Wilson J D, Lee R A, Balen A H, Rutherford A J
Department of Genitourinary Medicine, The General Infirmary at Leeds, UK.
Int J STD AIDS. 2007 May;18(5):308-11. doi: 10.1258/095646207780749583.
Hormonal changes may be important in the onset and clearance of bacterial vaginosis. We studied vaginal flora and serum oestradiol levels of 55 women at baseline and during hormonal treatment. None developed bacterial vaginosis (BV) from normal vaginal flora, 69% of women had normal flora at baseline increasing to 91% following hormonal treatment. The mean oestradiol level with BV was 39.07 ng/L compared with 176.41 ng/L with normal flora. Non-smokers had a mean oestradiol level of 173.95 ng/L compared with 118.67 ng/L in smokers. Recombinant follicle-stimulating hormone resulted in a mean oestradiol rise of 113.9 ng/L. The mean rise was 330.4 ng/L with improved vaginal flora but only 15.1 ng/L in persistently abnormal or worsening flora. A rise in oestradiol in this group of women was associated with a significant reduction of abnormal flora. Reversion from BV to normal flora was associated with a greater rise in oestradiol than where abnormal flora persisted or worsened. This study supports a possible hormonal influence in the natural history of BV. The lower oestradiol levels in smokers may help explain their increased risk of BV.
激素变化可能在细菌性阴道病的发病和清除过程中起重要作用。我们研究了55名女性在基线时以及激素治疗期间的阴道菌群和血清雌二醇水平。没有女性从正常阴道菌群发展为细菌性阴道病（BV），69%的女性在基线时阴道菌群正常，激素治疗后这一比例增至91%。患BV时雌二醇平均水平为39.07 ng/L，而阴道菌群正常时为176.41 ng/L。非吸烟者雌二醇平均水平为173.95 ng/L，吸烟者为118.67 ng/L。重组促卵泡激素使雌二醇平均升高113.9 ng/L。阴道菌群改善时平均升高330.4 ng/L，但在持续异常或恶化的菌群中仅升高15.1 ng/L。这组女性中雌二醇升高与异常菌群显著减少相关。从BV转变为正常菌群时雌二醇升高幅度大于异常菌群持续或恶化的情况。这项研究支持激素可能对BV自然病程有影响。吸烟者雌二醇水平较低可能有助于解释其患BV风险增加的原因。
