Effect of topical oxytocin gel on vaginal mucosa in postmenopausal Egyptian women: a clinical randomized trial

Asem Moussa; Kerstin Uvnäs Moberg; Ismael Elgrahy; Mohammad Elsayied; Mazen Abdel-Rasheed; Mohamed Farouk; Hany Saad; Hadeer Meshaal

doi:10.1093/jsxmed/qdac021

Effect of topical oxytocin gel on vaginal mucosa in postmenopausal Egyptian women: a clinical randomized trial

J Sex Med. 2023 Feb 14;20(2):177-183. doi: 10.1093/jsxmed/qdac021.

Authors

Asem Moussa¹, Kerstin Uvnäs Moberg², Ismael Elgrahy¹, Mohammad Elsayied³, Mazen Abdel-Rasheed⁴, Mohamed Farouk⁵, Hany Saad⁶, Hadeer Meshaal⁶

Affiliations

¹ Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
² Animal Environment and Health Department, Swedish University of Agricultural Sciences, Skara, Sweden.
³ Obstetrics and Gynecology Department, El Galaa Teaching Hospital, Cairo, Egypt.
⁴ Reproductive Health Research Department, National Research Centre, Cairo, Egypt.
⁵ Clinical Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
⁶ Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

PMID: 36763919
DOI: 10.1093/jsxmed/qdac021

Abstract

Background: Vaginal atrophy is common after menopause and is often linked to sexual dysfunction, particularly dyspareunia.

Aim: The study aimed to investigate the effect of intravaginally applied oxytocin on expressions of vaginal atrophy.

Methods: Fifty postmenopausal women aged 47 to 66 years with vaginal atrophy participated in this double-blinded placebo-controlled study. The women were randomized to intravaginal treatment with either gel with 600 IU/mL of oxytocin (oxytocin group) or gel alone (control group) once daily for 2 weeks. The gel consisted of hypromellose, pH 3.8 (Vagovital).

Outcomes: The color of the vaginal mucosa, the vaginal pH, and the cytology of vaginal epithelial cells were investigated before and after treatment.

Results: The color of the vaginal mucosa shifted from pale to red in all 25 patients treated with oxytocin but only in 4 patients in the control group (P < .001). There was a significant decrease in intravaginal pH in the oxytocin group and the control group, with the delta value being significantly greater in the oxytocin group than in the control group (P < .001). The vaginal maturation index increased significantly (P < .001) in the oxytocin group but not in the control group.

Clinical implications: Topical oxytocin gel offers an effective solution to the sexual dysfunction that is related to vaginal atrophy after menopause.

Strengths and limitations: Strengths include studying different outcomes of applying the oxytocin gel for vaginal atrophy. Limitations include the small-scale population with a relatively short duration of treatment (2 weeks).

Conclusion: Intravaginal treatment with a gel containing 600 IU/mL of oxytocin effectively counteracts physical expressions of vaginal atrophy.

Trial registration: ClinicalTrials.gov (NCT05275270; https://clinicaltrials.gov/ct2/show/NCT05275270).

Keywords: oxytocin; postmenopause; vaginal mucosa; vaginal pH; vaginal smear.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Administration, Intravaginal
Atrophy / drug therapy
Atrophy / pathology
Double-Blind Method
Egypt
Female
Humans
Mucous Membrane
Oxytocin* / pharmacology
Oxytocin* / therapeutic use
Postmenopause
Treatment Outcome
Vagina / pathology
Vaginal Diseases* / drug therapy
Vaginal Diseases* / pathology

Substances

Oxytocin

Associated data

ClinicalTrials.gov/NCT05275270