Mechanisms of uterine specificity of vaginal progesterone.

Endometrial transformations achieved by vaginal progesterone exceed those normally expected from the circulating concentrations obtained, this suggests some degree of direct vagina to uterus transport. We speculate on the different mechanisms involved in uterine specificity of vaginal progesterone and report data of a preliminary randomized study comparing progesterone concentrations in serum and endometrial tissue obtained from hysterectomy specimens after vaginal or i.m. administration. Eight post-menopausal women undergoing transabdominal hysterectomy were randomized to receive either vaginal progesterone gel, 90 mg, or i.m. progesterone formulation, 50 mg, at 08.00 and 20.00 on the day before surgery and at 06.00 on the day of surgery. Venous blood samples for progesterone measurement were drawn at 08.00 on the day before surgery and during the surgery. Endometrial progesterone concentrations were markedly higher in women who received vaginal progesterone (1.38+/-0.66 and 0.38+/-0.19 ng/mg protein, for vaginal and i.m. groups respectively) (P < 0.02) despite lower serum concentrations (4.17 < 0.56 and 32.32+/-11.06 ng/ml, for vaginal and i.m. groups respectively) (P < 0.001). The vaginal route induces endometrial progesterone concentrations that far exceed those expected from the serum progesterone concentrations achieved.

[The role of vaginal pH. Importance of its normalization in the prevention of recurrent vaginitis]. / Ruolo del pH vaginale. Importanza della sua normalizzazione nella prevenzione delle vaginiti recidivanti.

BACKGROUND: A sample of 100 women was clinically examined for a very various vulvovaginal symptomatology and an individual diagnosis of vulvovaginitis of different aetiology was established. METHODS: All women were treated with antibiotic and/or antimycotic drugs on the basis of individual diagnosis. Sixty women had only this treatment, while 40 women had also a supplementary treatment with a cleanser emulsion characterized by physiologic pH value and an antiseptic activity due to a vegetable extract (Saugella Attiva, Lab. Guieu). The symptomatologic changes due to the two treatments were compared. RESULTS AND CONCLUSIONS: Combined treatment (drug + antiseptic) obtained better results mostly in subjective symptomatology; this combined treatment was very useful in the recovery of the Doderlein population.