pH Balanced Gel for atrophic vaginitis in bc survivors
 

apparently just getting the pH right without the estrogen improves symptoms

Obstet Gynecol. 2011 Apr;117(4):922-7.
Vaginal pH-Balanced Gel for the Control of Atrophic Vaginitis Among Breast Cancer Survivors: A Randomized Controlled Trial.
Lee YK, Chung HH, Kim JW, Park NH, Song YS, Kang SB.

From the Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea.
Abstract
OBJECTIVE: : To estimate the effects of vaginal pH-balanced gel on vaginal symptoms and atrophy in breast cancer survivors treated with chemotherapy or endocrine therapy.

METHODS: : This was a randomized, double-blind, placebo-controlled study. Breast cancer survivors who experienced menopause after chemotherapy or endocrine therapy were voluntarily enrolled and randomly administered vaginal topical pH-balanced gel or placebo three times per week for 12 weeks. Vaginal dryness and dyspareunia were measured by visual analog scale, vaginal health index, and vaginal pH. The endometrium and ovary were evaluated by transvaginal ultrasonography.

RESULTS: : Among 98 enrolled women, 86 completed the treatment (n=44 and n=42 for the pH-balanced gel group and placebo group, respectively). Vaginal dryness and dyspareunia improved more in the pH-balanced gel group than in the placebo group (baseline mean 8.20 compared with end-point mean 4.23 [P=.001] and 8.23 compared with 5.48 [P=.040], respectively). Vaginal pH-balanced gel reduced the vaginal pH (gel: baseline mean 6.49 compared with end-point mean 5.00; placebo: 6.22 compared with 5.69 [P<.001]), and enhanced vaginal maturation index (gel: 45.5 compared with 51.2; placebo: 46.4 compared with 47.9 [P<.001]) and vaginal health index (gel: 15.8 compared with 21.1; placebo 14.3 compared with 16.98 [P=.002]). There was no significant difference in adverse effects between the two groups except for mild irritation at the early time of pH-balanced gel administration.

CONCLUSION: : Vaginal pH-balanced gel could relieve vaginal symptoms and improve vaginal health in breast cancer survivors who have experienced menopause after cancer treatment.

CLINICAL TRIAL REGISTRATION: : ClinicalTrials.gov, www.clinicaltrials.gov, NCT00607295.

LEVEL OF EVIDENCE: : I.

PMID: 21422866

Re: pH Balanced Gel for atrophic vaginitis in bc survivors
 

Lani,

Any idea where we can get this gel - what is it called, is it a prescription etc.?

Thanks for any additional information.

all the best
caya

Re: pH Balanced Gel for atrophic vaginitis in bc survivors
 

the article was out of Korea but it cites a clinical trial number which you ought to be able to look up @ clinical trials.gov

They should have an investigator and/or a primary corresponding author

In the meantime, I will see if I can get the full article and get back to you if I obtain some answers

Re: pH Balanced Gel for atrophic vaginitis in bc survivors
 

Many of us know about the product Replens but that same company makes another over the counter product called RepHresh. It is a buffered product that helps with the pH issues.

I have used it and it works very well. Its harder to find in drugstores than the more common Replens but you can find it online at drugstore.com

Also, I am sure any pharmacy will order it for you.

Re: pH Balanced Gel for atrophic vaginitis in bc survivors
 

From the article:"The gel contains lactic acid to maintain the vaginal pH at about 4.0 (package insert from Han Kook Pharmed Co, Ltd, Seoul, Korea)"

Re: pH Balanced Gel for atrophic vaginitis in bc survivors
 

Thanks Lani I will investigate and take this to my onc. next week as I have my semi-annual appointment.

Unfortunately Replens does not work for me - in fact it causes burning, stinging irritation. My gyn. told me she's had a few women complain of this same irritation. I use coconut oil 2x/day, and it does help, but if there is something new out there that will be better, I am more than willing to try it. Becky I am also interested in the RepHresh - since it is made by the same company, do you know if it contains the same ingredients? I would hesitate to try it if it does for fear of the same burning issues.

all the best
caya

Re: pH Balanced Gel for atrophic vaginitis in bc survivors
 

Caya

You'd have to check the box but I have the same problem as you with Replens. I bought the RepHresh a few years ago and had the same problem. I think it is the propylene glycols or surfactants used in such products but it may also be another common ingredient used in these formulations.

So.... I had the same burning problem with RepHresh as I did with Replens (which is a really "too bad" problem to have) as this is rare in general. I am saying that because these products are of great value to most women and I want to state this here because most women do not have this problem.

Re: pH Balanced Gel for atrophic vaginitis in bc survivors
 

Can someone expand on what is being discussed here? I have had more yeast infections since chemo than ever in my life. I have an onc follow up appointment in a few weeks. I sure would like to have some knowledge so I could ask intelligent questions...On the same day, I have my annual physical with my family doctor...Kind of seems redundant doesn't it?!

Re: pH Balanced Gel for atrophic vaginitis in bc survivors
 

I have tried the lactic acid gel and it does make a difference, although it is a bit messy. There can be a problem with stinging, so it might be easier to ease in with something that gets the vagina in better shape first. I have used vitamin E, as Lani recommended in an earlier posting.

I am writing in because I seem to really struggling to keep on top of bacterial vaginosis, even though one of lactic acid gel's more usual uses is to keep down bacterial vaginosis. I thought it was thrush until I started to have sex again (intercourse apparently is a trigger). In retrospect, I probably always a bit of a suffer since I was always itchy at the end of my period when younger (a telltale sign), but now I seem to struggle to keep the Vietnamese fish sauce smells away. Which is a shame really because things were actually going really well otherwise (painfree sex was a major achievement). I have had one round of metronidazole, but that gave me really bad thrush. The lactic acid gel works, it just stings and can get rather messy.

Has anybody else had increasing problems with bacterial vaginitis? Does it get better?

Re: pH Balanced Gel for atrophic vaginitis in bc survivors
 

The name of this product is Clino-san. There was a post on our board by Harrie about it back in 2009. Here is a link that came up when I googled "purchase Clino-san lubricant" : http://her2support.org/vbulletin/sho...eferrerid=1173

Hopeful