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VAGINAL COMBINED THERAPY
A NEW APPROACH TO
VAGINAL INFECTIONS
DR. DAN CALMAN
Dr. DAYAN – HOLISTIC MEDICAL
CENTER
Vaginal Infections
In the U.S.A.
The frequency of Vaginitis is difficult to ascertain.
 General Gynecologic clinics: 5-15%
 STD clinics: 32-64%
Causes of Vaginitis
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Infectious
Candidiasis
Trichomoniasis
Viral Infs.
Desquamative Inflammatory
Vaginitis (Clindamycin
responsive)
Foreign Bodies
Parasitic
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Noninfectious
Atrophic Vaginitis
Allergic Vaginitis
Collagen Vascular Dis.
(Behçet’s syn., Pemphigus)
Most Common Causes Of Vaginitis
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Bacterial Vaginosis (22-50%)
increased numbers of organisms such as Gardnerella vaginalis,
Bacteroides, Mobiluncus, and Mycoplasma hominis .
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Trichomoniasis (4-35%)
single-celled protozoan parasite Trichomonas vaginalis.
Trichomonas is associated with many perinatal complications and an
increased incidence of transmission of HIV.
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Vaginal Yeast Infection& Candidiasis (17-39%)
Vaginal candidiasis, Fungal infection of the vagina, sometimes called
thrush.
Approx. 75% of women will experience an episode of vulvovaginal
Candidiasis
Recurrence Rate
Vulvovaginal candidiasis – Chronic or
reccurent infections (4 or more infections per
year) may occur in 5% of the population.
RECCURENT DISEASE IS MORE DIFFICULT
TO TREAT !!!!!
 Bacterial Vaginitis- About 30% of patients
have recurrence within 3 months.
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As a result of recurrent treatment some
pathogenic strains develop antibiotic
resistance.
THIS CALLS FOR
A NEW APPROACH TO
VAGINAL INFECTIONS
!!!!!!!
Hyperthermia
Some pathogens fail to survive at high
temperature levels.
Hyperthermia (Cont.)
Candida
Extremely vulnerable to heat.
At high temperature Candida transforms into
its protective form (hyphae).
If not treated in 3 weeks it will return to its
original form.
Thus, the second session should be performed
exactly 3 weeks later.
Hyperthermia (Cont.)
T. Vaginalis
Succumbs to temperature above 40ºC, and
dies in not more than 35-40 minutes.
Hyperthermia (Cont.)
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Hyperthermia eradicates bacterial and
yeast infections
High temperature causes Vasodilatation
and enhanced blood supply to the vagina.
High Temperature causes regeneration of
epithelium of the vaginal walls.
Medispec Ltd.’s GynathermTM
Treatment is performed by inserting a probe into
the patient’s vagina, the probe being heated
gradually by circulating water.
Gynatherm All Over The Globe – Partial
List
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Denmark
Brazil
Switzerland
Sweden
Portugal
Italy
Guatamala
Hong-Kong
China
Russia
Ukraine
Safety
An animal study in a canine model
demonstrated no thermal damage to the
vaginal epithelium. (Factor, J; 1993,
Beilinson)
Effectiveness
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An animal study in a canine model
demonstrated negative post treatment
cultures in initially infected ( Chlamydia &
Trichomonas) dogs (Factor, J; 1993,
Beilinson)
Vaginal Heating Success Rate
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Di Fraia, A.: 43-47ºC for 20 min. sessions
(3-6 sessions) – 91.3%
Kaplan, B.: 43-49C for 20 min. sessions
(x2) - a significant improvement was found
in 77 % of patients., both objectively and
subjectively.
Ozone
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A molecule that manifests bactericidal, virucidal and
fungicidal actions.
First World War- ozone’s bactericidal properties were
used to treat infected wounds, mustard gas burns and
fistulas.
Ozone’s applications: wounds, fistulas, decubitus
ulcers, osteomyelitis, burns, staph. Infections, fungal
and radiation lesions, Herpes simplex and Zoster,
gangrene
Ozone (Cont.)
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High ozone concentrations – for disinfection
and debridment.
Low ozone concentrations – promote
epithelialization and healing.
Ozone’s T1/2 is 45 min. at 20ºC, losing its
concentration to 16% of its initial value in 2
hours.
Ozone has a very high diffusion coefficient into
tissues.
As a result – OZONE SERVES AS OXYGEN’S
SECONDARY MESSENGER TO TISSUES.
Ozone’s Curing Potential
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Antibacterial effect
Enhancement of Oxygen saturation in
tissues
Both Treatment Methods
Stand on their own as
effective modes of treatment
for recurrent /chronic
Vaginitis
Combination Therapy
(Vaginal douching with low concentration Ozone)
+
(Vaginal Hyperthermia
with the Gynatherm)
=
EFFECTIVITY ENHANCEMENT
!!!!!
Estimated Mechanism
Heat Vasodilatation Vaginal blood supply
(and O2) Enhancement+ Bacterial
Eradication
Ozone Enhanced O2 supply to the tissue+
Bacterial Eradication
Estimated Mechanism (Cont.)
Both treatment methods enhance
bacterial eradication + vaginal
tissue regeneration
Treatment Protocol
Research Protocol (anamnesis, physical exam., PAP
smear, microbiological culture)
 3-6 treatment sessions with 3 weeks interval.
 First treatment after the first menstruation.
 Prior to treatment the vagina is washed with 30ml of
dissolved Ozone.
 Probe is applied at body temperature for 1-2 min. for
adaptation
 Temperature is raised up to 49ºC for 18-19 additional
min. (total of 20 min)
Treatment Protocol (Cont.)
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Next treatments should be administered in
the same application of temperature and
time.
Between thermotherapy sessions, once
every 10 days vaginal enemas with low
concentration ozone gas are performed.
Our Medical Center Success Rate
75-80% improvement
No AE reported
Conclusion
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We find combined Thermal + Ozone therapy
safe and highly effective for the treatment of
Recurrent / Chronic Vaginitis.
Long-term follow-up is needed to elucidate
effectivity of treatment.
Further cooperation between medical centers
should be encouraged for additional data
collection.
THANK YOU !!!!!!