarian or uterine tumors, and blood disorders); irregular bleeding (including breakthroughs), which often indicates ectopic pregnancy or miscarriage unless associated with low-progestagen-content oral contraceptives; postmenopausal bleeding (caused by genital cancer, estrogen administration, and/or atrophic vaginitis); vaginal discharge; vulvo-vaginal discomfort; pelvic pain, including primary and secondary dysmenorrhea); genital anomalies; climacteric symptoms; and cervical cytological abnormalities. Language: English Keywords: MENSTRUATION | AMENORRHEA | MENORRHAGIA | DYSMENORRHEA | VAGINAL DESQUAMATE EFFECTS | CONGENITAL ABNORMALITIES | MENOPAUSE | CERVICAL EFFECTS | SIDE EFFECTS | METRORRHAGIA | Reproduction | Menstruation Disorders | Diseases | Vaginitis | Vaginal Abnormalities | Neonatal Diseases and Abnormalities | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Treatment | Bleeding | Signs and Symptoms Document Number: 802658 |
| 25. Title: DES Task Force summary report, September 21, 1978. Author: Fink DJ Source: [Bethesda, Maryland], U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, 1980 Oct. 68 p. Submitted on behalf of the Members/Consultants DES Task Force Abstract: It is estimated that up to 4-6 million Americans (mothers, daughters, sons) may have been exposed to diethylstilbestrol (DES) during pregnancy. Today, DES is no longer used for preventing pregnancy accidents but for other purposes including estrogen replacement in cases of hormone deficiency, prevention and treatment of certain menopause-related problems, treatment in selected cases of advanced breast and prostate cancer, suppression of lactation in new mothers who do not breastfeed their infants, postcoital contraception, and as a food supplement for cattle and sheep. Numerous studies have established the association between DES exposure in utero and the malignant clear cell adenocarcinoma of the vagina and cervix as well as other genital tract abnormalities in young females. The incidence of clear cell adenoma carcinoma is estimated to be between 1.4/1000 and 1.4/10,000 through age 24 among DES exposed daughters. It is not known whether there is a definite relationship between DES during pregnancy and risk of cancer in the DES mothers. Although recent studies have shown an excess of genital abnormalities in DES sons, there is yet no definitive data on the fertility implications of these findings. Further studies of all DES-related problems and of estrogen-containing drugs should be done. It is also recommended that a major educational program for all health professionals be conducted regarding the effects of DES exposure and the appropriate screening, diagnostic, and therapeutic measures. All DES-exposed individuals should be informed of their exposure and should be encouraged to seek appropriate medical attention. Language: English Keywords: DIETHYLSTILBESTROL | CONTRACEPTIVE AGENTS, ESTROGEN | CONTRACEPTIVE AGENTS, POSTCOITAL | VAGINAL CANCER | CERVICAL CANCER | CANCER | VAGINAL DESQUAMATE EFFECTS | HEALTH EDUCATION | COMMUNICATION | EMERGENCY CONTRACEPTION | SIDE EFFECTS | RESEARCH AND DEVELOPMENT | AGE FACTORS | Estrogens | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Neoplasms | Diseases | Vaginitis | Vaginal Abnormalities | Education | Treatment | Technology | Economic Factors | Population Characteristics | Demographic Factors | Population Document Number: 006725 |
| 26. Title: CCC tablets reports: a contraceptive agent. Author: Yamanouchi Pharmaceutical Company Source: Tokyo, Yamanouchi Pharmaceutical, (1979).. :97. Abstract: This report by the manufacturer provides basic information on CCC spermicidal contraceptive tablets, including active ingredient (polyoxyethylene-nonylphenyl ether), mechanism of action, side effects (irritation), product stability (specifically, results of aging tests), and description of basic tests for identifying the product. CCC occurs in a white, ring-form tablet which effervececes, releasing its surface active agent. The product has undergone limited clinical trials, the result sof which are also published. 1 study made by 15 instructors in a birth control practice included 379 conceivable families in 3 different districts who were followed for about 1 year to examine the agent's contraceptive effect and side effects. Conception occurred in 45 subjects, at a conception rate of 12.9, but it is claimed that the rate was better than before the trial onset. 21 of the pregnancies resulted from erroneous application, and it is claimed that the pregnancy rate, minus product misuse, was as low as 6.9. No side effects of particular note were mentioned. Another clinical trial had 107 families using the agent for 20 months (1114 months/couple). Failure occured in 3 cases, at a conception rate of 3.2. A heat sensation associated with the effervescence resulted in a few discontinations. Tests of vaginal secretion pH and vaginal semar showed no effect of the product. The 3rd trial reported numerous errors in usage of the product, and recommended that information on the Ogino system be disseminated along with proper usage of the agent. Language: English Keywords: LABORATORY ANIMALS | HUMAN VOLUNTEERS | CONTRACEPTIVE USE-EFFECTIVENESS | PROMOTION | VAGINAL TABLET | SPERMICIDAL CONTRACEPTIVE AGENTS | EVALUATION | SEX BEHAVIOR | VAGINAL DESQUAMATE EFFECTS | CONTRACEPTIVE METHOD ACCEPTABILITY | AGE FACTORS | SIDE EFFECTS | STANDARDS | ANALYSIS | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, SIDE EFFECTS | FAMILY PLANNING ACCEPTOR CHARACTERISTICS | Clinical Research | Research Methodology | Contraceptive Effectiveness | Contraception | Family Planning | Marketing | Economic Factors | Vaginal Spermicides | Contraceptive Methods | Contraceptive Agents | Behavior | Vaginitis | Vaginal Abnormalities | Diseases | Contraceptive Usage | Population Characteristics | Demographic Factors | Population | Treatment | Family Planning Acceptors | Family Planning Programs Document Number: 791783 |
| 27. Title: [Low dose gestagens as oral contraceptives] Les microprogestatifs en contraception orale. Author: Bernard I; Levreir M Source: BORDEAUX MEDICAL. 1979 Apr;12(11):747-56. Abstract: 574 women, 18-52 years of age, were given the low-dosage gestagen preparatons Milligynon, Norgestrienone, Microval, and Exluton over a total observation period of 9500 months. There was 1 pregnancy. Clinical examinations were given after 3 months and every subsequent 6-12 months. Laboratory tests were taken after 6 months an each subsequent year. 10-23% of the women reported shortened menstrual cycles and 10-25% reported lengthened menstrual cycles. 1-3% reported total amenorrhea, while 2-10% reported amenorrhea lasting from 60-200 days. 17-45% reported reduced menstrual bleeding and 10-16% reported increased menstrual bleeding. Tests showed a decreased FSH secretion and no LH secretion peaks. The plasma progesterone and urinary pregnandiol levels were found to be reduced. Endometrial studies showed endometrial atrophy or hypotrophy and in some cases cells in the proliferative stage. Cervical secretions were found to become more viscous and less abundant. Cytological studies showed predominantly superficial elements in vaginal tissues, intermediate cells in the exocervical tissues, and nucleo-plasmatic equilibrium in the endocrervical cells. The low-dose gestagens tended in some cases to reduce glucose tolerance, but counteracted lipid metabolic effects and hypercoagulability caused by combination preparations. Language: French Keywords: CLINICAL RESEARCH | LOW-DOSE PROGESTINS | MENSTRUATION DISORDERS | ORAL CONTRACEPTIVES | AMENORRHEA | METRORRHAGIA | CYTOLOGIC EFFECTS | CARBOHYDRATE METABOLIC EFFECTS | VAGINAL DESQUAMATE EFFECTS | Research Methodology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Diseases | Contraceptive Methods | Bleeding | Signs and Symptoms | Physiology | Biology | Metabolic Effects | Vaginitis | Vaginal Abnormalities Document Number: 798222 |
| 28. Title: Do oral contraceptives inhibit trichomonas vaginalis? Author: Bramley M; Kinghorn G Source: Sexually Transmitted Diseases. 1979 Oct-Dec;6(4):261-3. Abstract: OC (oral contraceptive) therapy has been implicated with vaginal yeast infections. This study compares OC users with and without various genital infections. 1143 women attending the Sheffield Special Treatment Clinic were grouped retrospectively as follows: 114 had trichomoniasis alone, 179 had yeast infections alone, 333 had gonorrhea, and 517 had no genital infections. OC usage was found to be significantly less among women with trichomoniasis alone (p < 0.002) as compared with those who had yeast infection (p < 0.001) alone and those who had no genital infection. There was a 95% rate of cure of trichomoniasis among all groups of women treated with a single oral dose of 2 g of metroniadazole. The findings suggest that OCs may inhibit trichomoniasis but enhance vaginal yeast infections. Language: English Keywords: CLINICAL RESEARCH | VAGINAL DESQUAMATE EFFECTS | AGE FACTORS | GENITAL EFFECTS, FEMALE | SEXUALLY TRANSMITTED DISEASES | ORAL CONTRACEPTIVES | SEX BEHAVIOR | Research Methodology | Vaginitis | Vaginal Abnormalities | Diseases | Population Characteristics | Demographic Factors | Population | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Reproductive Tract Infections | Infections | Contraceptive Methods | Contraception | Family Planning | Behavior Document Number: 798932 |
| 29. Title: Statistico epidemiological study of changes in the vaginal flora of contraceptive pill users in Alexandria. Author: Fares E; El-Ghazzawi E; Bedwani RN Source: Journal of the Egyptian Public Health Association. 1979;54(1-2):49-63. Abstract: A stratified random sample of 1000 women with proportionate allocation according to district of residence was taken from normal females living in Alexandria, Egypt, and attending family planning centers in order to understand social-pathological changes in the vaginal flora of oral contraceptive (OC) users. Cases were examined over 18 months, and all cases were given a combined OC. Bacteriology and pH changes in vaginal flora were determined after 18 months. Results of the bacteriological examination revealed a positive correlation between those having a vaginal discharge and pH above 5, mixed infection, and illiteracy. As the duration of pill use increased, so did the incidence of monilla, staphylococcus aureus, anaerobic streptococci, gram negative bacilli, trichomonas vaginalis, and hemophilus vaginalis, whereas lactobacilli decreased. Duration of pill use also corresponded to increase in vaginal pH. Longer duration of OC use, practice of bad hygiene, and illiteracy were factors associated with an alkaline pH, changed pattern of vaginal flora, and greater susceptibility to infection by staph aureus and E. coli. Language: English Keywords: STATISTICAL STUDIES | EPIDEMIOLOGIC METHODS | EGYPT | VAGINAL DESQUAMATE EFFECTS | SOCIOECONOMIC STATUS | EDUCATION | ORAL CONTRACEPTIVES, COMBINED | STATISTICS | FAMILY PLANNING ACCEPTOR CHARACTERISTICS | Studies | Research Methodology | Africa, Northern | Africa | Developing Countries | Vaginitis | Vaginal Abnormalities | Diseases | Socioeconomic Factors | Economic Factors | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Family Planning Acceptors | Family Planning Programs Document Number: 799005 |
| 30. Title: The contraceptive aspects of the anatomy, morphology, and physiology of the vagina. Author: Flowers CE Jr; Beck LR; Wilborn WH Source: In: Zatuchni GI, Sobrero AJ, Speidel JJ, Sciarra JJ, eds. Vaginal contraception: new developments. New York, Harper and Row, 1979. :13-22. (PARFR Series on Fertility Regulation) Proceedings of an International Workshop on New Developments in Vaginal Contraception, Guatemala City, Guatemala, April 25-27, 1979 Abstract: The vagina is lined with squamous epithelium which undergoes cyclic changes, which are more pronounced in the endometrium. During the ovulatory phase the surface of the vagina is a group of large polygonal cells, but during the luteal phase, desquamanation extends to the intermediate cells. The surface of the vagina has a 28-day cycle like that of the squamous epithelium of the skin. The ultrastructure of the vagina is a complex relationship between the basal and parabasal, intermediate, transitional, and superficial cells of the squamous epithelium. The natural moisture of the mucous membrane and presence of free glycogen foster bacterial growth; the balance of the bacterial environment depends on the dominance of lactic acids able to maintain an acid pH of 3.5-4. During sexual stimulation the pH of the vagina goes up, which facilitates the survival of the sperm. Little research has been done on the anatomy of the vagina, improved spermicides, or diaphragms. The vagina can absorb and transport substances of low molecular weight; it can transport steroids, prostaglandins, prostaglandin analogues, antibodies, and other agents. Biodegradable microcapsules are a promising new method for providing 5 months of contraception from 1 injection of 20% norethisterone in combination with saline. These capsules are ready for clinical evaluation. Language: English Keywords: VAGINAL DIAPHRAGM | VAGINAL RING | VAGINAL GEL | VAGINAL FOAM | VAGINAL DESQUAMATE EFFECTS | CONTRACEPTION RESEARCH | FEMALE CONTRACEPTION | INJECTABLES | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Vaginal Spermicides | Vaginitis | Vaginal Abnormalities | Diseases Document Number: 796493 |
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