Current trends in the treatment of vaginal disorders during early menopausal transition

Objective. To study the state of the vaginal microbiota during early menopausal transition and to evaluate the efficacy of local therapy with estriol in combination with Lactobacilli in improving vaginal health. Design. An observational non-randomized study. Patients and methods. This study included 36 patients aged 44.72 ± 1.18 years. Patients’ complaints were analyzed; vaginal fluid (VF) pH, vaginal maturation index (VMI), vaginal health index (VHI) at baseline and after local therapy with estriol + Lactobacilli were investigated. Hormone levels were estimated, and the state of the vaginal microbiota was examined using Femoflor®16 before and after therapy. Results. After therapy, the count of Lactobacilli and the values of VF pH, VMI and VHI returned to normal. Therapy contributed to the reduction of vulvovaginal atrophy symptoms: complaints of burning, dryness, itching, dyspareunia, and dysuria significantly decreased. Conclusion. Given the clinical changes during early menopausal transition, which manifest as vaginal health disorders and affect every third patient in this period, it is necessary to prescribe local therapy with estriol in combination with Lactobacilli to normalize the indicators of vaginal health. Key words: early menopausal transition, vulvovaginal atrophy, dysuria, local estriol therapy