IntrOductIOnMore than 80% of the women face physical and psychological problems when they approach menopause leading to a reduction in the quality of life [1]. World Health Organization (WHO) described quality of life as an individual's insight of their situation in life in the base of the culture and value systems in which they habit and in relation to their aims, expectancies, standards and concerns. Studies have revealed that menopause might have an adverse impact on quality of life of women [2].Several causes can disturb the quality of life in postmenopausal women. Stress, urinary incontinence is one of the factors that can influence the quality of life of women, since they evade social activities and limit their behavior [3]. Vulvovaginal disorders adversely impact sexual activity, psychosocial health and partner relationships [4]. More than 56% of postmenopausal women undergo dyspareunia affected by vaginal dryness [5], and the dyspareunia is correlated with reduced libido [6] and ultimately disturbed quality of life. The commonest urogenital symptoms related to menopause are vaginal dryness, followed by irritation or itching, discharge, and dysuria. These problems are the outcome of vaginal atrophy which is caused by decreased transudation through the vaginal epithelium and decreased cervical gland secretions due to post-menopausal estrogen reduction. Vaginal dryness is the commonest symptom of urogenital disorders in menopause. Vaginal atrophy is strongly associated with sexual disorder and lower urinary tract problems, such as frequency, nocturia and dysuria, also incontinence and recurring infection are reported more often in the existence of vaginal atrophy. These problems, apart from being troublesome also negatively influence their quality of life.

ObjectiveThis study was conducted to evaluate the therapeutic effects of vaginal royal jelly and vaginal estrogen on quality of life and vaginal atrophy in postmenopausal women.MethodsThis double-blind randomized controlled clinical trial was carried out at gynecology and obstetrics clinics of Hajar Hospital of Shahrekord University of Medical Sciences (Iran) from January 2013 to January 2014. The study was conducted on married postmenopausal women between 50 and 65 years old. Of 120 patients, 30 individuals were excluded based on the exclusion criteria, and 90 women were randomly distributed into three groups of 30 royal jelly vaginal cream 15%, vaginal Premarin, and placebo (lubricant), for three months. At the beginning and the end of the study, quality of life and vaginal cytology assay were evaluated. Data were analyzed by SPSS Version 11.ResultsVaginal cream of royal jelly is significantly more effective than vaginal cream of Premarin and lubricant in improvement of quality of life in postmenopausal women (p<0.05). Moreover, Pap smear results showed that vaginal atrophy in vaginal Premarin group was lower than the other groups (p<0.001), and there was no significant difference between lubricant and royal jelly groups (p=0.89).ConclusionAdministration of vaginal royal jelly was effective in quality-of-life improvement of postmenopausal women. Given to the various properties of royal jelly and its effectiveness on quality of life and vaginal atrophy in postmenopausal women, further studies are recommended for using =royal jelly in improving menopausal symptoms.Clinical trial registrationThe trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT code: 2014112220043n1.FundingShahrekord University of Medical Sciences supported this research (project no. 1440).