Treatment and prevention of urogenital disorders in postmenopausal women with type II diabetes

The aim of this study is to assess the incidence and structure of urogenital disorders in postmenopausal patients with type II diabetes mellitus, evaluate the efficacy of substitute hormone therapy of this disorders with estriol (ovestin, Organon, Netherlands), and investigate estriol effects on carbohydrate metabolism. Fifty patients with type II diabetes aged 64.96 ±0.6 years (M ± SD), disease duration 13.44 ± 7.25 years (M ± SD), and Hb Aj_c 9.15 ± 0.16% were examined. Comprehensive clinical and gynecological examinations were carried out. Urogenital manifestations were evaluated using a 4-point score, vaginal pH was assessed, bacteriological analysis of vaginal microflora and microbiological analysis of urine were carried out, and karyopycnotic index and level of Hb Aj_c were assessed. Patients complained of false incontinence (82%), dry vagina (70%)), and itching in the vulva (66%). Seventy-four percent of women developed urogenital disorders 2-5 years after the onset of menopause, 12%) after 1-1.5 years, and 14%) with the onset of menopause; in 65% these symptoms were evident before diabetes manifestation. After 6-month substitute therapy the incidence of urogenital symptoms decreased, only 6.7%) patients still complained of dryness in the vagina, 26.7%) of itching in the vulva, and 26.7%) of false incontinence. Vaginal pH decreased from 7.1 ± 0.17 to 5.8 ± 0.25 (p < 0.05), the content of lactobacilli increased and of E. coli dropped from 46.6 to 6.6%.

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