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TREATMENT OF VULVOVAGINITIS WITH ESTROGEN

CHARLES MAZER, M.D.; FRED R. SHECHTER, M.D.
[+] Author Affiliations

PHILADELPHIA

From the Philadelphia Institute for Medical Research in the Philadelphia General Hospital.


JAMA. 1939;112(19):1925-1928. doi:10.1001/jama.1939.02800190039010
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Infections of the immature vagina present a social and medical problem of considerable magnitude, especially in hospitals and asylums for children. Despite the available diagnostic procedures, it is often most difficult to differentiate the transmissible (gonococcic) from the nonspecific form of vulvovaginitis. It therefore becomes imperative to isolate at considerable cost and inconvenience every institutional case of vulvovaginitis. The occurrence of gonococcic vulvovaginitis in the home of a family presents no less a problem in preventing the spread of the infection to young sisters and schoolmates. In many instances the condition remains unrecognized until two or more members of a family are affected.

Although serious complications such as arthritis, salpingitis and ophthalmia are relatively infrequent, unless the gonococcus assumes an unusual virulence in passing through one or more susceptible hosts even the mild form of the infection leaves its imprint on the psyche of the affected child. The persistence of

REFERENCES

Taussig, F. J.: Diseases of the Vulva , New York, D. Appleton & Co., 1931;.
Mazer, Charles, and Rubin, S.:  Vulvovaginitis in Children , Am. Physician 31: 653 ( (Dec.) ) 1926;.
Ruys, A. Charlotte:  The Etiology of Vulvovaginitis Infantum . J. A. M. A. 105:862 ( (Sept. 14) ) 1935;.
Mascall, W. N.:  Pathological Diagnosis of Female Gonorrhea , Lancet 2:233 ( (July 29) ) 1933;.
Schauffler, G. C., and Kuhn, Clifford:  Information Regarding Gonorrhea in the Immature Female , Am. J. Obst. & Gynec. 25: 374 ( (March) ) 1933;.
Cooperman, M. B.:  Gonococcus Arthritis in Infancy: A Clinical Study of Forty-Four Cases , Am. J. Dis. Child. 33:932 ( (June) ) 1927;.
Miller, J. R.:  Two Years' Experience with Theelin Treatment of Gonorrheal Vaginitis , Am. J. Obst. & Gynec. 29:553 ( (April) ) 1935;.
Ruys, A. Charlotte, and Jens, P. A.:  Kulturelle Untersuchung des Rektalschleimes bei Kindern mit Vulvovaginitis gonorrhoica , München. med. Wchnschr. 80:846 ( (June 2) ) 1933;.
Cruickshank, Robert, and Sharman, Albert:  Biology of Vagina in Human Subject; Glycogen in Vaginal Epithelium and Its Relation to Ovarian Activity , J. Obst. & Gynaec., Brit. Emp. 41:190 ( (April) ) 1934;.
Lewis, R. M., and Weinstein, Louis:  The Production of Vaginal Acidity by Estrin , Surg.. Gynec. & Obst. 63:640 ( (Nov.) ) 1936;.
Davis, M. E.:  The Treatment of Senile Vaginitis with Ovarian Follicular Hormone , Surg., Gynec. & Obst. 61:680 ( (Nov.) ) 1935;.
Lewis, R. M.:  Study of Effects of Theelin on Gonorrheal Vaginitis in Children , Am. J. Obst. & Gynec. 26: 593 ( (Oct.) ) 1933;.
Allen, Edgar: Sex and Internal Secretions , Baltimore, Williams & Wilkins Company, 1932;.
Allen, Edgar, and Diddle, A. W.:  Ovarian Follicular Hormone Effects on Ovaries , Am. J. Obst. & Gynec. 29:83 ( (Jan.) ) 1935;.
Mazer, Charles, and Israel, S. L.:  Studies on the Optimal Dosage of Estrogens: An Experimental and Clinical Evaluation , J. A. M. A. 108: 163 ( (Jan. 16) ) 1937;.
Mazer, Charles; Meranze, D. R., and Israel, S. L.:  Evaluation of the Constitutional Effects of Large Doses of Estrogenic Principle , J. A. M. A. 105:257 ( (July 27) ) 1935;.
Berger, Milan:  Besonders hohe Wirksamkeit des Follikelhormons bei vaginaler Instillation , Klin. Wchnschr. 14: 1601 ( (Nov. 9) ) 1935;.
Lewis, R. M., and Adler, E. L.:  Gonorrheal Vaginitis: Results of Treatment with Different Preparations and Amounts of Estrogenic Substance , J. A. M. A. 106: 2054 ( (June 13) ) 1936;.
Te Linde, R. W., and Brawner, J. N., Jr.:  Experiences with Amniotin in the Treatment of Gonococcal Vaginitis in Children , Am. J. Obst. & Gynec. 30:512 ( (Oct.) ) 1935;.
Phillips, R. B.:  Theelin Therapy in Vulvovaginitis , New England J. Med. 213:1026 ( (Nov. 21) ) 1935;.
Brown, D. K.:  Management of Vulvovaginitis in Children , Brit. J. Ven. Dis. 11:207 ( (July) ) 1935;.
Reichert, J. L.; Epstein, I. M.; Jung, Ruth, and Colwell, Charlotte A.:  Infection of Lower Part of Genital Tract in Girls , Am. J. Dis. Child. 54:459 ( (Sept.) ) 1937;.
Limper, M. A., and Hieronymus, E. E.:  Treatment of Gonorrheal Vaginitis in Childhood with Estrogenic Substances , J. Pediat. 9:240 ( (Aug.) ) 1936;.
Drs. Gregory Stragnell and Erwin Schwenk supplied the material employed in this work.
Te Linde, R. W.:  The Treatment of Gonococcic Vaginitis with the Estrogenic Hormone , J. A. M. A. 110: 1633 ( (May 14) ) 1938;.
Morrell, J. A.; Powers, H. H.; Varley, J. R., and DeFrates, J.:  The Results of Oral Administration of Amniotin to Monkeys , Endocrinology 14: 174 ( (May) -June) 1930;.

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Taussig, F. J.: Diseases of the Vulva , New York, D. Appleton & Co., 1931;.
Mazer, Charles, and Rubin, S.:  Vulvovaginitis in Children , Am. Physician 31: 653 ( (Dec.) ) 1926;.
Ruys, A. Charlotte:  The Etiology of Vulvovaginitis Infantum . J. A. M. A. 105:862 ( (Sept. 14) ) 1935;.
Mascall, W. N.:  Pathological Diagnosis of Female Gonorrhea , Lancet 2:233 ( (July 29) ) 1933;.
Schauffler, G. C., and Kuhn, Clifford:  Information Regarding Gonorrhea in the Immature Female , Am. J. Obst. & Gynec. 25: 374 ( (March) ) 1933;.
Cooperman, M. B.:  Gonococcus Arthritis in Infancy: A Clinical Study of Forty-Four Cases , Am. J. Dis. Child. 33:932 ( (June) ) 1927;.
Miller, J. R.:  Two Years' Experience with Theelin Treatment of Gonorrheal Vaginitis , Am. J. Obst. & Gynec. 29:553 ( (April) ) 1935;.
Ruys, A. Charlotte, and Jens, P. A.:  Kulturelle Untersuchung des Rektalschleimes bei Kindern mit Vulvovaginitis gonorrhoica , München. med. Wchnschr. 80:846 ( (June 2) ) 1933;.
Cruickshank, Robert, and Sharman, Albert:  Biology of Vagina in Human Subject; Glycogen in Vaginal Epithelium and Its Relation to Ovarian Activity , J. Obst. & Gynaec., Brit. Emp. 41:190 ( (April) ) 1934;.
Lewis, R. M., and Weinstein, Louis:  The Production of Vaginal Acidity by Estrin , Surg.. Gynec. & Obst. 63:640 ( (Nov.) ) 1936;.
Davis, M. E.:  The Treatment of Senile Vaginitis with Ovarian Follicular Hormone , Surg., Gynec. & Obst. 61:680 ( (Nov.) ) 1935;.
Lewis, R. M.:  Study of Effects of Theelin on Gonorrheal Vaginitis in Children , Am. J. Obst. & Gynec. 26: 593 ( (Oct.) ) 1933;.
Allen, Edgar: Sex and Internal Secretions , Baltimore, Williams & Wilkins Company, 1932;.
Allen, Edgar, and Diddle, A. W.:  Ovarian Follicular Hormone Effects on Ovaries , Am. J. Obst. & Gynec. 29:83 ( (Jan.) ) 1935;.
Mazer, Charles, and Israel, S. L.:  Studies on the Optimal Dosage of Estrogens: An Experimental and Clinical Evaluation , J. A. M. A. 108: 163 ( (Jan. 16) ) 1937;.
Mazer, Charles; Meranze, D. R., and Israel, S. L.:  Evaluation of the Constitutional Effects of Large Doses of Estrogenic Principle , J. A. M. A. 105:257 ( (July 27) ) 1935;.
Berger, Milan:  Besonders hohe Wirksamkeit des Follikelhormons bei vaginaler Instillation , Klin. Wchnschr. 14: 1601 ( (Nov. 9) ) 1935;.
Lewis, R. M., and Adler, E. L.:  Gonorrheal Vaginitis: Results of Treatment with Different Preparations and Amounts of Estrogenic Substance , J. A. M. A. 106: 2054 ( (June 13) ) 1936;.
Te Linde, R. W., and Brawner, J. N., Jr.:  Experiences with Amniotin in the Treatment of Gonococcal Vaginitis in Children , Am. J. Obst. & Gynec. 30:512 ( (Oct.) ) 1935;.
Phillips, R. B.:  Theelin Therapy in Vulvovaginitis , New England J. Med. 213:1026 ( (Nov. 21) ) 1935;.
Brown, D. K.:  Management of Vulvovaginitis in Children , Brit. J. Ven. Dis. 11:207 ( (July) ) 1935;.
Reichert, J. L.; Epstein, I. M.; Jung, Ruth, and Colwell, Charlotte A.:  Infection of Lower Part of Genital Tract in Girls , Am. J. Dis. Child. 54:459 ( (Sept.) ) 1937;.
Limper, M. A., and Hieronymus, E. E.:  Treatment of Gonorrheal Vaginitis in Childhood with Estrogenic Substances , J. Pediat. 9:240 ( (Aug.) ) 1936;.
Drs. Gregory Stragnell and Erwin Schwenk supplied the material employed in this work.
Te Linde, R. W.:  The Treatment of Gonococcic Vaginitis with the Estrogenic Hormone , J. A. M. A. 110: 1633 ( (May 14) ) 1938;.
Morrell, J. A.; Powers, H. H.; Varley, J. R., and DeFrates, J.:  The Results of Oral Administration of Amniotin to Monkeys , Endocrinology 14: 174 ( (May) -June) 1930;.
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