{"id":16388,"date":"2023-05-19T13:14:59","date_gmt":"2023-05-19T11:14:59","guid":{"rendered":"https:\/\/looketmedecine.fr\/?p=16388"},"modified":"2024-10-05T23:28:14","modified_gmt":"2024-10-05T21:28:14","slug":"un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu","status":"publish","type":"post","link":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/","title":{"rendered":"LM N\u00b01 \/ 2023. Alterations in mucosal transudation in vulvovaginal atrophy: mechanisms involved? The role of hyaluronic acid. Denis COUCHOUREL, PhD, Medical and Scientific Director, Vivacy Laboratories"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"16388\" class=\"elementor elementor-16388\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-81f53f8 e-flex e-con-boxed e-con e-parent\" data-id=\"81f53f8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3222d33 elementor-widget elementor-widget-text-editor\" data-id=\"3222d33\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4 style=\"text-align: right;\"><strong>Still taboo subjects.\u00a0<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f02ae56 e-flex e-con-boxed e-con e-parent\" data-id=\"f02ae56\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-95b42d7 elementor-widget elementor-widget-text-editor\" data-id=\"95b42d7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3 style=\"text-align: center;\"><span style=\"color: #0000ff;\"><strong>Alterations in mucosal transudation in vulvovaginal atrophy: what mechanisms are involved? Influence of hyaluronic acid.<\/strong><\/span><\/h3><h3 style=\"text-align: center;\"><span style=\"color: #800080;\"><strong>Denis COUCHOUREL, PhD, <\/strong><\/span><\/h3><h3 style=\"text-align: center;\"><span style=\"color: #800080;\"><strong>Medical and Scientific Director of Vivacy Laboratories<\/strong><\/span><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-67e5eb8 elementor-widget elementor-widget-image\" data-id=\"67e5eb8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"199\" height=\"300\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14-199x300.png\" class=\"attachment-medium size-medium wp-image-6720\" alt=\"Denis Couchourel, PhD\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14-199x300.png 199w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14-681x1024.png 681w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14-768x1155.png 768w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png 940w\" sizes=\"(max-width: 199px) 100vw, 199px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-64fb695 elementor-widget elementor-widget-image\" data-id=\"64fb695\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"300\" height=\"196\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2020\/10\/lemarchand-1-3-300x196.png\" class=\"attachment-medium size-medium wp-image-807\" alt=\"\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2020\/10\/lemarchand-1-3-300x196.png 300w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2020\/10\/lemarchand-1-3.png 449w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-67a789b elementor-widget elementor-widget-text-editor\" data-id=\"67a789b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2><span style=\"color: #800080;\"><strong>Introduction<\/strong><\/span><\/h2><h5><span style=\"color: #0000ff;\"><strong>In 2014, the foundation for the definition of genitourinary menopausal syndrome was laid (Portman et al, 2014). <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\">In essence, any disturbance in the metabolism of sex hormones can induce a series of symptoms grouped under the name of MGS <strong>(Figure 1).<\/strong><\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-baf3e0b e-flex e-con-boxed e-con e-parent\" data-id=\"baf3e0b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9adf590 elementor-widget elementor-widget-image\" data-id=\"9adf590\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"800\" height=\"455\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-84-1024x583.png\" class=\"attachment-large size-large wp-image-16402\" alt=\"\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-84-1024x583.png 1024w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-84-300x171.png 300w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-84-768x437.png 768w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-84-1536x874.png 1536w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-84-18x10.png 18w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-84.png 1562w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4480dc9 elementor-widget elementor-widget-video\" data-id=\"4480dc9\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;video_type&quot;:&quot;hosted&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-hosted-video elementor-wrapper elementor-open-inline\">\n\t\t\t\t\t<video class=\"elementor-video\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Vivacy-Desirial-PLUS_Video2_V9-FR-2.mp4\" controls=\"\" preload=\"metadata\" controlslist=\"nodownload\"><\/video>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-de68321 elementor-widget elementor-widget-text-editor\" data-id=\"de68321\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5><span style=\"color: #0000ff;\"><strong>Thus, this syndrome can occur obviously at menopause (Nappi et al, 2014) but also in younger patients, particularly in women who are breast cancer survivors. <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\">In fact, some of the treatments offered to them result in an estrogen deficiency leading to permanent or non-permanent amenorrhea <em>(Rosenberg et al, 2013; Falk et al, 2016<\/em>).<\/span><\/h5><h5><span style=\"color: #0000ff;\">Patients undergoing chemotherapy or radiotherapy protocols may also be concerned.<\/span><\/h5><h5><span style=\"color: #0000ff;\">MUMS therefore greatly affects the quality of life of patients, and not only physically.<\/span><\/h5><h5><span style=\"color: #0000ff;\">Indeed, the sexual and intimate health of women as well as their self-esteem are also largely impacted, leading to deleterious consequences on their sleep and the quality of their daily life <em>(Nappi et al, 2019). <\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\">So this is a very important issue at the population level.<\/span><\/h5><h3><span style=\"color: #800080;\"><strong>Vulvovaginal atrophy (VVA) is one of the main components of MUMS <\/strong><em>(Shifren et al, 2018)<\/em><strong>.<\/strong><\/span><\/h3><h5><span style=\"color: #0000ff;\">The very structure of the tissues of the urogenital tract is in fact directly dependent on sexual hormones and in particular on estrogens.<\/span><\/h5><h5><span style=\"color: #0000ff;\">The symptomatology related to VVA is also well characterized and includes sensations of vaginal dryness, burning, and irritation evoked by the MUMS scale <em>(McBride et al, 2010).<\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\">Therefore, it is interesting to focus on this VVVA because it implies an alteration in the synthesis and diffusion of mucus used for lubrication of the vaginal walls and introitus.<\/span><\/h5><h5><span style=\"color: #0000ff;\">This is a very specific phenomenon involving the process of transudation that we will detail below and which depends largely on the capacity of the submucosal tissues to transport water to the surface.<\/span><\/h5><h3><span style=\"color: #800080;\"><strong>Synthesis and regulation of endogenous vaginal moisturizing fluid.<\/strong><\/span><\/h3><h5><span style=\"color: #0000ff;\">The importance of hormonal support on the proper functioning of the female reproductive tract is illustrated by the <strong>figure 2<\/strong>\u00a0:<\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d06aa85 elementor-widget elementor-widget-image\" data-id=\"d06aa85\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"935\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-85.png\" class=\"attachment-large size-large wp-image-16409\" alt=\"\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-85.png 700w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-85-225x300.png 225w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-85-9x12.png 9w\" sizes=\"(max-width: 700px) 100vw, 700px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-446db4b elementor-widget elementor-widget-text-editor\" data-id=\"446db4b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"color: #800080;\"><strong><em>Figure 2.<\/em><\/strong><strong><em>Regulation of cellular functions of vaginal tissues by sex steroid hormones (I). <\/em>(Traish et al, 2004).<\/strong><\/span><\/p><p style=\"text-align: left;\"><span style=\"color: #800080;\"><strong><em>Estrogens, androgens and progestins influence specific cellular processes depending on the anatomical plane considered within the vaginal tissue. <\/em><\/strong><\/span><\/p><ul><li style=\"text-align: left;\"><span style=\"color: #800080;\"><strong><em>In particular, these actions can lead to <\/em><\/strong><\/span><\/li><li style=\"text-align: left;\"><span style=\"color: #800080;\"><strong><em>(1) the synthesis, secretion and reuptake of neurotransmitters;<\/em><\/strong><\/span><\/li><li style=\"text-align: left;\"><span style=\"color: #800080;\"><strong><em>(2) the contraction of the smooth muscles present in the vascular walls; <\/em><\/strong><\/span><\/li><li style=\"text-align: left;\"><span style=\"color: #800080;\"><strong><em>(3) permeation of the vaginal epithelium; <\/em><\/strong><\/span><\/li><li style=\"text-align: left;\"><span style=\"color: #800080;\"><strong><em>(4) autocrine or paracrine production of vasoactive growth factors; <\/em><\/strong><\/span><\/li><li style=\"text-align: left;\"><span style=\"color: #800080;\"><strong><em>(5) regulation of the synthesis\/degradation balance of the main components of the extracellular matrices of the epithelium and the lamina propria.\u00a0<\/em><\/strong><\/span><\/li><\/ul><p style=\"text-align: left;\"><span style=\"color: #800080;\"><strong><em>The sum of these different actions determines the global physiological responses which will result in a particular blood flow, a hydration \/ lubrication of the epithelial surface which may or may not be effective, or a capacity for muscle contraction which may or may not be effective.\u00a0<\/em><\/strong><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6d31193 elementor-widget elementor-widget-text-editor\" data-id=\"6d31193\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5><span style=\"color: #0000ff;\"><strong>Therefore, any change (physiological or pathological) in the hormonal support described in this figure will lead to varying degrees of alterations in neurotransmitter function, tissue structure and composition, and smooth muscle contractility.<\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>The vaginal blood flow will therefore tend to decrease. <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>However, the efficiency of lubrication depends closely on vascular flow.<\/strong><\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a3c9dde elementor-widget elementor-widget-text-editor\" data-id=\"a3c9dde\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span style=\"color: #800080;\"><strong>Mechanism of vaginal fluid synthesis<\/strong><\/span><\/h3><h5><span style=\"color: #0000ff;\"><strong>Vaginal fluid is therefore produced by the vaginal wall and is not strictly speaking a secretion. <\/strong><\/span><span style=\"color: #0000ff;\"><strong>It is a transudate. <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\">Indeed, under the influence of arterial pressure, an ultrafiltrate is likely to form directly from the capillary network which is particularly dense at the level of the lamina propria.<\/span><\/h5><h5><span style=\"color: #0000ff;\">These small vessels are fenestrated allowing a certain level of 'leakage' and therefore the formation of a transudate.<\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>(Figure 3, subtypes C and D).<\/strong><\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0189547 elementor-widget elementor-widget-image\" data-id=\"0189547\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"273\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-86.png\" class=\"attachment-large size-large wp-image-16413\" alt=\"\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-86.png 993w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-86-300x102.png 300w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-86-768x262.png 768w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-86-18x6.png 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3146224 elementor-widget elementor-widget-text-editor\" data-id=\"3146224\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"color: #800080;\"><strong><em>Figure 3: Classification of capillaries according to their degree of permeability. <\/em><\/strong><\/span><\/p><ul><li><span style=\"color: #800080;\"><strong><em>(A) continuous capillaries (brain). <\/em><\/strong><\/span><\/li><li><span style=\"color: #800080;\"><strong><em>(B) continuous capillaries (muscles). The transit of pinocytosis vesicles allows limited exchanges with surrounding tissues. <\/em><\/strong><\/span><\/li><li><span style=\"color: #800080;\"><strong><em>(C) Fenestrated capillaries allowing wider exchanges. <\/em><\/strong><\/span><\/li><li><span style=\"color: #800080;\"><strong><em>(D) Sinusoidal capillaries allowing maximum exchange. (Kobayashi et al, 2005)<\/em><\/strong><\/span><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d718913 elementor-widget elementor-widget-text-editor\" data-id=\"d718913\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5><span style=\"color: #0000ff;\"><strong>The fluid thus formed then literally 'percolates' to the superficial epithelial layers and then reaches the surface. <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>Interestingly, the membrane of the vaginal epithelium limits the reabsorption of Na+ present in the transudate.<\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\">This feature creates an additional osmotic force that further increases the call for water to the epithelial surface <em>(Levin et al, 1997)<\/em>.<\/span><\/h5><h5><span style=\"color: #0000ff;\">K+, Ca2+ and Cl- ions are also particularly concentrated there.<\/span><\/h5><h5><span style=\"color: #0000ff;\">Vaginal transudate also contains a large number of sialoproteins, albumin, and small molecules such as lactate and urea amino acids <em>(Levin et al, 1977; Levin R et al, 1978). <\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>The amount produced is sufficient to moisten the vaginal wall and allow for the comfort of daily life.<\/strong><\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fb6913e elementor-widget elementor-widget-text-editor\" data-id=\"fb6913e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span style=\"color: #800080;\"><strong>Hormonal regulation of vaginal transudate production<\/strong><\/span><\/h3><h5><span style=\"color: #0000ff;\">Hormonal support of vaginal tissue homeostasis <strong>(Figure 2)<\/strong> is particularly important for the transudation mechanism mentioned in the previous paragraph.<\/span><\/h5><h5><span style=\"color: #0000ff;\">In particular, the binding of sex steroids to their respective receptors induces a complex signaling cascade leading to lubrication of the epithelium. <strong>(Figure 4)<\/strong>\u00a0<\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-76e868f elementor-widget elementor-widget-image\" data-id=\"76e868f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"592\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-87.png\" class=\"attachment-large size-large wp-image-16420\" alt=\"\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-87.png 999w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-87-300x222.png 300w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-87-768x568.png 768w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-87-16x12.png 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b053969 elementor-widget elementor-widget-text-editor\" data-id=\"b053969\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"color: #800080;\"><strong><em>Figure 4:<\/em><\/strong><strong> <em>Regulation of cellular functions of vaginal tissues by sex steroid hormones (II). (Traish et al, 2004). <\/em><\/strong><\/span><\/p><p><span style=\"color: #800080;\"><strong><em>The binding of the hormonal ligand (estrogens, progesterone and testosterone in particular) to their specific receptors (whether they are classically intra-cellular or membrane-based) triggers a cellular response. <\/em><\/strong><\/span><\/p><p><span style=\"color: #800080;\"><strong><em>It can take various forms: activation of ion channels, mitotic activity, induction of the synthesis of growth factors or neurotransmitters. <\/em><\/strong><\/span><\/p><p><span style=\"color: #800080;\"><strong><em>In any case, these hormone-dependent mechanisms allow the vagina to adapt the intensity of transudation, especially during phases of sexual excitement. <\/em><\/strong><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-86d1525 elementor-widget elementor-widget-text-editor\" data-id=\"86d1525\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5><span style=\"color: #0000ff;\">Note that the transduction pathways described can be non-genomic, i.e. they can be activated via membrane receptors.<\/span><\/h5><h5><span style=\"color: #0000ff;\">This concept is relatively new for steroid hormones since the authors have long thought that their actions could only be envisaged through their binding to a cytoplasmic receptor which necessarily induces protein synthesis.<\/span><\/h5><h5><span style=\"color: #0000ff;\">However, this system is by definition incompatible with a rapid reaction to a stimulus since the steps of transcription, translation, maturation and excretion of proteins take time.<\/span><\/h5><h5><span style=\"color: #0000ff;\">However, rapid effects of steroid hormones have been increasingly demonstrated since the early 2000s and these functions must now be taken into account in the spectrum of expected hormonal actions <em>(Schmidt et al, 2000; Falkenstein E et al, 2000; Couchourel et al, 2004). <\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\">It is therefore logical to observe a significant decrease in transudate production in ovariectomized animals.<\/span><\/h5><h5><span style=\"color: #0000ff;\">The phenomenon is fully reversible if estrogenic supplementation is subsequently applied <em>(Min et al, 2003).<\/em><\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-68decc1 elementor-widget elementor-widget-text-editor\" data-id=\"68decc1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span style=\"color: #800080;\"><strong>Transport of transudate through the vaginal epithelium<\/strong><\/span><\/h3><h5><span style=\"color: #0000ff;\">The transport of aqueous fluids through the mucosal wall is not so obvious.<\/span><\/h5><h5><span style=\"color: #0000ff;\">Indeed, the transudate must find its way through a relatively thick non-keratinized pluristratified epithelium.<\/span><\/h5><h5><span style=\"color: #0000ff;\">This tissue is of course made up of successive layers of cells linked together by focal adhesion plates of the desmosome type.<\/span><\/h5><h5><span style=\"color: #0000ff;\">It is therefore a globally hydrophobic environment and not very conducive to baso-apical aqueous fluid movements.<\/span><\/h5><h5><span style=\"color: #0000ff;\">In this context, the transudate will use dedicated structures to be able to cross this cellular barrier.<\/span><\/h5><h5><span style=\"color: #0000ff;\">Aquaporins (AQPs) are a family of transmembrane proteins with 4 members identified in mammals <em>(AQP1 to AQP4) (Ishibashi K, 2009). <\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\">Hundreds of other isoforms have also been identified in other organisms, including plants <em>(Maurel C et al, 2015). <\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\">They all share a number of characteristics.<\/span><\/h5><h5><span style=\"color: #0000ff;\">For example, they weigh on average 30 KDa, they have 6 transmembrane segments and they form a tetramer within the lipid bilayer of the membrane and they are often associated with ion channels <strong>(Figure 5)<\/strong><\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9683925 elementor-widget elementor-widget-image\" data-id=\"9683925\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"693\" height=\"468\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-88.png\" class=\"attachment-large size-large wp-image-16436\" alt=\"\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-88.png 693w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-88-300x203.png 300w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-88-18x12.png 18w\" sizes=\"(max-width: 693px) 100vw, 693px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b4febe8 elementor-widget elementor-widget-text-editor\" data-id=\"b4febe8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"color: #800080;\"><strong><em>Figure 5: <\/em><\/strong><\/span><\/p><ol><li><span style=\"color: #800080;\"><strong><em>(A)a tetramer of 4 subunits delimit a central water-permeable channel. <\/em><\/strong><\/span><\/li><li><span style=\"color: #800080;\"><strong><em>(B) Each subunit itself allows the passage of water molecules. <\/em><\/strong><\/span><\/li><li><span style=\"color: #800080;\"><strong><em>(C) PQAs are very often associated with ion channels (here TRPV4, permeable to Ca2+ and Mg2+ ions) (Verkman et al, 2011)<\/em><\/strong><\/span><\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ad94426 elementor-widget elementor-widget-text-editor\" data-id=\"ad94426\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5><span style=\"color: #0000ff;\">In a tissue such as the epithelium of the vaginal mucosa, PQAs are strictly necessary for the transport of transudate from the capillaries of the lamina propria to the surface.<\/span><\/h5><h5><span style=\"color: #0000ff;\">Numerous studies in animals have highlighted this crucial role.<\/span><\/h5><h5><span style=\"color: #0000ff;\">For example, in 1999, Ma et al demonstrated that deletion of the gene encoding AQP5 in mice suppressed fluid secretion from the salivary glands <em>(Ma et al, 1999). <\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\">The same demonstration could be made for the mucous membrane of the trachea.<\/span><\/h5><h5><span style=\"color: #0000ff;\">In this particular case, the recovered fluid (which was significantly reduced in quantity) also exhibited hyperosmolarity <em>(Song et al, 2001).<\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\">When the knockout involved the gene coding for AQP1, the synthesis of cerebrospinal fluid in the choroid plexus as well as the production of aqueous humor by the ciliary epithelium of the eye were decreased.<\/span><\/h5><h5><span style=\"color: #0000ff;\">Thus, the authors concluded that AQP is strongly involved in the regulation of intracranial and intraocular pressures <em>(Zhang et al, 2002). <\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\">As in the previous work, the osmolarity of the obtained fluids was also strongly disturbed.<\/span><\/h5><h5><span style=\"color: #0000ff;\">At the vaginal level, AQP3, AQP5 and AQP6 could be identified in rats. <em>(Park et al, 2008). <\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\">In addition, the amount of PQAs present in the tissues is sensitive to the estrogenic hormonal support <strong>(Figure 6),<\/strong> confirming some of the assumptions made in the model presented in the <strong>figures 3 and 4.<\/strong>\u00a0<\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ca5fbdf elementor-widget elementor-widget-image\" data-id=\"ca5fbdf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"404\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-89.png\" class=\"attachment-large size-large wp-image-16446\" alt=\"\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-89.png 1025w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-89-300x152.png 300w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-89-768x388.png 768w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-89-18x9.png 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5194ca3 elementor-widget elementor-widget-text-editor\" data-id=\"5194ca3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"color: #800080;\"><strong><em>Figure 6: Expression levels of identified PQAs in the vaginal wall. <\/em><\/strong><\/span><\/p><p><span style=\"color: #800080;\"><strong><em>The measurement is done by quantifying the optical density after immunocytochemical labeling. <\/em><\/strong><\/span><\/p><p><span style=\"color: #800080;\"><strong><em>The measured amounts of PQA decrease compared to the healthy control when the model (rat) is ovariectomized. <\/em><\/strong><\/span><\/p><p><span style=\"color: #800080;\"><strong><em>When ovariectomized rats are supplemented with estrogen, the PQA level rises and becomes comparable to the control (Zhu et al, 2105)<\/em><\/strong><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9390a44 elementor-widget elementor-widget-text-editor\" data-id=\"9390a44\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5><span style=\"color: #0000ff;\"><strong>Park K et al<\/strong> have also suggested that nerve stimulation at the pelvic level could also induce translocation of AQP1 and AQP2 from the cell cytosol to the membranes.<\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>Thus, the role of PQAs in vaginal lubrication could also be of great importance during the sexual arousal phase <em>(Park et al, 2008)<\/em> by allowing a drastic increase in the quantity of transudate available on the surface of the vaginal epithelium.<\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>The transcellular transport just described is therefore an important aspect of epithelial crossing. <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>It is necessary, but not sufficient to fully optimize the lubrication of the vaginal wall. <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\">Indeed, the extracellular matrix present between the cells can be a facilitator depending on its structure and composition. <strong>(Figure7)\u00a0<\/strong><\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1d66c24 elementor-widget elementor-widget-image\" data-id=\"1d66c24\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"444\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-90.png\" class=\"attachment-large size-large wp-image-16463\" alt=\"\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-90.png 954w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-90-300x166.png 300w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-90-768x426.png 768w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Sans-titre-90-18x10.png 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4686ece elementor-widget elementor-widget-text-editor\" data-id=\"4686ece\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"color: #800080;\"><strong><em>Figure 7: Composition of the extracellular matrix between the submucosal capillaries and the basal lamina supporting the epithelium. <\/em><\/strong><\/span><\/p><p><span style=\"color: #800080;\"><strong><em>This basal lamina is mainly composed of highly organized repetitive patterns of collagen, laminin, fibronectin and proteoglycans.<\/em><\/strong><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-88e35eb elementor-widget elementor-widget-text-editor\" data-id=\"88e35eb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h5><span style=\"color: #0000ff;\">As mentioned above, the transudate (green downward arrow) originates from the windows separating the endothelial cells from the capillaries and tends to flow passively (thanks to hydrostatic pressure) towards the epithelial cells.<\/span><\/h5><h5><span style=\"color: #0000ff;\">Nevertheless, for the system to be effective, the basal lamina must not block this aqueous flow.<\/span><\/h5><h5><span style=\"color: #0000ff;\">That is why it must necessarily show a certain hygroscopicity.<\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>This essential property is held by the molecules of the glycosaminoglycan group, and more particularly by hyaluronic acid (HA).<\/strong>\u00a0<\/span><\/h5><h5><span style=\"color: #0000ff;\">Indeed, this long sweet polymer is charged because of the presence of carboxyl groups, giving it a very important affinity for water.<\/span><\/h5><h5><span style=\"color: #0000ff;\">Moreover, when these molecules are in solution, electrostatic bonds are created, defining subdomains within which water can also be trapped and attracted.<\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>Hyaluronic acid is synthesized by 3 isoforms of the 'hyaluronan synthase': HAS1, HAS2 and HAS3. <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\">However, it was shown in 2013 that HAS2 (responsible for the formation of the longest chains of endogenous hyaluronic acid) could modulate its effectiveness depending on the hormones present.<\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong><em>Specifically, when the hormonal environment is estrogen-dominant, HAS2 increases its synthesis of high molecular weight HA. <\/em><\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\">At the same time, the expression of CD44 on the surface of the surrounding cell membranes tends to decrease, as if the organism wanted to favour a mode of action of HA based on its intrinsic chemical properties rather than its functions depending on a receptor-ligand interaction.<\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong><em>On the other hand, in a progestin-dominant environment, it is HAS3 that sees its activity increase strongly. <\/em><\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong><em>Yet this isoform is specialized in the synthesis of small molecules of HA that have a high affinity for HA membrane receptors (including CD44) (Raheem et al, 2013). <\/em><\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\">These results further illustrate that in addition to the intensity of transudate synthesis (which is highly dependent on vasodilation and intra capillary pressure, <strong>figure 3<\/strong>), the amount of fluid available at the mucosal surface is also tightly regulated by many parameters active during the epithelial crossing stage.<\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>AQP and AH are 2 essential actors of this regulation.<\/strong><\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8aee686 elementor-widget elementor-widget-text-editor\" data-id=\"8aee686\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span style=\"color: #800080;\"><strong>Conclusion<\/strong><\/span><\/h3><h5><span style=\"color: #0000ff;\"><strong>Vaginal lubrication is a complex phenomenon whose effectiveness can vary according to a large number of regulatory parameters:<\/strong><\/span><\/h5><ul><li><h5><span style=\"color: #0000ff;\">The vascular origin of the ultrafiltrate induces a dependence on the density of the subepithelial capillary network but also on its vasodilatation and on the blood pressure prevailing in these vessels.<\/span><\/h5><\/li><li><h5><span style=\"color: #0000ff;\">Once formed, the transudate must then pass through the vaginal epithelium via AQPs in the function is subject to complex hormonal control.<\/span><\/h5><\/li><li><h5><span style=\"color: #0000ff;\">In addition to transcellular fluid transport, the HA content of the extracellular matrix is also a facilitating parameter for lubrication. Here again, the hormonal environment will direct the profile of actions that HA can perform in this context.<\/span><\/h5><\/li><\/ul><h5><span style=\"color: #0000ff;\"><strong>Finally, the factors influencing vaginal lubrication presented in this summary are by no means exhaustive. There are of course other regulatory loops. <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\">As an example and to open the reflection, let's just note that in 2015 a paper published in \"Nature\" demonstrated the ability of HA from the extracellular matrix to act on a cationic transporter named TRPV1.<\/span><\/h5><h5><span style=\"color: #0000ff;\">TRPV1 was previously studied in the context of pain transmission at nociceptive nerve endings <em>(Caires R et al, 2015).<\/em><\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>We could therefore consider an additional and much more direct means of action of HA on pain related to the absence of transudate on the surface of the vaginal epithelium. <\/strong><\/span><\/h5><h5><span style=\"color: #0000ff;\"><strong>In addition to its moisturizing properties, HA may also act directly on the nerve signal. This hypothesis remains unconfirmed to date, but it illustrates the need to refine our knowledge of this type of molecular interaction.<\/strong><\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-232d6b3 elementor-widget elementor-widget-text-editor\" data-id=\"232d6b3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><span style=\"color: #0000ff;\"><strong>Bibliography<\/strong><\/span><\/h3><h6><span style=\"color: #993366;\">Caires R, Luis E, Taberner FJ, Fernandez-Ballester G, Ferrer-Montiel A, Balazs EA, Gomis A, Belmonte C, de la Pe\u00f1a E. Hyaluronan modulates TRPV1 channel opening, reducing peripheral nociceptor activity and pain. Nat Commun. 2015 Aug 27;6:8095.<\/span><\/h6><h6><span style=\"color: #993366;\">Couchourel D, Leclerc M, Filep J, Brunette MG <a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15249127\/\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Testosterone enhances calcium reabsorption by the kidney.<\/a>Mol Cell Endocrinol. 2004 Jul 30;222(1-2):71-81<\/span><\/h6><h6><span style=\"color: #993366;\">Falk, S.J.; Bober, S. Vaginal Health During Breast Cancer Treatment. Curr. Oncol. Rep. 2016, 18, 32.<\/span><\/h6><h6><span style=\"color: #993366;\"><a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Falkenstein+E&amp;cauthor_id=10843198\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Falkenstein<\/a>\u00a0<a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10843198\/#full-view-affiliation-1\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">E<\/a>,\u00a0<a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Norman+AW&amp;cauthor_id=10843198\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Norman<\/a> AW,\u00a0<a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Wehling+M&amp;cauthor_id=10843198\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Wehling<\/a> M. Mannheim classification of nongenomically initiated (rapid) steroid action(s) J Clin Endocrinol Metab. 2000 May;85(5):2072-5.<\/span><\/h6><h6><span style=\"color: #993366;\">Ishibashi K: New members of mammalian aquaporins: AQP10-AQP12. Handb Exp Pharmacol 2009;190:251-262.<\/span><\/h6><h6><span style=\"color: #993366;\"><a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Kobayashi+S&amp;cauthor_id=15814956\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Kobayashi<\/a> S,\u00a0<a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Meir+A&amp;cauthor_id=15814956\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Meir<\/a> A,\u00a0<a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Baba+H&amp;cauthor_id=15814956\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Baba<\/a> H,\u00a0<a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Uchida+K&amp;cauthor_id=15814956\" target=\"_blank\" rel=\"noopener noreferrer nofollow\"> Uchida<\/a> K,\u00a0<a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Hayakawa+K&amp;cauthor_id=15814956\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Hayakawa<\/a> K. Imaging of intraneural edema by using gadolinium-enhanced MR imaging: experimental compression injury. AJNR Am J Neuroradiol. 2005 Apr;26(4):973-80.<\/span><\/h6><h6><span style=\"color: #993366;\">Levin R, Wagner G. Human vaginal fluid-ionic composition and modification by sexual arousal. J Physiol 1977;266:62-3<\/span><\/h6><h6><span style=\"color: #993366;\">Levin R, Wagner G. Mechanism for vaginal ion movement in women. J Physiol 1978;284:172-3.<\/span><\/h6><h6><span style=\"color: #993366;\">Levin RJ. Actions of spermicidal and virucidal agents on electrogenic ion transfer across human vaginal epithelium in vitro. Pharmacology and Toxicology. 1997 ; 81, 219 - 225.<\/span><\/h6><h6><span style=\"color: #993366;\">Levin RJ, Wylie K. Vaginal vasomotion-Its appearance, measurement, and usefulness in assessing the mechanisms of vasodilation. J Sex Med 2008;5:377-86<\/span><\/h6><h6><span style=\"color: #993366;\">Ma, T., Song, Y., Gillespie, A., Carlson, E. J., Epstein, C. J. and Verkman, A. S. Defective secretion of saliva in transgenic mice lacking aquaporin-5 water channels. J. Biol. Chem. 1999. 274, 20071-20074.<\/span><\/h6><h6><span style=\"color: #993366;\">Maurel C, Boursiac Y, Luu DT, Santoni V, Shahzad Z, Verdoucq L: Aquaporins in plants. Physiol Rev 2015;95:1321-1358<\/span><\/h6><h6><span style=\"color: #993366;\">Min K, Munarriz R, Kim NN, Choi S, O'Connell L, Goldstein I, Traish AM. Effects of ovariectomy and estrogen replacement on basal and pelvic nerve stimulated vaginal lubrication in an animal model. J Sex Marital Ther 2003;29(Suppl. 1):77-84.<\/span><\/h6><h6><span style=\"color: #993366;\">Nappi, R.E.; Martini, E.; Cucinella, L.; Martella, S.; Tiranini, L.; Inzoli, A.; Brambilla, E.; Bosoni, D.; Cassani, C.; Gardella, B. Addressing Vulvovaginal Atrophy (VVA)\/Genitourinary Syndrome of Menopause (GSM) for Healthy Aging in Women. Front. Endocrinol. 2019, 10, 561<\/span><\/h6><h6><span style=\"color: #993366;\">Nappi, R.E.; Palacios, S. Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause. Climacteric 2014, 17, 3-9.<\/span><\/h6><h6><span style=\"color: #993366;\"><a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Mac+Bride+MB&amp;cauthor_id=20042564\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Mac Bride<\/a> MB,\u00a0<a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Rhodes+DJ&amp;cauthor_id=20042564\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Rhodes<\/a> DJ,\u00a0<a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/?sort=pubdate&amp;term=Shuster+LT&amp;cauthor_id=20042564\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Shuster<\/a> LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010 Jan;85(1):87-94.<\/span><\/h6><h6><span style=\"color: #993366;\">Park K, Han HJ, Kim SW, Jung SI, Kim SO, Lee HS, Lee MN, Ahn K. Expression of aquaporin water channels in rat vagina: Potential role in vaginal lubrication. J Sex Med 2008; 5:77-82<\/span><\/h6><h6><span style=\"color: #993366;\">Portman, D.J.; Gass, M.L. Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. Menopause 2014, 21, 1063-1068.<\/span><\/h6><h6><span style=\"color: #993366;\">Raheem KA, Marei WF, Mifsud K, Khalid M, Wathes DC, Fouladi-Nashta AA. Regulation of the hyaluronan system in ovine endometrium by ovarian steroids. Reproduction. 2013 Apr 29;145(5):491-504<\/span><\/h6><h6><span style=\"color: #993366;\">Rosenberg, S.M.; Partridge, A.H. Premature menopause in young breast cancer: Effects on quality of life and treatment interventions. J. Thorac. Dis. 2013, 5 (Suppl. 1), S55-S61.<\/span><\/h6><h6><span style=\"color: #993366;\">Schmidt BM, Gerdes D, Feuring M, Falkenstein E, Christ M, Wehling M. <a style=\"color: #993366;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10662536\/\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">Rapid, nongenomic steroid actions: A new age?<\/a> Front Neuroendocrinol. 2000 Jan;21(1):57-94<\/span><\/h6><h6><span style=\"color: #993366;\">Shifren, J.L. Genitourinary Syndrome of Menopause. Clin. Obs. Gynecol. 2018, 61, 508-516.<\/span><\/h6><h6><span style=\"color: #993366;\">Song, Y. and Verkman, A. S.. Aquaporin-5 dependent fluid secretion in airway submucosal glands. J. Biol. Chem. 2001. 276, 41288-41292.<\/span><\/h6><h6><span style=\"color: #993366;\">Traish AM, Kim N, Munarriz R, Goldstein I. Female genital sexual arousal: biochemical mediators and potential mechanisms of dysfunction. Drug. Discov. Today. Dis. Mech. 2004, Vol. 1 (1), 91-97.<\/span><\/h6><h6><span style=\"color: #993366;\">Verkman AS. Aquaporins at a glance. J Cell Sci. 2011 Jul 1;124(Pt 13):2107-12.<\/span><\/h6><h6><span style=\"color: #993366;\">Zhu J, Xia J, Jiang J, Jiang R, He Y, Lin H. Effects of estrogen deprivation on expression of aquaporins in rat vagina. Menopause. 2015 Aug;22(8):893-8.<\/span><\/h6>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cc7e5b3 elementor-widget elementor-widget-image\" data-id=\"cc7e5b3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"993\" src=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Capture-decran-2023-06-03-a-08.39.18-825x1024.png\" class=\"attachment-large size-large wp-image-17444\" alt=\"\" srcset=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Capture-decran-2023-06-03-a-08.39.18-825x1024.png 825w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Capture-decran-2023-06-03-a-08.39.18-242x300.png 242w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Capture-decran-2023-06-03-a-08.39.18-768x953.png 768w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Capture-decran-2023-06-03-a-08.39.18-1237x1536.png 1237w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Capture-decran-2023-06-03-a-08.39.18-10x12.png 10w, https:\/\/looketmedecine.fr\/wp-content\/uploads\/2023\/05\/Capture-decran-2023-06-03-a-08.39.18.png 1547w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Sujets encore tabous.\u00a0 Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : quels sont les m\u00e9canismes impliqu\u00e9s\u00a0? Influence de l&rsquo;acide hyaluronique. Denis COUCHOUREL, PhD, Directeur medical et scientifique des laboratoires Vivacy Introduction En 2014, les bases de la d\u00e9finition du syndrome g\u00e9nito-urinaire de la m\u00e9nopause ont \u00e9t\u00e9 pos\u00e9es (Portman et al, 2014). En [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":6720,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[45],"tags":[315,307],"auteur":[377],"mots-cles":[],"class_list":["post-16388","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sujets-encore-tabous","tag-lm1-theme-sujets-encore-tabous-2023","tag-replay-lm1-2023","auteur-denis-couchourel"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>LM N\u00b01 \/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l&#039;acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy - Revue fran\u00e7aise N\u00b01 pour la recherche en sant\u00e9 esth\u00e9tique<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/posts\/16388\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"LM N\u00b01 \/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l&#039;acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy - Revue fran\u00e7aise N\u00b01 pour la recherche en sant\u00e9 esth\u00e9tique\" \/>\n<meta property=\"og:description\" content=\"Sujets encore tabous.\u00a0 Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : quels sont les m\u00e9canismes impliqu\u00e9s\u00a0? Influence de l&rsquo;acide hyaluronique. Denis COUCHOUREL, PhD, Directeur medical et scientifique des laboratoires Vivacy Introduction En 2014, les bases de la d\u00e9finition du syndrome g\u00e9nito-urinaire de la m\u00e9nopause ont \u00e9t\u00e9 pos\u00e9es (Portman et al, 2014). En [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/\" \/>\n<meta property=\"og:site_name\" content=\"Revue fran\u00e7aise N\u00b01 pour la recherche en sant\u00e9 esth\u00e9tique\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/looketmedecine.magazine\/\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-19T11:14:59+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-10-05T21:28:14+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png\" \/>\n\t<meta property=\"og:image:width\" content=\"940\" \/>\n\t<meta property=\"og:image:height\" content=\"1414\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Albert-Claude Benhamou\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Albert-Claude Benhamou\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"17 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/\"},\"author\":{\"name\":\"Albert-Claude Benhamou\",\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/#\\\/schema\\\/person\\\/d674c704426e829b385c4dd691b8e3cc\"},\"headline\":\"LM N\u00b01 \\\/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l&rsquo;acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy\",\"datePublished\":\"2023-05-19T11:14:59+00:00\",\"dateModified\":\"2024-10-05T21:28:14+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/\"},\"wordCount\":3427,\"publisher\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/looketmedecine.fr\\\/wp-content\\\/uploads\\\/2021\\\/11\\\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png\",\"keywords\":[\"Lm1 th\u00e8me Sujets encore tabous 2023\",\"Replay Lm1 2023\"],\"articleSection\":[\"Sujets encore tabous\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/\",\"url\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/\",\"name\":\"LM N\u00b01 \\\/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l'acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy - Revue fran\u00e7aise N\u00b01 pour la recherche en sant\u00e9 esth\u00e9tique\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/looketmedecine.fr\\\/wp-content\\\/uploads\\\/2021\\\/11\\\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png\",\"datePublished\":\"2023-05-19T11:14:59+00:00\",\"dateModified\":\"2024-10-05T21:28:14+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/#primaryimage\",\"url\":\"https:\\\/\\\/looketmedecine.fr\\\/wp-content\\\/uploads\\\/2021\\\/11\\\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png\",\"contentUrl\":\"https:\\\/\\\/looketmedecine.fr\\\/wp-content\\\/uploads\\\/2021\\\/11\\\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png\",\"width\":940,\"height\":1414,\"caption\":\"Denis Couchourel, PhD\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/en\\\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\\\/\\\/looketmedecine.fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"LM N\u00b01 \\\/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l&rsquo;acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/#website\",\"url\":\"https:\\\/\\\/looketmedecine.fr\\\/\",\"name\":\"Revue fran\u00e7aise N\u00b01 pour la recherche en sant\u00e9 esth\u00e9tique\",\"description\":\"La sant\u00e9 esth\u00e9tique fond\u00e9e sur des preuves scientifiques\",\"publisher\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/looketmedecine.fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/#organization\",\"name\":\"Looketmedecine\",\"url\":\"https:\\\/\\\/looketmedecine.fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/looketmedecine.fr\\\/wp-content\\\/uploads\\\/2020\\\/11\\\/cropped-LookMedecine_Logo_Textuel_Noir.png\",\"contentUrl\":\"https:\\\/\\\/looketmedecine.fr\\\/wp-content\\\/uploads\\\/2020\\\/11\\\/cropped-LookMedecine_Logo_Textuel_Noir.png\",\"width\":1500,\"height\":145,\"caption\":\"Looketmedecine\"},\"image\":{\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/looketmedecine.magazine\\\/\",\"https:\\\/\\\/www.instagram.com\\\/looketmedecine\\\/?hl=fr\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/looketmedecine.fr\\\/#\\\/schema\\\/person\\\/d674c704426e829b385c4dd691b8e3cc\",\"name\":\"Albert-Claude Benhamou\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/f4c13b834cf55e3822893169175e3671a59788fb9e2d84d3a223c96e83a8f09e?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/f4c13b834cf55e3822893169175e3671a59788fb9e2d84d3a223c96e83a8f09e?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/f4c13b834cf55e3822893169175e3671a59788fb9e2d84d3a223c96e83a8f09e?s=96&d=mm&r=g\",\"caption\":\"Albert-Claude Benhamou\"},\"url\":\"https:\\\/\\\/looketmedecine.fr\\\/en\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"LM N\u00b01 \/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l'acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy - Revue fran\u00e7aise N\u00b01 pour la recherche en sant\u00e9 esth\u00e9tique","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/posts\/16388","og_locale":"en_US","og_type":"article","og_title":"LM N\u00b01 \/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l'acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy - Revue fran\u00e7aise N\u00b01 pour la recherche en sant\u00e9 esth\u00e9tique","og_description":"Sujets encore tabous.\u00a0 Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : quels sont les m\u00e9canismes impliqu\u00e9s\u00a0? Influence de l&rsquo;acide hyaluronique. Denis COUCHOUREL, PhD, Directeur medical et scientifique des laboratoires Vivacy Introduction En 2014, les bases de la d\u00e9finition du syndrome g\u00e9nito-urinaire de la m\u00e9nopause ont \u00e9t\u00e9 pos\u00e9es (Portman et al, 2014). En [&hellip;]","og_url":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/","og_site_name":"Revue fran\u00e7aise N\u00b01 pour la recherche en sant\u00e9 esth\u00e9tique","article_publisher":"https:\/\/www.facebook.com\/looketmedecine.magazine\/","article_published_time":"2023-05-19T11:14:59+00:00","article_modified_time":"2024-10-05T21:28:14+00:00","og_image":[{"width":940,"height":1414,"url":"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png","type":"image\/png"}],"author":"Albert-Claude Benhamou","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Albert-Claude Benhamou","Est. reading time":"17 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/#article","isPartOf":{"@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/"},"author":{"name":"Albert-Claude Benhamou","@id":"https:\/\/looketmedecine.fr\/#\/schema\/person\/d674c704426e829b385c4dd691b8e3cc"},"headline":"LM N\u00b01 \/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l&rsquo;acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy","datePublished":"2023-05-19T11:14:59+00:00","dateModified":"2024-10-05T21:28:14+00:00","mainEntityOfPage":{"@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/"},"wordCount":3427,"publisher":{"@id":"https:\/\/looketmedecine.fr\/#organization"},"image":{"@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/#primaryimage"},"thumbnailUrl":"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png","keywords":["Lm1 th\u00e8me Sujets encore tabous 2023","Replay Lm1 2023"],"articleSection":["Sujets encore tabous"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/","url":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/","name":"LM N\u00b01 \/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l'acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy - Revue fran\u00e7aise N\u00b01 pour la recherche en sant\u00e9 esth\u00e9tique","isPartOf":{"@id":"https:\/\/looketmedecine.fr\/#website"},"primaryImageOfPage":{"@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/#primaryimage"},"image":{"@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/#primaryimage"},"thumbnailUrl":"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png","datePublished":"2023-05-19T11:14:59+00:00","dateModified":"2024-10-05T21:28:14+00:00","breadcrumb":{"@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/#primaryimage","url":"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png","contentUrl":"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2021\/11\/Capture-de\u0301cran-2021-11-18-a\u0300-08.25.14.png","width":940,"height":1414,"caption":"Denis Couchourel, PhD"},{"@type":"BreadcrumbList","@id":"https:\/\/looketmedecine.fr\/en\/un-autre-regard-sur-la-sante-esthetique-du-corps-4-1-sujets-encore-tabous-la-sante-esthetique-vaginale-alterations-de-la-transsudation-muqueuse-dans-le-cadre-des-atrophies-vulvo-vaginales-qu\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Accueil","item":"https:\/\/looketmedecine.fr\/"},{"@type":"ListItem","position":2,"name":"LM N\u00b01 \/ 2023. Alt\u00e9rations de la transsudation\u00a0muqueuse dans le cadre des atrophies vulvo-vaginales : m\u00e9canismes impliqu\u00e9s\u00a0? Place de l&rsquo;acide hyaluronique. Denis COUCHOUREL, PhD, Directeur m\u00e9dical et scientifique des laboratoires Vivacy"}]},{"@type":"WebSite","@id":"https:\/\/looketmedecine.fr\/#website","url":"https:\/\/looketmedecine.fr\/","name":"N\u00b01 French magazine for research in aesthetic health","description":"Aesthetic health based on scientific evidence","publisher":{"@id":"https:\/\/looketmedecine.fr\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/looketmedecine.fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/looketmedecine.fr\/#organization","name":"Looketmedicine","url":"https:\/\/looketmedecine.fr\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/looketmedecine.fr\/#\/schema\/logo\/image\/","url":"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2020\/11\/cropped-LookMedecine_Logo_Textuel_Noir.png","contentUrl":"https:\/\/looketmedecine.fr\/wp-content\/uploads\/2020\/11\/cropped-LookMedecine_Logo_Textuel_Noir.png","width":1500,"height":145,"caption":"Looketmedecine"},"image":{"@id":"https:\/\/looketmedecine.fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/looketmedecine.magazine\/","https:\/\/www.instagram.com\/looketmedecine\/?hl=fr"]},{"@type":"Person","@id":"https:\/\/looketmedecine.fr\/#\/schema\/person\/d674c704426e829b385c4dd691b8e3cc","name":"Albert-Claude Benhamou","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/f4c13b834cf55e3822893169175e3671a59788fb9e2d84d3a223c96e83a8f09e?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/f4c13b834cf55e3822893169175e3671a59788fb9e2d84d3a223c96e83a8f09e?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/f4c13b834cf55e3822893169175e3671a59788fb9e2d84d3a223c96e83a8f09e?s=96&d=mm&r=g","caption":"Albert-Claude Benhamou"},"url":"https:\/\/looketmedecine.fr\/en"}]}},"_links":{"self":[{"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/posts\/16388","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/comments?post=16388"}],"version-history":[{"count":142,"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/posts\/16388\/revisions"}],"predecessor-version":[{"id":23813,"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/posts\/16388\/revisions\/23813"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/media\/6720"}],"wp:attachment":[{"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/media?parent=16388"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/categories?post=16388"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/tags?post=16388"},{"taxonomy":"auteur","embeddable":true,"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/auteur?post=16388"},{"taxonomy":"mots-cles","embeddable":true,"href":"https:\/\/looketmedecine.fr\/en\/wp-json\/wp\/v2\/mots-cles?post=16388"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}