The effect of oxytocin vaginal gel on vaginal atrophy in postmenopausal women: a randomized controlled trial

Abstract

Background: Around 90% of postmenopausal women are suffering from vaginal atrophy. This study aimed to evaluate the effect of oxytocin vaginal gel on vaginal atrophy among postmenopausal women. Methods: This was a randomized controlled trial that was conducted on 96 postmenopausal women who suffered from vaginal atrophy. The inclusion criteria were: literate women, age 40-60, at least 1 year passed from their last menstrual period or the level of FSH > 40 IU, monogamous women with the sexual relationship. Women in the intervention group, requested to use one applicator of 400 IU oxytocin gel per night and women in the placebo group used placebo each night. The subjective symptoms of vaginal atrophy, vaginal PH, maturation index were measured before and after the intervention. Results: The number of superficial cells was increased significantly in the oxytocin group compared to placebo (38.7 ± 7.18 vs. 3.69 ± 2.76, p = 0.0001), while the number of parabasal cells was decreased significantly in the oxytocin compared to placebo after the intervention. The improvement of the maturation index was more dominant in the oxytocin group (increased from 7.76 ± 4.68 to 52.48 ± 7.54) in comparison to the placebo group (increased from 8.58 ± 4.35 to 13.25 ± 5.06). The PH of the vagina decreased significantly in the oxytocin group in comparison to the placebo group (p = 0.0001). After 8 weeks, 88.6 and 7.1% of women in the oxytocin and placebo groups did not show the severe symptoms of vaginal atrophy (p = 0.001). Conclusion: The results of this study showed that eight-week intervention with oxytocin vaginal gel (400 IU) could significantly improve the vaginal maturation index, subjective symptoms of vaginal atrophy and reduce the PH of the vagina. Using this medication in women who have a contraindication for hormone therapy is recommended. Trial registration: IRCT20160602028220N2.

Neural Functions of Hypothalamic Oxytocin and its Regulation

“…IAO can increase functional connectivity of neural circuits involved in action observation and social perception among old men ( Valdes-Hernandeza et al, 2021 ). Decreased OT levels in elderly people are associated with reduced sex steroid production, socially emotional deficits, symptoms of neurodegenerative diseases, lower sexual ability, reduced vagal nervous tone and low muscle power ( Sannino et al, 2017 ; Zohrabi et al, 2020 ). As shown in aged male rats, the number of parvocellular OT neurons and their OT release are significantly decreased in the PVN, DVC and substantia gelatinosa of the spinal cord ( Calza et al, 1990 ), which weakens the regulation of visceral activity.…”

The Efficacy of Oxytocin Gel in Postmenopausal Women with Vaginal Atrophy: An Updated Systematic Review and Meta-Analysis

“…The seven included studies [14][15][16][17][18][19]24] were double-blinded, randomized, placebo-controlled trials published between 2011 and 2020, with different follow-up periods varied from 7, 14 weeks in AL-saqi et al studies [18,19], one month in Torky et al [15], eight weeks in Abedi et al [17] and Zohrabi et al [24], and 1,12 weeks in Jonasson et al studies [14,16]. Four trials were conducted in Sweden [14,16,18,19], two in Iran [17,24], and another one in Egypt [15]. All included studies had used intravaginal oxytocin gel versus placebo, with different oxytocin doses varied from 100 to 400 and 600 IU.…”

Oxytocin in Women’s Health and Disease

“…Menopausal atrophy of accessory reproductive organs is a common sign of reduced ovary functions. However, topical OT application can reverse vaginal atrophy ( 132 , 133 ). Similarly, a high proportion of women develop osteoporosis after menopause, which increases the incidence of bone fractures.…”