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Behandlung der vaginalen Atrophie mit einer Kombination von Östriol und Laktobazillen

Ein klinischer Überblick

Treatment of vaginal atrophy with estriol and lactobacilli combination

A clinical review—German version

  • Menopause und Frauengesundheit
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

In den letzten Jahren wurde eine große Zahl von Studien zur Pathophysiologie der symptomatischen vulvovaginalen Atrophie (VVA) bzw. des urogenitalen Menopausesyndroms („genitourinary syndrome of menopause“ [GSM]) bei peri- und postmenopausalen Frauen und zu den Behandlungsmöglichkeiten für diese Zustände publiziert. Die Leitlinien verschiedener Gesellschaften wurden im Bereich der vaginalen Therapie von VVA/GSM aktualisiert. In diesen wird die vaginale Gabe von Östrogenen favorisiert. Die Kombination einer ultraniedrigen vaginalen Dosis von 0,03 mg Östriol (E3) und lyophilisiertem, lebensfähigem Lactobacillus acidophilus KS400 (0,03 mg E3/L) entspricht einem Produkt mit dualem Wirkmechanismus, der nicht nur die Proliferation und Reifung des Vaginalepithels, sondern auch die Wiederherstellung der laktobazillären Mikroflora fördert. Es ist hinreichend belegt, dass die Kombination ein gesundes vaginales Ökosystem schafft und aufrechterhält. Die Anwendung verbessert die klinischen Anzeichen und Symptome sowie die Lebensqualität menopausaler Frauen, die an vaginaler Atrophie leiden, erheblich. Die Kombinationstherapie ist gut verträglich, mit einer niedrigen Gesamthäufigkeit von Nebenwirkungen und einer vernachlässigbaren systemischen Östriolresorption. Basierend auf jüngsten wissenschaftlichen Erkenntnissen und den aktuellen Behandlungsleitlinien kann die 0,03 mg-E3/L-Kombination als eine Behandlungsoption für die symptomatische vaginale Atrophie bei peri- und postmenopausalen Frauen in Betracht gezogen werden.

Abstract

In recent years, a vast quantity of clinical data has been accumulated on the pathophysiology of symptomatic vulvovaginal atrophy (VVA)/genitourinary syndrome of menopause (GSM) in peri- and postmenopausal women and on the treatment options for these conditions. Guidelines from several societies have recently been updated in favor of VVA/GSM vaginal therapy with the lowest possible doses of estrogens. The combination of a vaginal ultra-low dose of 0.03 mg of estriol (E3) and lyophilized, viable Lactobacillus acidophilus KS400 (0.03 mg-E3/L) is a unique product with a dual mechanism of action supporting not only the proliferation and maturation of the vaginal epithelium, but also restoration of the lactobacillary microflora. It has been demonstrated efficiently to establish and maintain a healthy vaginal ecosystem. Use of this combination considerably improves the clinical signs and symptoms as well as the quality of life of menopausal women suffering from vaginal atrophy. This combination therapy is well tolerated with a low overall incidence of side-effects and negligible estriol absorption. Based on recent scientific evidence and current treatment guidelines, the 0.03 mg-E3/L combination could be considered one of the options for the treatment of symptomatic vaginal atrophy in aging menopausal women.

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Danksagung

Die Autoren möchten sich bei Gabriela Zwyssig, Medinova AG, Schweiz, und Dr. Christian Rosé, Pierre Fabre, Deutschland, für ihre Anmerkungen zum Manuskript bedanken. Ebenfalls bedanken sie sich bei Stephan Biber, Medinova AG, Schweiz, für die wissenschaftliche Überarbeitung der deutschen Übersetzung des Manuskripts.

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Die Erstellung des Originalartikels in Climacteric und der offene Online-Zugang zur Publikation wurden von Medinova AG, Schweiz, finanziert.

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  1. Bereiche Endokrinologie und Menopause, Department für Frauengesundheit, Universitätsklinikum Tübingen, Calwer Str. 7, 72076, Tübingen, Deutschland

    A. O. Mueck & X. Ruan

  2. Abteilung für gynäkologische Endokrinologie, Klinik für Gynäkologie und Geburtshilfe Peking, Capital Medical University, Peking, Volksrepublik China

    A. O. Mueck & X. Ruan

  3. Wissenschaftliche und Medizinische Abteilung, Medinova AG, Zürich, Schweiz

    V. Prasauskas &  P. Grob

  4. Klinik für Gynäkologie und Geburtshilfe, Universität Regensburg, Regensburg, Deutschland

    O. Ortmann

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Correspondence to A. O. Mueck.

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Interessenkonflikt

V. Prasauskas und P. Grob sind Mitarbeiter von Medinova AG, Schweiz. A.O. Mueck, X. Ruan und O. Ortmann hatten in den vergangenen zwei Jahren keinen Interessenkonflikt im Zusammenhang mit dieser Publikation, d. h. keine Vorträge oder Teilnahme an „advisory boards“, keine Honorare im Zusammenhang mit Produkten, die in dieser Publikation diskutiert werden. Die Verantwortung für Inhalt und Erstellung des Artikels tragen allein die Autoren.

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L. Kiesel, Münster

A.O. Mueck, Tübingen

P. Stute, Bern

Die englische Version dieses Beitrags wurde erstpubliziert in Climacteric (2018) 21(2):140–147, https://doi.org/10.1080/13697137.2017.1421923. Abdruck der deutschen Version mit freundl. Genehmigung der Autoren und von Informa UK Limited

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Mueck, A.O., Ruan, X., Prasauskas, V. et al. Behandlung der vaginalen Atrophie mit einer Kombination von Östriol und Laktobazillen. Gynäkologische Endokrinologie 16, 280–289 (2018). https://doi.org/10.1007/s10304-018-0208-9

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