Hygiène intime féminine

(Version Complète en Anglais)

Vulvovaginal Candidiasis

Vulvovaginal candidiasis (VVC, commonly known as vaginal candidiasis) is a fungal infection caused by Candida species typically C. albicans[i]. According to epidemiological data[ii], approximately 70% of all women will have at least one episode of VVC in their lifetime.
The disease is characterized by an acute inflammation of the vulva and vaginal mucosa induced or accompanied by an overgrowth of Candida organisms (usually ubiquitous and commensal[iii]).
The signs and symptoms are usually characterised by lumpy white discharge which adheres to the vaginal walls, erythema, edema, and abrasions in the vulva and vagina, usually accompanied by dyspareunia[iv].
The triggering of most VVC cases is associated with diverse predisposing or triggering factors such as the use of antibiotics, increased levels of oestrogens (use of oral contraceptives, hormone replacement therapies, pregnancy), poorly controlled diabetes mellitus, sexual activity, and the use of excessively tight clothing[v].

On the other hand, about 8 to 10% of women are susceptible to recurrence of this problem (VVC)[vi] and experience approximately 4 or more episodes per year. This recurrent infectious process is usually idiopathic and independent of the potential risk factors. These cases usually require long-course regimens of antifungal use over a number of months (sometimes years) and which still do not efficiently prevent recurrence[vii].

According to data obtained in 2019[viii] from 248 non-pregnant women, most participants (78%) indicate a clinical history of VVC, and 34% are already defined as VVC patients. The most commonly experienced signs and symptoms are itching, burning and flushing in both diseases, and the most common risk factors are the use of antibiotics, followed by sexual intercourse, climate/humidity changes, and the use of feminine hygiene products. However, most women (73%) point out that they do not know the cause, stating that the diagnosis was obtained clinically/by the doctor, and the other women reported having been self-diagnosed. The most common treatment is over-the-counter drugs[1].
A physician’s diagnosis of VVC with pelvic examination and laboratory tests, using antifungals as treatment, especially in the case of VVCR, shows 71% of patients require continuous pharmacological treatment (sometimes with the inclusion of oral antibiotics) in order to control symptomatology, though the problem is not fully eradicated.

Ozone Therapy as a Solution

Ozone therapy in the treatment of recurrent Candida albicans[ix]

The aim of this study was to verify the efficacy of dietary adjustments and ozone therapy in the treatment of VVC.
A total of 150 patients with vulvovaginitis, aged between 30 and 50 and with at least 6 months of disease evolution, participated in this study, having no response to the usual pharmacological treatment and positive cultures for Candida albicans.
The treatment was based on colon hydrotherapy with ozonated water (10 sessions), performed with daily application of intravaginal ozone insufflations at a concentration of 20 μg/mL and a speed of 0.2 L/min for 10 minutes (10 sessions), application of ozonated oil with peroxide levels between 400 and 600 mEq for 10 days and 4 auto-hemotherapies at a concentration of 2.0 μg 1x/week.
At the end of treatment, the vaginal microbiota was rebalanced with the use of vaginal tablets of Lactobacillus for 7 days and oral tablets of Lactobacillus for 1 month. It was verified that 85% of the patients showed a favourable response to treatment and 10% remained asymptomatic for 1 year, whilst 5% of the patients did not respond to treatment.
These indicators conclude that Intravaginal Ozone Therapy offers an effective alternative to conventional treatment with fungicides, offering not only a solution that leads to remission of symptoms, but also demonstrates negative vaginal cultures and exudates in patients with vulvovaginitis, whilst increasing igA and Lactobacillus in the vaginal mucosa and hence showing potentiation without having any disruptive effect on saprophytes.

The Effect of Treatment with Ozonated Olive Oil vs Clotrimazole on Vulvovaginal candidiasis[x]

This study, which took place in the Department of Gynecology of the Mashhad School of Medicine at the University of Medical Sciences in Mashhad, Iran, aimed to compare the effects of ozonated olive oil vs clotrimazole on the treatment of vulvovaginal candidiasis.
A total of 100 patients who had been referred to the clinic after confirmation of having vulvovaginal candidiasis, were randomized into two groups (1 to be treated with ozonated olive oil (OA) and the other with clotrimazole).
Patients underwent treatment with either OA or clotrimazole for 7 days and were evaluated at the beginning and end of the intervention by means of anamnesis and paraclinical examinations. The study verified changes in the degree of pruritus, burning sensation, and leukorrhea using a questionnaire that patients filled out at the beginning and end of the treatments.
The results showed that both groups expected a significant reduction in symptoms, plus both vaginal cultures for candidiasis were negative, with no significant differences between the two groups regarding symptoms of pruritus and leukorrhea.
The clotrimazole group experienced fewer symptoms of a burning sensation than the OA group
The study concluded that considering the potential efficacy of ozonated oil in improving the clinical symptoms and paraclinical aspects of treatment in patients with vulvovaginal candidiasis, the treatment may be an effective topical form in these patients.

Antifungal activity of Olive Oil and Ozonated Olive Oil on Candida spp. and Saprochaete spp.[xi]

In this study, we aimed to verify the inhibition ability of ozonated olive oil on the growth of 38 strains of Candida albicans, Candida glabrata, Candida krusei and Candida parapsilosis, as well as on Saprochaete capitata.
Two different samples of ozonated olive oil (OZO1 with 1352 mmol—mEq/kg and OZO2 with 1053 mmol—mEq/kg) and two olive oil samples (OL1 with 392 mmol—mEq/kg and OL2 with 370 mmol—mEq/kg) were used with different biochemical parameters, which were analysed and compared according to their antifungal capacity, and fluconazole was used as the control.
The antifungal activity, from the highest to the lowest OZO1 > OZO2 > OL1 ≥ OL2, showed that ozonated olive oil can help in the fungal control, even in cases that are resistant to fluconazole.

Activozone Intimate Hygiene

Formulated with a balanced blend of ozonated vegetable oils and very mild natural surfactants derived from amino acids and oat extract, this formulation is sulfate-free, perfumeless, and contains no essential oils, respecting the pH of the intimate area and respective microbiome whilst deeply moisturizing.
Intended for daily intimate hygiene, it favours the protection of the most sensitive mucous membranes, sanitizes, soothes, relieves, and calms discomfort, promoting rapid rebalancing of the microbiota of the skin and mucous membranes.

[1] Over-the-counter

[i] Epidemiology and pathogenesis of recurrent vulvovaginal candidiasis. Am J Obstet Gynecol. 1985 Aug 1;152(7 Pt 2):924-35.

[ii] Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations. Am J Obstet Gynecol. 1998 Feb;178(2):203-11.

[iii] An intravaginal live Candida challenge in humans leads to new hypotheses for the immunopathogenesis of vulvovaginal candidiasis. Infect Immun. 2004 May;72(5):2939-46.

[iv] Pathogenesis and treatment of recurrent vulvovaginal candidiasis. Clin Infect Dis. 1992 Mar;14 Suppl 1:S148-53.

[v] Vaginitis. N Engl J Med. 1997 Dec 25;337(26):1896-903.

[vi] Pathogenesis and treatment of recurrent vulvovaginal candidiasis. Clin Infect Dis. 1992 Mar;14 Suppl 1:S148-53.

[vii] Candida infections of the genitourinary tract. Clin Microbiol Rev. 2010 Apr;23(2):253-73. doi: 10.1128/CMR.00076-09.

[viii] Current patient perspectives of vulvovaginal candidiasis: incidence, symptoms, management and post-treatment outcomes. BMC Womens Health. 2019 Mar 29;19(1):48. doi: 10.1186/s12905-019-0748-8.

[ix] Ozonoterapia en el tratamiento de la vulvo-vaginitis recurrente por Candida albicans. Revista Española de Ozonoterapia vol. 5, nº 1. pp 99-107, 2015. ISSN: 2174-3215

[x] The Effects of Ozonated Olive Oil and Clotrimazole Cream for Treatment of Vulvovaginal Candidiasis. Altern Ther Health Med. 2016 Jul;22(4):44-9.

[xi] Antifungal Activity of Olive Oil and Ozonated Olive Oil Against Candida Spp. and Saprochaete Spp. The Journal of the International Ozone Association. Volume 39, 2017 – Issue 6. doi.org/10.1080/01919512.2017.1322490