VAJİNAL ENFEKSİYONLARIN KADINLARIN GÜNLÜK YAŞAMINA ETKİSİ VE ALTERNATİF TEDAVİ YAKLAŞIMLARI

Year 2023, Volume: 20 Issue: 4, 2037 - 2047, 31.12.2023

Nazan Akbulut , Zeynep Daşıkan

https://doi.org/10.38136/jgon.1198348

Abstract

Üreme sisteminin yapısını oluşturan savunma mekanizmalarının mikroorganizmalar tarafından bozulması ile üreme sistemi enfeksiyonları oluşur. Yetişkin kadınlarda oldukça sık görülen üreme sistemi enfeksiyonları kadınların poliklinik başvuruları arasında en sık karşılaşılan şikayetler arasında yer almaktadır. Bu enfeksiyonlardan biri olan vajinitler; vajinanın enfeksiyonu veya inflamasoyunudur. Vajinitler; vajinal akıntı, kaşıntı, yanma, irritasyon, ağrı ve kötü koku ile karakterizedir. Tedavi edilmedikleri zaman pelvik inflamatuar hastalığa neden olabilir. Bu durum ise infertilite, ektopik gebelik, preterm doğum ve düşük doğum ağırlıklı bebek, koryoamnionit gibi komplikasyonlara neden olabilir. Tüm bu şikayetler kadınların üreme sağlığı ve cinsel sağlığını, yaşam kalitesini hatta psikolojisini olumsuz yönde etkilemektedir. Vajinit tanısı alan kadınların günlük yaşamı da son derece kötü etkilenmektedir. Yapılan çalışmalarda kadınlar vajinit semptomlarında dolayı negatif bir beden imgesi, düşük benlik saygısı ve hayal kırıklığı ile umutsuzluk hisleri ile beraber üzgün ve depresif hissettiklerini ifade etmişlerdir.
Son derece basit ve kadının hayat döngüsü boyunca en az bir kez karşılaştığı bu enfeksiyonlara kanıt temelli güncel alternatif ve tamamlayıcı tedavilerin etkisi de son yıllarda yadsınamaz düzeydedir. Literatüre bakıldığında vajinit tedavisinde genital hijyen uygulamaları, probiyotik/yoğut, propolis kullanımı ile bitkisel tedaviler ve mikrobiyota çalışmaları ön plana çıkmaktadır. Vajinal enfeksiyonların yönetiminde hemşirenin birincil rolü, riskli sağlık davranışlarını değiştirmek, vajinal enfeksiyonların ortaya çıkmasını ve tekrarlamasını önlemek güncel literatürü takip ederek eğitim ve danışmanlık vermektir.

Keywords

vajinal enfeksiyon, kanıta dayalı uygulama, alternatif tedavi

THE EFFECT OF VAGINAL INFECTIONS ON WOMEN’S DAILY LIVES AND EVIDENCE-BASED ALTERNATIVE THERAPY APPROACHES

Abstract

With the deterioration of the defence mechanisms constituting the structure of the reproductive system by microorganisms, reproductive system infections occur. Seen rather frequently in adult women, the reproductive system infections are among the most frequently encountered complaints in outpatient applications. One of these infections, vaginitis is the infection or inflammation of vagina.Vaginitis is characterised by bad smell, pain, irritation, inflammation, itchiness and vaginal discharge. Left untreated, it can cause pelvic inflammatory disease. This circumstance may conduce to complications such as infertility, ectopic pregnancy, preterm birth, low-birth-weight baby and chorioamnionitis. All these complaints affect women’s reproductive health and sexual health, quality of life, and even their psychology adversely. Daily lives of women diagnosed with vaginitis are also extremely negatively affected. In the studies conducted, women stated that they felt depressive and upset with accompanying negative body image, low self-respect, disappointment and desperation due to the symptoms of vaginitis.

The effect of evidence-based, current alternative therapies and aftercare against these infections, which are exceptionally simple and which a woman encounters at least once in her life cycle, in recent years is at an undeniable level. Viewing the literature, the genital hygiene practices, the use of probiotics/yoghurt, propolis, and herbal treatments and microbiota studies are highlighted in the treatment of vaginitis. The primary roles of the nurse in the management of vaginal infections are changing the risky health behaviours, prevention of the emergence and repetition of the vaginal infections, and, following the current literature, providing education and consultancy.

Keywords

Vaginal Infections, evidence-based application, alternative therapy

References

• 1. Paladine, HL, ve Desai UA, Vaginitis: Diagnosis and Treatment. American family physician 2018; 97(5), 321–329
• 2. Altınbaş R, Vajinal Enfeksiyonlara Yaklaşım, Temel Kadın Hastalıkları ve Doğum Bilgisi (pp.641-648) Akademisyen Kitabevi A.Ş 2020
• 3. Moshfeghy Z, Tahari S, Janghorban R, Najib FS, Mani A, ve Sayadi M, Association of sexual function and psychological symptoms including depression, anxiety and stress in women with recurrent vulvovaginal candidiasis. Journal of the Turkish German Gynecological Association, 21(2), 90–96. 2020
• 4. Amabebe E, Anumba DOC, The vaginal microenviroment: The physiologic role of lactobacilli. Front. İn Medicine (Lausanne) 2018; 13(5),181.
• 5. Adolfsson A, Hagander A, Mahjoubipour F, Larsson P-G, How Vaginal Infections Impact Women's Everyday Life: Women's Lived Experiences of Bacterial Vaginosis and Recurrent Vulvovaginal Candidiasis. Advances in Sexual Medicine 2017; 7(1): 1-19
• 6. Sianou A, Galyfos G, Moragianni D, ve Baka S, Prevalence of vaginitis in different age groups among females in Greece. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology 2017; 37(6), 790–794
• 7. Bilardi J, Walker S, McNair R, Mooney-Somers J, Temple-Smith M, Bellhouse, C.,... ve Bradshaw C Women’s management of recurrent bacterial vaginosis and experiences of clinical care: a qualitative study. PLoS One 2016; 11(3)
• 8. Askari S, F Jahromi, BN, Dehghanian A, Zarei A, Tansaz M, Badr P, Azadi A, ve Mohagheghzadeh A Effect of a novel herbal vaginal suppository containing myrtle and oak gall in the treatment of vaginitis: a randomized clinical trial. Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences 2020; 28(2), 603–614
• 9. Daşıkan Z, Kılıç B, Baytok C, Kocairi, H, ve Kuzu S Genital Akıntı Şikayetiyle Polikliniğe Başvuran Kadınların Genital Hijyen Uygulamaları. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 2015; 4(1), 113-124
• 10. Usta R, Mardin ili Ömerli İlçe Devlet Hastanesi Toplum Sağlığı Merkezine başvuran kadınların genital hijyen davranışları ve etkileyen faktörler. Okan Üniversitesi, Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı, Yüksek Lisans Tezi, Yayınlanmamış Tez, Kerime Derya Beydağ İstanbul 2017
• 11. Rashad MR, Mohamed HSE, Emara HA, Elsabiey I, ve MorsySalim H Risk Factors and Quality of Life in Women Diagnosed with Vaginal Infection. Annals of the Romanian Society for Cell Biology 2021; 25(6), 20009-20021.
• 12. Liu C, Zhang Y, Kong S, Tsui I, Yu Y, ve Han F. Applications and therapeutic actions of complementary and alternative medicine for women with genital infection. Evidence-based complementary and alternative medicine : eCAM, 2014, 658624.
• 13. Vaginitis in Nonpregnant Patients: ACOG Practice Bulletin, Number 215. Obstetrics and gynecology 2020; 135(1), e1–e17
• 14. Yazıcı S, Çuvadar A Genital Sistem Enfeksiyonlarının Önlenmesi ve Ebelik Yaklaşımları J Health Pro Res 2019; 1(1): 33-37
• 15. Ma X, Wu M, Wang C, Li H, Fan A, Wang Y., ... ve Xue F Aerobik vajinitte yaygın aerobik bakterilerin patogenezi ve olumsuz gebelik sonuçları: bir anlatı incelemesi. Üreme Sağlığı 2022; 19 (1), 1-11.
• 16. Han Y, Liu Z, ve Chen T Role of Vaginal Microbiota Dysbiosis in Gynecological Diseases and the Potential Interventions. Frontiers in microbiology, 2021; 12, 643422
• 17. Karakoç ZÇ, Vajinitlerde Etiyoloji Değişiyor mu? Tek Merkez Verilerinin Paylaşımı Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 2021;8(1):18-22
• 18. Denning DW, Kneale M, Sobel JD ve Rautemaa-Richardson R Global burden of recurrent vulvovaginal candidiasis: a systematic review. The Lancet infectious diseases 2018; 18(11), e339-e347.
• 19. Farr A, Effendy I, Frey Tirri B, Hof H, Mayser P, Petricevic L, ... ve Mendling W Guideline: Vulvovaginal candidosis (AWMF 015/072, level S2k). Mycoses 2021; 64(6), 583-602.
• 20. Brand SR, Degenhardt TP, Person K, ve ark., A phase 2, randomized, double-blind, placebo-controlled, dose-ranging study to evaluate the efficacy and safety of orally-administered VT-1161 in the treatment of recurrent vulvovaginal candidiasis. Am J Obstet Gynecol, 2019; 218: 624.e1-624.e9.
• 21. Rahman S, Ozan AT, Vajinal Akıntı Şikayeti Olan Kadınlarda Sık Görülen Genital Yol Enfeksiyonlarının İncelenmesi MCBU SBED 2020; 7(4): 469 -475
• 22. Meites E, Gaydos CA, Hobbs MM, Kissinger P, Nyirjesy P, Schwebke J R, ... ve Workowski KA. A review of evidence-based care of symptomatic trichomoniasis and asymptomatic Trichomonas vaginalis infections. Clinical infectious diseases, 2015; 61(suppl_8), S837-S848.
• 23. Nyirjesy P, Management of persistent vaginitis. Obstet Gynecol. 2014 ;124(6):1135-1146.
• 24. Bilardi JE, Walker S, Temple-Smith M, McNair R, Mooney-Somers J, ve ark., The Burden of Bacterial Vaginosis: Women’s Experience of the Physical, Emotional, Sexual and Social Impact of Living with Recurrent Bacterial Vaginosis. PLoS ONE 2013; 8(9): e74378.
• 25. Sobel JD, Recurrent vulvovaginal candidiasis. American journal of obstetrics and gynecology 2016; 214(1), 15–21
• 26. Payne SC, Cromer PR, Stanek MK, ve Palmer AA, Evidence of African- American Womenʼs Frustrations with Chronic Recurrent Bacterial Vaginosis. Journal of the American Academy of Nurse Practitioner 2010; 101-108
• 27. Lehtoranta L, Ala-Jaakkola R, Laitila A, Maukonen J. Healthy Vaginal Microbiota and Influence of Probiotics Across the Female Life Span. Front Microbiol. 2022 Apr 8;13:819958
• 28. Torcia MG, Interplay among vaginal microbiome, immune response and sexually transmitted viral infections. Int. J. Mol. Sci. 2019; 20:266.
• 29. Arena B, ve Daccò MD, Evaluation of vaginal microbiota in women admitted to the hospital for premature labour. Acta Bio Medica: Atenei Parmensis, 2021; 92(5).
• 30. Aslan E ve Bechelaghem N, To 'douche' or not to 'douche': hygiene habits may have detrimental effects on vaginal microbiota. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, 2018; 38(5), 678–681.
• 31. Akça D, Türk R, Kadınların Genital Hijyene İlişkin Davranışlarının Belirlenmesi Kafkas J Med Sci 2021; 11(1):1–9
• 32. Han C, Li H, Han L, Wang C, Yan Y, Qi W, Fan A, Wang Y, ve Xue, F, Aerobic vaginitis in late pregnancy and outcomes of pregnancy. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2019; 38(2), 233–239
• 33. Mehta S, Grover A, Mittal N, Nanda P, Khatuja R ve Naseem A, Reusable sanitary napkins-time to revisit. Journal of public health (Oxford, England), 2020; fdaa192. Advance online publication.
• 34. Karaahmet AY, Temur Ş, Avcı E, Söylenmez H, Aygün H, Kutlu L, Postpartum Kadınların Perine Hijyen Eğitimi Memnuniyetlerinin Değerlendirilmes, Haliç Üniversitesi Sağlık Bilimleri Yüksekokulu 2020; 3(1), 41-42
• 35. Joanna HR, Qiyan C, Rachel JT, Paul G, Traditional beliefs and practices in the postpartum period in Fujian Province, China: a qualitative study; BMC Pregnancy and Childbirth 2007; 7(8);55-8
• 36. AbdelAziem AA, Khalid Yassin, Hadeel A, I.Characteristics of female sexual dysfunctions and obstetric complications related to female genital mutilation in Omdurman maternity hospital, Sudan;Reprod Health. 2018, 15-7
• 37. Adesulu-Dahunsi AT, Role of probiotics in prevention and treatment of Candida vaginitis and Bacterial vaginosis. In Probiotics in the Prevention and Management of Human Diseases 2022; (pp. 243-249). Academic Press.
• 38. Vieira-Baptista P, De Seta F, Verstraelen H, Ventolini G, Lonnee-Hoffmann R ve Lev-Sagie A The vaginal microbiome: V. therapeutic modalities of vaginal microbiome engineering and research challenges. Journal of Lower Genital Tract Disease, 2022; 26(1), 99-104.
• 39. Sert ÜY, Bozkurt N, İnsan Mikrobiotası ve Jinekolojik Hastalıklara Olan Etkisi Jinekoloji - Obstetrik ve Neonatoloji Tıp Dergisi 2019; 16 (4) 244-249
• 40. van de Wijgert JHHM, Verwijs MC, Agaba SK, ve ark., Intermittent lactobacilli-containing vaginal probiotic or metronidazole use to prevent bacterial vaginosis recurrence: a pilot study incorporating microscopy and sequencing. Sci Rep 2020;10:3884.
• 41. Bohbot J, M Brami, G, Goubard, Harvey T, La vaginose bactérienne en 10 questions [Ten questions about bacterial vaginosis]. Gynecologie, obstetrique, fertilite & senologie 2020; 48(9), 693–702.
• 42. Buggio L, Somigliana, E, Borghi A, Vercellini, P, Probiotics and vaginal microecology: fact or fancy?. BMC women's health 2019; 19(1), 25
• 43. Homayouni A, Bastani P, Ziyadi S, Mohammad-Alizadeh-Charandabi S, Ghalibaf M, Mortazavian AM, Mehrabany EV Effects of probiotics on the recurrence of bacterial vaginosis: a review. J Low Genit Tract 2014; 18:79–86
• 44. Fares BS., Abd el Kader S, Abd El Hamid AA, Gaafar HM, Effect of ingestion of yogurt containing Lactobacillus acidophilus on vulvovaginal candidiasis among women attending a gynecological clinic. Egyptian Nursing Journal 2017; 14(1)
• 45. Falconi-McCahill A, Bacterial Vaginosis: A Clinical Update with a Focus on Complementary and Alternative Therapies. Journal of midwifery & women's health 2019; 64(5), 578–591
• 46. Pasupuleti VR, Sammugam L, Ramesh N, Gan SH. Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits. Oxid Med Cell Longev. 2017;2017:1259510.
• 47. Onbaşlı D, Çelik GY, Kahraman S, Kanbur, M. Apiterapi ve İnsan Sağlığı Üzerine Etkileri. Erciyes Üniv Vet Fak Derg 2019; 16(1), 49-56.
• 48. Bankova V, Popov M, Trusheva Propolis volatile compounds: chemical diversity and biological activity: a review. Chemistry Central journal 2014; 8, 28.
• 49. Siqueira AB, Rodriguez LR, Santos RK, et al. Antifungal activity of propolis against Candida species isolated from cases of chronic periodontitis. Braz Oral Res. 2015;29:S1806-83242015000100278
• 50. I. R. G. Capoci, S. Bonfim-Mendonça Pde, G. S. Arita et al., “Propolis is an efficient fungicide and inhibitor of biofilm production by vaginal Candida albicans,” Evidence-Based Complementary and Alternative Medicine, vol. 2015, Article ID 287693, 9 pages, 51. Faria DR, Melo RC, Arita GS, ve ark., Fungicidal Activity of a Safe 1,3,4-Oxadiazole Derivative Against Candida albicans. Pathogens. 2021;10(3):314. Published 2021 Mar 7
• 52. Farida S, Sahlan M, Rohmatin E, ve Adawiyah R, Endonezya propolis mumunun Tetragonula sp. sınırlı vajinal kandidiyazis hastalarında bir tedavi olarak. Suudi biyolojik bilimler dergisi 2020; 27 (1), 142–146.
• 53. Corrêa JL, Veiga FF, Jarros IC, Costa MI, Castilho PF, de Oliveira K, Rosseto HC, Bruschi ML, Svidzinski T, ve Negri M, Propolis extract has bioactivity on the wall and cell membrane of Candida albicans. Journal of ethnopharmacology 2020; 256, 112791
• 54. Yilmaz AC, ve Aygin D, Honey Dressıng In Wound Treatment: A Systematıc Revıew. Complementary therapies in medicine 2020; 51, 102388.
• 55. Ismail NH, Ibrahim SF, Jaffar FHF, Mokhtar MH, Chin KY, Osman K. Augmentation of the Female Reproductive System Using Honey: A Mini Systematic Review. Molecules. 2021 Jan 27;26(3):649
• 56. Mohd Kamal DA, Ibrahim SF, Kamal H, Kashim M, ve Mokhtar, MH, Physicochemical and Medicinal Properties of Tualang, Gelam and Kelulut Honeys: A Comprehensive Review. Nutrients, 2021; 13(1), 197
• 57. Banaeian S., Sereshti M., Rafieian-Kopaei M., Farahbod F., Kheiri S. Comparison of vaginal ointment of honey and clotrimazole for treatment of vulvovaginal candidiasis: A random clinical trial. J. Med. Mycol 2017;27:494–500
• 58. Dormohammadi M ve Noori Dolooee R, Effect of Honey on Women’s Reproductive Health: A Narrative Review. Complementary Medicine Journal 2021; 11(1), 6-19.
• 59. Jahdi F, Hamzehgardeshi Z, Kuolaei MD, ve ark., Vulvovaginal candidiasis symptom reduction - honey, yogurt-and-honey and clotrimazole vaginal cream - a triple blind randomized control trial. J Evolution Med Dent Sci 2021 ;10(08):515-521,
• 60. Khalilzadeh S, Eftekhar T, Rahimi R, Mehriardestani M, ve Tabarrai M, An Evidence-Based Review of Medicinal Plants Used for the Treatment of Vaginitis by Avicenna in "the Canon of Medicine". Galen medical journal 2019; 8, e1270.
• 61. Liang YD, Bai WJ, Li CG, et al. Piperine Suppresses Pyroptosis and Interleukin-1β Release upon ATP Triggering and Bacterial Infection. Front Pharmacol. 2016;7:390. Published 2016 Oct 20
• 62. Masoudi M, Rafieian Kopaei M, ve Miraj, SA, Comparison of the efficacy of metronidazole vaginal gel and Myrtus (Myrtus communis) extract combination and metronidazole vaginal gel alone in the treatment of recurrent bacterial vaginosis. Avicenna journal of phytomedicine 2017; 7(2), 129–136.
• 63. Yassin MT, Mostafa AA, ve Al-Askar AA, In vitro anticandidal potency of Syzygium aromaticum (clove) extracts against vaginal candidiasis. BMC complementary medicine and therapies, 2020; 20(1), 25