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Introduction: Conjugated estrogens, when used by the vaginal route for the relief of vaginal dryness and atrophy, can produce endometrial changes., Objective: To know the effect of vaginal conjugated estrogens application frequency on endometrial thickness in postmenopausal women., Method: Seventy postmenopausal women with vaginal dryness who received conjugated estrogen cream (0.625 mg/1 g) for 12 weeks were studied. The women were divided according to application frequency as follows: group 1, twice-weekly (n = 35), and group 2, thrice-weekly (n = 35). At baseline and at end-of-treatment, vaginal cytology was examined to determine the estrogenic value, and an endovaginal ultrasound was performed to measure endometrial thickness. The comparison between groups was carried out with Mann Whitney's U-test, and the comparison between baseline and post-treatment values, with Wilcoxon's test., Results: Of 70 recruited women, only 38 were studied, 19 in each group, paired by baseline estrogenic value. No difference was found between groups, neither at baseline nor after treatment, in the maturation index, estrogenic value or endometrial thickness., Conclusion: There were no differences in endometrial thickness between the conjugate estrogen cream different application frequencies., (Copyright: © 2019 SecretarÍa de Salud.)

Background: it is known that vitamin D increases the population of superficial cells, so the objective of the present work was to evaluate the effect in Mexican postmenopausal women who were using or not oral calcitriol., Methods: postmenopausal women with vaginal dryness that received at random: calcium 500 mg orally every 24 h or calcitriol 0.25 μg every 24 h during two months. At the beginning of treatment and at two months a vaginal Pap smear was performed. The maturation index was determined and the estrogenic value was calculated. Vaginal dryness was evaluated using an analog visual scales and vaginal by the moistening of a pH test strip. Student's t test was used for statistical analysis., Results: 23 postmenopausal women were studied and divided as follows: group I (calcium) = 11 women and group II (calcitriol) = 12 women. In the analyzed parameters only the average of superficial cells was significantly greater at the end of treatment in the calcitriol group., Conclusion: calcitriol use increased the average of superficial cells in vaginal cytology, but didn't modify vaginal dryness.

Background: local estrogen treatments have been used for vaginal dryness management. The objective was to determine the maturation index (MI) and vaginal dryness after the treatment with topic conjugated estrogens (TCE) in low and conventional doses in Mexican women., Methods: postmenopausal women that received vaginal TCE cream. Group I Low-dose which received 0.5 g of TCE twice a week and Group II Conventional-dose with one g of TCE twice a week. The MI was determined and estrogenic value (EV) was calculated. Vaginal dryness was evaluated with an analog visual scale, and vaginal humidity by the moistening of a pH test strip measured in millimeters. Statistical analysis with Student's t test for independent and paired samples was done., Results: 27 women were studied, group I (n = 13), group II (n = 14). There weren't any differences in the analyzed parameters. Both treatments increased the MI and decreased the vaginal dryness., Conclusions: low and conventional dose of TCE had similar effect in vaginal scope in Mexican women.

Objective: To compare vaginal dryness in two groups of postmenopausal women according to hormone replacement therapy schedule using pH test strip., Methods: Twenty-two healthy postmenopausal women were divided into two groups according to the treatment they received: Group I, conjugated equine estrogens (CEE) 0.625 mg/day (n = 15); Group II, CEE 0.625 mg/day plus medroxyprogesterone 2.5 mg/day (n = 7). Vaginal dryness intensity was analyzed using an analog visual scale and vaginal humidity by measuring the moistening, in millimeters, of a pH test strip. Both were evaluated at baseline and 3 months after the beginning of treatment. The comparison among groups and between baseline and final results was done with Student's t test for paired and independent samples, respectively., Results: No differences were found in age and in anthropometric variables among the groups. In both groups, vaginal dryness intensity significantly decreased and the pH test strip moistening significantly increased, but the magnitude of the moistening was greater in the group with medroxyprogesterone., Conclusions: When medroxyprogesterone was added to estrogen therapy, a greater vaginal moistening of pH test strip was observed than when estrogen was used alone.

Objective: To objectively analyze vaginal dryness in postmenopausal women., Methods: Forty healthy postmenopausal women, were divided in three groups according to the treatment they received. Group I, conjugated equine estrogens (CEE) 0.625 mg/day (n=20), group II, CEE 0.625 mg/day plus chlormadinone 1 mg/day (n=13), and group III, CEE 0.625 mg/day plus medroxyprogesterone 2.5 mg/day (n=7). Vaginal dryness intensity was analyzed using an analog visual scale, and vaginal humidity measuring the moistening in mm of a pH test strip. Both were evaluated at baseline and 3 months after the beginning of treatment. The comparison among groups and between the baseline and final results was done with Student's t-test for paired and independent samples, respectively. Pearson correlation analysis was carried out between final vaginal dryness intensity and the final moistening of the pH test strip., Results: No statistically significant differences were found in age neither in somatometric variables among the groups. In the three groups, vaginal dryness intensity significantly decreased and the pH test strip moistening significantly increased. A significant negative correlation was only found in group II (-0.690 P<0.009)., Conclusions: Vaginal dryness evaluation assessing the pH test strip moistening is an objective method to evaluate this symptom in postmenopausal women, and the results are independent of the hormone replacement therapy schedule.

This article review the congenital vaginal absence, as well as the evolution of the different techniques to construct a neo vagina. Also the advantages and disadvantages of the most used actual techniques are discussed.

Objective: To describe 19 cases with Rokitansky syndrome, as well as their endocrine features, and other associated malformations., Methods: Nineteen cases of utero-vaginal atresia are reported. Serum levels of luteinizing hormone, follicle stimulating hormone, prolactin, estradiol, and progesterone were measured. Genetic study was done by karyotype and X chromatin. Pelvic ultrasound was performed, and searches for associated urinary and bone malformations were done by intravenous pyelogram and spinal column X-rays, respectively., Results: In all patients, mammary growth began between 9 and 12 years, and pubic hair growth between 11 and 14 years. Nine of them sought advice for primary amenorrhea, and 10 for difficulty in sexual intercourse. Thirteen patients had begun sexual activity, between 18 and 30 years of age; six of them had dyspareunia, and in four it was impossible to have sexual intercourse, but three reported satisfactory sexual relations. External genitalia were normal in all, vaginal length was between 0.5 and 7 cm, and in all ended in a blind pouch. On pelvic ultrasound, normal ovaries and absent uterus were delineated; only one had polycystic ovaries. All had a 46XX karyotype and positive X chromatin. Hormone levels were normal in 16, 3 had hyerprolactinemia. In 7 out of 11 in whom progesterone was measured, it was ovulatory. In 8 out of 11, the pyelogram was abnormal, and in the same number, skeletal anomalies were found., Conclusions: In three patients, MURCS association was documented. It is proposed as an easy and minimally invasive study protocol for diagnosis.

Several materials have been used in neovagina construction, but most of them show some kind of drawback. This is the report of a case in which cultured allogenic epidermal sheets were used instead of skin grafting for a McIndoe procedure.

Thirty women in which an abdominal hysterectomy has been done and with climacterical symptoms were studied in order to analyze which modification has the vaginal cytology according to body weight and body fat distribution after conjugated estrogen administration as hormone replacement therapy. Once divided according to weight it was found that there was an increase in estrogenic value (EV) in women with normal weight and in those with obesity. When divided according to body fat distribution only there was an increase in intermediate cells and in EV in the group with lower body fat distribution. These findings show that body fat distribution is more important than body weight over EV in women which are receiving estrogen replacement therapy.

Many conditions have an abnormal development of the vagina, which impair satisfactory sexual activity. Non-surgical and surgical procedures have been developed to correct this situation, the Abbe-Wharton-McIndoe operation is one with the best results, but it has the disadvantage that the scar produced in the place where the skin graft is taken has an awful appearance. Although the oxidized regenerated cellulose (ORC) has been extensively used in pelvic surgery to avoid or diminish the adhesion formation, no other uses have been described for this material; we decided to use ORC instead of skin graft at the moment of the Abbe-Wharton-McIndoe procedure, in order to achieve rapid epithelization of the recently created cavity and avoiding skin graft taken. This is the report of four cases with Rokitansky syndrome in which a vagina was created using the McIndoe procedure and ORC was used instead of skin graft. At 12 weeks after surgery a complete epithelization of the new open cavity was achieved with the presence of mature vaginal epithelium. The conclusion is that ORC is an alternative instead of skin graft, with the advantage of avoiding the skin graft taken as well as the scar obligatorily produced with that procedure, and also achieving a complete and quick epithelization of the new cavity.