Sexually transmitted infections (STIs) such as gonorrhea, herpes simplex virus 2 (HSV 2), hepatitis C, human papilloma viruses (HPV) and human immunodeficiency virus type 1 (HIV) are a global health concern affecting millions of lives. Although extensive efforts have been geared towards prevention and treatment of STIs, little progress has been achieved. Recently, efforts to develop microbicides have been focused on the commensal bacterial species that comprise the vaginal microbiome and their role in immunity and disease pathogenesis. The lower FRT which includes the cervix and vagina has endogenous bacterial species that are supported by the mucosal epithelium. Lactobaccilli are the dominant endogenous bacterial species in the vagina of most women; lactobacilli convert glycogen to lactic acid (LA) which maintains a low pH environment in the vagina and serves as a deterrent to infectious organisms. The purpose of this research project was to determine the effects of LA on vaginal integrity and inflammation in a vaginal epithelial cell (VEC) tissue model, and on the ability of the broadly neutralizing anti-HIV antibody, VRCO1, to inactivate HIV in vitro. Effects of LA exposure on the viability and integrity of vaginal epithelium were determined by histology, MTT assay and measurement of transepithelial electric resistance (TEER). In addition, an enzyme-linked immunosorbent assay (ELISA) was used to measure concentrations of cytokines secreted by the VEC epithelial cells in response to different doses of LA. Using TLR agonists to simulate infection in the VEC model, we tested the hypothesis that LA has anti-inflammatory properties that modulate immune responses of the vaginal epithelium. We assessed the effect of LA on the neutralization activity of the anti-HIV-1 monoclonal antibody VRCO1 in the TZM-bl HIV neutralization assay. Tissue morphology and integrity were not affected by exposure to LA. Low concentrations of IL-1β and RANTES were expressed by VEC tissues in response to L-LA treatment. VEC tissues expressed significantly elevated concentrations of IL-1RA (p<0.0001), an anti-inflammatory cytokine, in response to LA regardless of incubation time and LA doses. In addition, treatment of VEC tissues with Poly I: C in the presence of LA dampened upregulated expression of IL-1β, TNF-alpha and IL-6 in response to the TLR 3 agonist. LA also elicited significantly higher IL-1RA concentrations when apically added to the TLR agonist-treated VEC tissues. These data suggest that LA elicits an anti-inflammatory response in the vaginal epithelium. LA acidic conditions as low as pH 3.5 did not affect the ability of VRC01, to prevent HIV infection. We found that LA, at concentrations present in vaginal secretions of normal women, inhibited the inflammatory response to a TLR agonist, possibly due to upregulated Il-1RA synthesis. In addition, the functionality of VRCO1 in an acidic milieu was not diminished, providing evidence that antibodies can function in the low pH vaginal environment. This report highlights the potential use of LA in the vagina as a microbicide due to its virucidal activity and anti-inflammatory properties. It also indicates that monoclonal antibody-based vaginal microbicides will not be neutralized by LA. There is still a need to elucidate the exact mechanisms by which LA confers immuno-modulatory properties within the female reproductive tract.

Abstract Introduction Chris Hani Baragwanath (CHB) hospital has 20 000 deliveries per annum, with 25% by caesarean section (CS). Therefore, vaginal birth after caesarean section (VBAC) is an important delivery option. We questioned the reasons for the low VBAC success following trial of labour (TOL). The primary objective was to determine the proportion of eligible patients attempting TOL and the VBAC success rate. Secondary objectives were to establish reasons for failed VBAC, predictive factors for VBAC, and maternal and neonatal morbidity and mortality. Methodology A retrospective descriptive study by record review, analysing demographic, obstetric and delivery outcome variables of women with one prior CS in a subsequent pregnancy. Results From the 340 patients eligible for VBAC, 287 (84.4%) attempted TOL and 53 (15.6%) had an elective repeat caesarean section (ERCS). VBAC success was 51.6% (148/287). Prelabour rupture of membranes and prolonged latent phase of labour resulted in 40% of failed VBAC. Successful VBAC was associated with a higher parity, lower birth weight and lower gestation (p<0.001). Positive predictors of successful VBAC were previous vaginal birth (p=0.004), previous VBAC (p=0.038), previous CS for malpresentation (p=0.012), birth weight <3500g (p=0.003), and gestation ≤ 39 weeks (p<0.001). Negative predictors were previous CS for cephalopelvic disproportion (p=0.003) and women with no prior vaginal deliveries (p<0.001). There was no maternal mortality. Complications however, included 2 uterine ruptures, 2 uterine dehiscences, 4 hysterectomies, and one intrapartum fetal death. Adverse maternal outcomes were increased with TOL compared to ERCS (p=0.038), and more so with failed compared to successful VBAC (p=0.002). Adverse neonatal outcomes were also increased with TOL compared to ERCS (p=0.048), however there was no difference in neonatal outcomes between failed and successful VBAC (p=0.420). Conclusion VBAC remains a viable option for patients with one prior CS in this setting, despite a lower VBAC success than developed countries. Failed VBAC due to prelabour rupture of membranes and prolonged latent phase of labour remains a problem.

The development of antibody-based drugs is continuing to expand at a rapid pace, especially for use at mucosal surfaces to prevent or treat infectious diseases and other conditions. A better understanding of how the Fc region of antibodies interacts with Fc-binding proteins at mucosal sites can inform an optimal design for antibody-based drugs. The Human Contraception Antibody (HCA) is a human IgG1 monoclonal antibody currently under development as a topical vaginal contraceptive. HCA binds to sperm via its Fab domains and causes rapid agglutination with other sperm in close proximity resulting in near complete immobilization of sperm over a wide area. In order to determine whether HCA participates in Fc-mediated functions in the female reproductive tract (FRT), we assessed the activity of HCA and engineered variants in three assays of Fc-mediated functions: complement-dependent cytotoxicity (CDC), antibody-dependent cellular phagocytosis (ADCP), and mucus trapping. The physiological relevance of CDC was confirmed by characterizing complement levels and activity in cervical mucus. Finally, we described the activity of a novel Fc receptor expressed by vaginal epithelium. With complement, HCA significantly reduced sperm motility and increased the number of lysed sperm via CDC. Additionally, human cervical mucus was found to have sufficient levels of complement to induce the classical complement cascade. HCA-opsonized sperm associated with macrophages and were phagocytosed via ADCP. HCA also trapped sperm in ovulatory human cervical mucus, significantly reducing their progression. Variants of HCA with mutated or obstructed Fc domains had decreased abilities to perform these Fc functions, while multivalent IgM-like and IgA variants of HCA were very effective in both sperm agglutination and Fc assays. We also investigated the novel expression of Fc alpha RI (CD89) by human vaginal epithelium and provide evidence that this Fc receptor may transport IgA through the mucosa. Basal application of IgA resulted in IgA in apical supernatants which was significantly reduced following treatment with a CD89 blocker. In summary, these studies provide an improved understanding of the possible Fc functions of HCA and other antibodies in the human FRT, including interactions with complement, cervical mucus, and Fc receptors. Determining which interactions can occur in vivo and which are desired for a specific indication can inform the design of mucosally applied antibody-based drugs like HCA, a much-needed novel contraceptive antibody.

No description available.

No

Orientador: Rozany Mucha Dufloth / Coorientador: Luiz Carlos Zeferino / Banca: Cesar Cabello dos Santos / Banca: Sophie Françoise Mauricette Derchain / Banca: Gilberto Uemura / Banca: Maria Luiza Cotrim Sartor de Oliveira / Resumo: INTRODUÇAO: A utilização do exame de citologia cérvico-vaginal para rastreamento do carcinoma do colo do útero diminuiu a incidência e mortalidade desse carcinoma e não há dúvidas que a identificação de lesões precursoras é importante nos cuidados com a saúde da mulher. Há poucos estudos sobre a associação do resultado de citologia cérvico-vaginal alterado em mulheres gestantes e mulheres com sangramento genital brasileiras. Além disso, ainda permanece controverso se as gestantes deveriam ser submetidas ao exame de citologia cérvico-vaginal como rotina do pré-natal e se a citologia cérvico-vaignal pode ser utilizada como método único de exclusão de neoplasia do colo do útero para as mulheres com informação clínica de sangramento genital. OBJETIVOS: Estudar os fatores associados ao resultado do exame de citologia cérvico-vaginal alterado para mulheres gestantes e não-gestantes (idade, idade de início da atividade sexual, intervalo entre exames); e para mulheres com informação clínica de sangramento genital. MÉTODOS: Estudo observacional analítico que avaliou os resultados dos exames de citologia cérvico-vaginal encaminhados ao laboratório de Citopatologia Dr José Aristodemos Pinotti do Centro de Atenção Integrada à Saúde da Mulher da Universidade Estadual de Campinas durante o período de Janeiro de 2000 a Dezembro de 2009 (10 anos) oriundos de mais de 70 municípios da região de Campinas, São Paulo - Brasil. O resultado do exame de citologia cérvico-vaginal foi reportado de acordo com o Sistema Bethesda. A partir dos formulários próprios da Instituição foram extraídos dados clínicos, citopatológicos e sociodemográficos necessários para a realização do presente estudo. RESULTADOS: Controlada a idade, idade de início da atividade sexual e intervalo entre exames não há diferença quanto a prevalência de lesão intraepitelial escamosa de alto grau entre mulheres gestantes e... / Abstract: Not available / Doutor

A candidíase vaginal (CV) é uma doença causada por fungos do gênero Candida spp. que acomete milhares de mulheres no mundo. Estima-se que 75% das mulheres sofrerão CV pelo menos uma vez durante a vida fértil, 40 a 50% terão o segundo episódio e 5 a 8% sofrerão a forma recorrente, caracterizada pela ocorrência de quatro ou mais episódios durante um ano. O tratamento ainda permanece um desafio para as candidíases complicadas. A terapia fotodinâmica (TFD) é uma modalidade terapêutica que utiliza substâncias fotossensibilizadoras (FS) e uma fonte de luz, que juntas, produzem espécies reativas de oxigênio, tóxicas para micro-organismos e inofensivas para a célula animal hospedeira. O objetivo deste trabalho foi avaliar os efeitos antifúngicos e anti-inflamatórios da TFD mediada por azul de metileno (AM) e laser de emissao vermelha (LEV) no tratamento da CV em modelo animal. Fêmeas de camundongos BALB/c, com 6 a 10 semanas foram estrogenizadas e, 72h após, receberam via intravaginal 20&mu;L de suspensão contendo 107 UFC/mL de C. albicans ATCC 90028. Cinco dias após, a TFD foi aplicada na vagina das fêmeas, utilizando AM 1000&mu;M e laser (100mW, 660nm, energia de 36J por 6 min ou duas aplicações de 18J por 3min, com intervalo de 24h entre sessões). Após 0, 24 e 96h foram feitas lavagens vaginais para recuperação fúngica, cultivo microbiológico, eutanásia para remoção das vaginas e estudo histológico. Lâminas coradas por hematoxilina e eosina foram utilizadas para contagem da área de células inflamatórias (ACI), utilizando o programa ImageJ. Os resultados mostraram que TFD in vivo reduziu a carga fúngica em aproximadamente 1,6 log UFC/mL e, quando aplicada em duas sessões de 18J por 3min, diminuiu a ACI. A TFD mediada por LEV e AM 1000&mu;M mostra-se como alternativa promissora para o desenvolvimento de novas modalidades terapêuticas para vaginites fúngicas. / Vaginal candidiasis (VC) is a disease caused by fungi of the genus Candida spp. that affects thousands of women worldwide. It is estimated that 75% of women in childbearing age will have VC at least once, 40 to 50% will have a second episode and 5 to 8 % will suffer recurrent form, characterized by the occurrence of four or more episodes during one year. Treatment remains a challenge for complicated candidiasis. Photodynamic therapy (PDT) is a therapeutic modality that uses photosensitizing (FS) substances and a light source, which together produce reactive oxygen species, toxic to microorganisms and harmless to host animal cell. The aim of this study was to evaluate antifungal and anti - inflammatory effects of PDT mediated by methylene blue (MB) and red laser (RL) in the treatment of CV in an animal model. Female BALB/c mice 6 to 10 weeks were estrous and 72h after received intravaginally 20&mu;L of suspension containing 107 CFU/mL of C. albicans ATCC 90028. Five days after, PDT was applied in the vagina of females using MB 1000&mu;M and laser (100mW, 660nm, 36J for 6 min or two applications of 18J for 3 min, with an interval of 24h between sessions). Vaginal washes for fungal recovery and microbiological culture, and euthanasia for removal of vaginas and histological study were made after 0, 24 and 96h. Glass slides stained by hematoxylin and eosin were used for counting the area of inflammatory cells (AIC) using ImageJ software. PDT in vivo reduced the fungal burden in approximately 1.6 log CFU/mL, and, when applied in two sessions with 18J for 3min, decreased the AIC. PDT mediated by RL and MB 1000&mu;M shown as a promising alternative for the development of new therapeutic modalities for yeast vaginitis.

A menopausa é conseqüência da falência ovariana, caracterizada pela queda na produção de estrógenos, podendo causar na mulher vários sintomas e condições patológicas como vaginite atrófica, osteoporose e doençsa cardiovasculares. A terapia estroprogestiva é largamente prescrita na pós-menopausa, no entanto existem freqüentes efeitos colaterais e contra-indicações, inclusive possibilidade de aumento do câncer de mama. Devido a toda esta polêmica as terapias alternativas para combaterem os sintomas da menopausa estão largamente sendo exploradas, neste contexto cita-se os fitohormônios. A isoflavona é um deles obtido de várias plantas e mais usualmente da soja, que possui na sua molécula uma estrutura fenólica que se liga aos receptores de estrogênio e exerce um efeito estrogênico. Neste estudo enfocando a isoflavona, extraída da soja Glycine max, para o tratamento dos sintomas da menopausa, avaliou-se o efeito desse composto sobre a maturação do epitélio cérvico-vaginal e microbiota vaginal. Para isto propô-se um estudo randomizado, duplo cego, placebo controlado do qual participaram 49 voluntárias. Um grupo de 23 mulheres recebeu 1 cápsula/dia de 40 mg de caseína de leite, constituindo o grupo placebo e o outro grupo de 26 mulheres tratadas com 1 cápsula/dia de 40 mg de isoflavona. Amostras de urina e secreção vaginal para colpocitograma, colpocitograma com coleta úmida, bacterioscopia foram colhidas antes do início e ao término do tratamento. Foram determinados índice de maturação (I.M.) e valor de maturação (V.M.) pela técnica da citologia hormonal. O estudo da microbiota foi avaliado por exame direto a fresco e bacterioscopia de Gram. As mulheres participantes do estudo forneceram dados através de entrevistas mensais, antes do início e após o término do estudo, respondendo a questionários sobre queixas, sintomas, história da vida sexual, percepção da menopausa, estado de saúde e questões sócio demográficas. A avaliação destes dados aparece no índice de Kuppermann, nas maiores queixas e melhoras mais evidentes das mulheres tratadas com isoflavona. A avaliação do I.M. resultou no grupo tratado com isoflavona em redução significativa das células parabasais (P=0,003) no colpocitograma tradicional, em aumento significativo das células superficiais cianofílicas (P=0,006) e tendência de aumento das células superficiais eosinofílicas (P=0,18). No colpocitograma obtido por coleta úmida houve diminuição significativa das células parabasais (P=0,004), aumento significativo na porcentagem de células superficiais cianofílicas (P=0,008) e tendência de aumento das células superficiais eosinofílicas (P=0,18). No urocitograma houve redução significativa de células parabasais (P=0,008), aumento significativo na porcentagem de células superficiais cianofílicas (P=0,013) e aumento das células superficiais eosinofílicas (P=0,002). No grupo placebo não se observou variação significativa nos índices acima mencionados. O V.M. no grupo tratado com isoflavona apresentou aumento significativo (P=0,007) no colpocitograma tradicional, colpocitograma, obtido por coleta úmida (P=0,004); e no urocitograma (P=0,0008). No grupo placebo houve diminuição significativa (P=0,02) para este índice. Após o tratamento pela isoflavona houve aumento significativo de bacilos de Döederlein (P=0,005), diminuição significativa de 19,3% nos casos de vaginose bacteriana (índice de Nugent) e diminuição de outros agentes microbiológicos patogênicos. Houve diminuição dos sintomas da menopausa após o tratamento com isoflavona, também se observou diminuição das queixas após o tratamento com placebo. / The lack of estrogens characterizes postmenopausal condition and is associated with pathological conditions and symptoms, including atrophic vaginites, osteoporosis and cardiovascular disease. Hormone replacement therapy is recommended for postmenopausal women but there are contraindications and side effects. There are many alternative therapy researches in order to alleviate these symptoms. Soy isoflavone has hormonal effects in postmenopausal women, by binding a common phenolic structure to estrogens receptors. The aim of this study focusing isoflavone, extracted from soy beans Glycine max, was to evaluate the effects of isofavone on vaginal cytology, vaginal maturation index (M.I.), maturation value (M.V.), vaginal microbiota and menopausal symptoms. This study involved 49 postmenopausal women, a randomized double blind placebo controlled. The first group of 23 women was treated with 40 mg/day capsule of placebo (caseyne) and the second group of 26 women was treated with 40 mg/day capsule of isoflavone. Urine and vaginal samples for 3 slides: colpocytogram, wet sample colpocytogram, Gram-stained smears was taken at baseline and after treatment in order to determine M.I., M.V., vaginal microbiological findings and colpocytologic findings. Study participants answered an in-person interview with questions in order to determine menopausal symptoms, complains, menopause perception, sexual life, general health to determine, for instance the Kuppermann menopausal index (KMI) at baseline, every month and after six-months of treatment. The M.I. from traditional colpocytogram reduced significantly the parabasal cells (P=0,003), increased significantly the percentage of Superficial Cianophilic cells (P=0,006), there was a tendence of increasing the Superficial Eosinofilic cells (P=0,18). From wet sample colpocytogram, similar results were obtained: reduced significantly the parabasal cells (P=0,004), increased significantly the percentage of Superficial Cianophilic cells (P=0,008) there was a tendence of increasing the Superficial Eosinofilic cells (P=0,18).. In urocytogram, the results obtained were: reduced significantly the parabasal cells (P=0,008), increased significantly the percentage of Superficial Cianophilic cells (P=0,013), increase of Superficial Eosinofilic cells (P=0,002). For placebo group there were no significative changes. The Maturation Value, M.V. increased significtively (P=0,007) in traditional colpocytogram; in wet sample colpocytogram (P=0,004) and in urocytogram (P=0,0008), comparing with placebo was observed significant decrease (P=0,02) for M.V. After treatment with isoflavone there was significative increase of Döederlein bacillus (P=0,005), decrease of 19,3% in cases of bacterial vaginosis (Nugent score) and decrease of others pathogenic microbial agents. The symptoms decreased significatively in woman treated with placebo and decreased significatively in women treated with isoflavone.

Este estudo avaliou a contratilidade dos músculos do assoalho pélvico (MAP) de mulheres com dor pélvica crônica (DPC) comparadas com mulheres sem dor pélvica. Para essa avaliação foi realizada a palpação vaginal e a perineometria. Na palpação vaginal a função muscular foi classificada usando a escala de Oxford modificada de 0 a 5. Também foi avaliada a capacidade de contração, coordenação e a resistência dos MAP. A capacidade de contração foi registrado como sim ou não; a coordenação foi avaliada pela capacidade de contração dos músculos do assoalho pélvico, sem a utilização da musculatura acessória e a resistência foi o tempo em que a paciente manteve a contração dos MAP. A avaliação da pressão de contração dos MAP foi realizada através do perineômetro, que consiste em um aparelho que registra a pressão vaginal gerada pela contração dos MAP em medidas de cmH2O. Foram analisadas 78 mulheres, com e sem DPC. A análise comparativa entre os grupos mostrou que existe diferença estatisticamente significativa em relação ao seguintes itens: força muscular demonstrada pela Escala Modificada Oxford (p = 0,018), resistência muscular (p <. 0001), a função intestinal (p = 0,012), infecção do trato urinário (p = 0,006), cirurgia abdominal (p <0,0001), parto vaginal (p = 0,041), a cesariana (p = 0,002), dispareunia (p <0,001) , índice de massa corporal (p = 0,0127) e pressão de contração demonstrada pela perineometria (p = 0,0001). Não houve diferença significativa na capacidade de contração (p = 0,152), coordenação muscular (p = 0,999), incontinência urinária de esforço (p = 0,804), história obstétrica (p = 0,692), a presença de partos (p = 0,414), aborto ( p = 0,804) e idade (p = 0,2992). Houve uma forte correlação entre a escala de Oxford e perineometria, com um valor de p 0,0001. Este estudo concluiu que as mulheres com DPC têm alteração na contratilidade do MAP em relação às mulheres sem DPC, demonstrado pela escala de Oxford modificada e perineometria. / This study evaluated the contractility of the muscles of the pelvic floor of women with chronic pelvic pain compared with women without pelvic pain. The evaluation of the pelvic floor muscles was performed by vaginal palpation and perineometry. In vaginal palpation the muscle function was classified using the modified Oxford scale of 0 to 5. It was also evaluated the ability contraction, coordination and strength of the pelvic floor muscles. Contraction capacity was recorded as yes or no; coordination was evaluated by the contraction capacity of the pelvic floor muscles without the use of accessory muscles and the resistance was recorded with the time that the patient could sustain the contraction of the pelvic floor muscles. The evaluation of floor muscles contraction pressure was conducted through the perineometer, consisting of an apparatus which records vaginal pressure generated by the contraction of MAP in cm H2O measures. We analyzed 78 women, with and without CPP. The comparative analysis between the groups showed that there is a statistically significant difference in relation to the following: Scale Modified Oxford (p = 0.018), the muscle strength (p <.0001), intestinal function (p = 0.012), urinary tract infection (p = 0.006), abdominal surgery (p <0.0001), vaginal birth (p = 0.041), cesarean section (p = 0.002), dyspareunia (p <0.001), BMI (p = 0.0127) and perineometry (p = 0.0001). There was no significant difference in the contraction capacity (p = 0.152), muscle coordination (p = 0.999), urinary incontinence (p = 0.804), obstetric history (p = 0.692), presence of births (p = 0.414), abortion (p = 0.804) and age (p = 0.2992). There was a strong correlation between the scale of Oxford and perineometry, with a p value of 0.0001. This study found that women with CPP have change in contractility of MAP in relation to controls, demonstrated by the modified Oxford scale and perineometry.

A menopausa é conseqüência da falência ovariana, caracterizada pela queda na produção de estrógenos, podendo causar na mulher vários sintomas e condições patológicas como vaginite atrófica, osteoporose e doençsa cardiovasculares. A terapia estroprogestiva é largamente prescrita na pós-menopausa, no entanto existem freqüentes efeitos colaterais e contra-indicações, inclusive possibilidade de aumento do câncer de mama. Devido a toda esta polêmica as terapias alternativas para combaterem os sintomas da menopausa estão largamente sendo exploradas, neste contexto cita-se os fitohormônios. A isoflavona é um deles obtido de várias plantas e mais usualmente da soja, que possui na sua molécula uma estrutura fenólica que se liga aos receptores de estrogênio e exerce um efeito estrogênico. Neste estudo enfocando a isoflavona, extraída da soja Glycine max, para o tratamento dos sintomas da menopausa, avaliou-se o efeito desse composto sobre a maturação do epitélio cérvico-vaginal e microbiota vaginal. Para isto propô-se um estudo randomizado, duplo cego, placebo controlado do qual participaram 49 voluntárias. Um grupo de 23 mulheres recebeu 1 cápsula/dia de 40 mg de caseína de leite, constituindo o grupo placebo e o outro grupo de 26 mulheres tratadas com 1 cápsula/dia de 40 mg de isoflavona. Amostras de urina e secreção vaginal para colpocitograma, colpocitograma com coleta úmida, bacterioscopia foram colhidas antes do início e ao término do tratamento. Foram determinados índice de maturação (I.M.) e valor de maturação (V.M.) pela técnica da citologia hormonal. O estudo da microbiota foi avaliado por exame direto a fresco e bacterioscopia de Gram. As mulheres participantes do estudo forneceram dados através de entrevistas mensais, antes do início e após o término do estudo, respondendo a questionários sobre queixas, sintomas, história da vida sexual, percepção da menopausa, estado de saúde e questões sócio demográficas. A avaliação destes dados aparece no índice de Kuppermann, nas maiores queixas e melhoras mais evidentes das mulheres tratadas com isoflavona. A avaliação do I.M. resultou no grupo tratado com isoflavona em redução significativa das células parabasais (P=0,003) no colpocitograma tradicional, em aumento significativo das células superficiais cianofílicas (P=0,006) e tendência de aumento das células superficiais eosinofílicas (P=0,18). No colpocitograma obtido por coleta úmida houve diminuição significativa das células parabasais (P=0,004), aumento significativo na porcentagem de células superficiais cianofílicas (P=0,008) e tendência de aumento das células superficiais eosinofílicas (P=0,18). No urocitograma houve redução significativa de células parabasais (P=0,008), aumento significativo na porcentagem de células superficiais cianofílicas (P=0,013) e aumento das células superficiais eosinofílicas (P=0,002). No grupo placebo não se observou variação significativa nos índices acima mencionados. O V.M. no grupo tratado com isoflavona apresentou aumento significativo (P=0,007) no colpocitograma tradicional, colpocitograma, obtido por coleta úmida (P=0,004); e no urocitograma (P=0,0008). No grupo placebo houve diminuição significativa (P=0,02) para este índice. Após o tratamento pela isoflavona houve aumento significativo de bacilos de Döederlein (P=0,005), diminuição significativa de 19,3% nos casos de vaginose bacteriana (índice de Nugent) e diminuição de outros agentes microbiológicos patogênicos. Houve diminuição dos sintomas da menopausa após o tratamento com isoflavona, também se observou diminuição das queixas após o tratamento com placebo. / The lack of estrogens characterizes postmenopausal condition and is associated with pathological conditions and symptoms, including atrophic vaginites, osteoporosis and cardiovascular disease. Hormone replacement therapy is recommended for postmenopausal women but there are contraindications and side effects. There are many alternative therapy researches in order to alleviate these symptoms. Soy isoflavone has hormonal effects in postmenopausal women, by binding a common phenolic structure to estrogens receptors. The aim of this study focusing isoflavone, extracted from soy beans Glycine max, was to evaluate the effects of isofavone on vaginal cytology, vaginal maturation index (M.I.), maturation value (M.V.), vaginal microbiota and menopausal symptoms. This study involved 49 postmenopausal women, a randomized double blind placebo controlled. The first group of 23 women was treated with 40 mg/day capsule of placebo (caseyne) and the second group of 26 women was treated with 40 mg/day capsule of isoflavone. Urine and vaginal samples for 3 slides: colpocytogram, wet sample colpocytogram, Gram-stained smears was taken at baseline and after treatment in order to determine M.I., M.V., vaginal microbiological findings and colpocytologic findings. Study participants answered an in-person interview with questions in order to determine menopausal symptoms, complains, menopause perception, sexual life, general health to determine, for instance the Kuppermann menopausal index (KMI) at baseline, every month and after six-months of treatment. The M.I. from traditional colpocytogram reduced significantly the parabasal cells (P=0,003), increased significantly the percentage of Superficial Cianophilic cells (P=0,006), there was a tendence of increasing the Superficial Eosinofilic cells (P=0,18). From wet sample colpocytogram, similar results were obtained: reduced significantly the parabasal cells (P=0,004), increased significantly the percentage of Superficial Cianophilic cells (P=0,008) there was a tendence of increasing the Superficial Eosinofilic cells (P=0,18).. In urocytogram, the results obtained were: reduced significantly the parabasal cells (P=0,008), increased significantly the percentage of Superficial Cianophilic cells (P=0,013), increase of Superficial Eosinofilic cells (P=0,002). For placebo group there were no significative changes. The Maturation Value, M.V. increased significtively (P=0,007) in traditional colpocytogram; in wet sample colpocytogram (P=0,004) and in urocytogram (P=0,0008), comparing with placebo was observed significant decrease (P=0,02) for M.V. After treatment with isoflavone there was significative increase of Döederlein bacillus (P=0,005), decrease of 19,3% in cases of bacterial vaginosis (Nugent score) and decrease of others pathogenic microbial agents. The symptoms decreased significatively in woman treated with placebo and decreased significatively in women treated with isoflavone.