Dolore vulvo-vaginale, candidosi recidivante e rischio familiare per il diabete

Dolore vulvo-vaginale, candidosi recidivante e rischio familiare per il diabete
I fattori critici emersi dallo studio VuNet su 1183 casi – Parte II

Alessandra Graziottin1,2 – Orcid, Dania Gambini2, Elena Boero2– Orcid, Filippo Murina3,4 – Orcid, ricercatori del gruppo Vu-net 

1 – Centro di Ginecologia e Sessuologia medica, H. San Raffaele Resnati Milano

2 – Fondazione Alessandra Graziottin per la cura del dolore nella donna Onlus

3 – Servizio di Patologia del Tratto Genitale Inferiore, Ospedale V. Buzzi – Università degli Studi di Milano

4 – Associazione Italiana Vulvodinia Onlus

Autore di riferimento: Alessandra Graziottin

DOI: 10.53146/lriog1202127


The VuNet (Vulvodynia Network) Project is an observational study set out to investigate the epidemiological characteristics and comorbidities of chronic vulvar pain. It involved 1183 women, enrolled between December 2016 and November 2018 in 21 Italian medical centers. Supported by the collected evidence that 32% patients with vulvar pain were affected by recurrent vulvo- vaginal candidiasis (RVVC), this article aims at analyzing the role of Candida infections in the genesis of vulvar pain and dyspareunia, and diabetes, or familiarity for diabetes, as a key predisposing factor. The recurrent/persistent inflammation associated with an aberrant immune-allergic reaction to Candida antigens may be a strong co-factor for developing vestibulodynia in this cluster of patients. The co-prevalence of 17.5% patients reporting food or respiratory allergies suggests a parallel predisposition to the development of allergic reactions. The anamnesis revealed a higher rate of diabetes in first- and second-degree relatives of the patients, both from the mother’s (8.4%) and father’s side (8.6%), versus the Italian national prevalence of 5.3% for the population un- der 65. Genetic predisposition for diabetes alters the carbohydrate metabolism predisposing to vulvovaginal candidiasis. Collectively, our data highlight the importance of investigating metabolic vulnerabilities to diabetes, both in the patient and her family, and encourage appropriate lifestyles, including: a net reduction in the consumptions of glucose or saccharose, body weight control, and daily aerobic exercise to reduce peripheral insulin resistance. The ultimate goals are reducing predisposing factors for candidiasis, vestibulodynia and coital pain in this cluster of patients, and tailoring treatment accordingly.

Keywords: vulvovaginal candidiasis; vulvar pain; vestibolodynia; dyspareunia; diabetes.

Presente in LRIOG Nr.2 – 2021

e-ISSN: 1824-0283

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Laser rigenerativo vulvo – vaginale

Laser rigenerativo vulvo – vaginale: quando, come e perchè

Filippo Murina – Orcid

Servizio di Patologia del Tratto Genitale Inferiore, Ospedale V. Buzzi – Università degli Studi di Milano

DOI: 10.53146/lriog1202114


The use of lasers to treat gynaecological conditions including genitourinary syndrome of the menopause (GSM) has become increasingly popular over recent years. The evidence suggests laser therapy may be beneficial as a non-hormonal treatment in GSM. However, we do not know what the optimum treatment regime or interval is or what the role is for sexual hormones either before or in addition to laser treatment. It was demonstrated that a combination regimen of laser and ospemifene may improve clinical effectiveness. Application of the regenerative laser to the vestibule for vulvar pain and dyspareunia is a promising and safe treatment option in postmenopausal women with the use of appropriate parameters. Clinicians need to be aware of the limitations, risks and outcomes of laser therapy as well as the need for careful evaluation of women to ensure appropriate patient selection. Patients also need to be advised and counselled about realistic expectations of outcomes. Indiscriminate treatment of patients with little evaluation and assessment and counselling will lead to poor satisfaction outcomes and morbidity.

Keywords: laser; genitourinary syndrome of the menopause; dyspareunia; vulvar pain.

Presente in LRIOG Nr.1 – 2021

e-ISSN: 1824-0283

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