Intravaginally applied oxytocin improves post-menopausal vaginal atrophy

Shahla H Al-Saqi, Kerstin Uvnäs-Moberg, Aino F Jonasson, Shahla H Al-Saqi, Kerstin Uvnäs-Moberg, Aino F Jonasson

Abstract

Objective: To explore the efficacy of local oxytocin for the treatment of post-menopausal vaginal atrophy.

Design: Double-blinded randomised controlled trial.

Setting: Healthy post-menopausal women in Stockholm, Sweden.

Participants: Sixty four post-menopausal women between February and June 2012 at the Karolinska University Hospital Huddinge/Sweden.

Main outcome measures: The efficacy of oxytocin for treatment of vaginal atrophy after seven weeks and cytological evaluation.

Results: The percentage of superficial cells in the vaginal smears and the maturation values were significantly increased after seven weeks of treatment with vagitocin 400 IU (p = 0.0288 and p = 0.0002, respectively). The vaginal pH decreased significantly after seven weeks of treatment with vagitocin 100 IU (p = 0.02). The scores of vaginal atrophy, according to the histological evaluation, were significantly reduced after administration of vagitocin 100 IU (p = 0.03). The thickness of the endometrium did not differ between the treatment and placebo groups after seven weeks of treatment. The symptom experienced as the most bothersome was significantly reduced after seven weeks of treatment in the women receiving vagitocin 400 IU compared to women in the placebo group (p = 0.0089).

Conclusions: Treatment with intravaginally applied oxytocin could be an alternative to local estrogen treatment in women with post-menopausal vaginal atrophy.

Keywords: Estrogen; oxytocin; post-menopausal; vaginal atrophy; vagitocin.

© The Author(s) 2015.

Figures

Figure 1.
Figure 1.
Study flowchart.
Figure 2.
Figure 2.
The percentage of superficial cells at weeks 0, 2, and 7 for vagitocin 400 IU (purple), vagitocin 100 IU (pink), and placebo (green). The increase in the percentage of the superficial cells from weeks 0–7 in the vagitocin 400 IU group was significant (p = 0.0288).
Figure 3.
Figure 3.
The maturation value at weeks 0, 2, and 7 for vagitocin 400 IU (purple), vagitocin 100 IU (pink), and placebo (green). The increase in the maturation value from weeks 0–7 in the vagitocin 400 IU and placebo groups was significant (p = 0.0002 and p = 0.0494, respectively).
Figure 4.
Figure 4.
Vaginal pH at weeks 0, 2, and 7 for vagitocin 400 IU (purple), vagitocin 100 IU (pink), and placebo (green). The decrease in the pH from weeks 0–7 in the vagitocin 100 IU group was significant (p = 0.024).

References

    1. Greendale GA, Lee NP, Arriola ER. The menopause. Lancet 1999; 353: 571–580.
    1. Sturdee DW, Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric 2010; 13: 509–522.
    1. Nilsson K, Risberg B, Heimer G. The vaginal epithelium in the postmenopause--cytology, histology and pH as methods of assessment. Maturitas 1995; 21: 51–556.
    1. Ballagh SA. Vaginal hormone therapy for urogenital and menopausal symptoms. Semin Reprod Med 2005; 23: 126–140.
    1. Meisels A. The maturation value. Acta Cytol 1967; 11: 249.
    1. Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician 2000; 61: 3090–3096.
    1. Bergman A, Karram MM, Bhatia NN. Changes in urethral cytology following estrogen administration. Gynecol Obstet Inves 1990; 29: 211–213.
    1. Bachmann G, Bouchard C, Hoppe D, et al. Efficacy and safety of low-dose regimens of conjugated estrogens cream administered vaginally. Menopause 2009; 16: 719–727.
    1. Wakavaiachi VM, Girao MJ, Sartori MG, et al. Changes in the lower urinary tract in continent women and in women with stress urinary incontinence, according to menopausal status. Int Urogynecol J Pel 2001; 12: 156–160.
    1. Legendre G, Fritel X, Ringa V, et al. [Urinary incontinence and menopause]. Prog Urol 2012; 22: 615–621.
    1. Krause M, Wheeler TL, 2nd, Snyder TE, et al. Local effects of vaginally administered estrogen therapy: a review. J Pelvic Med Surg 2009; 15: 105–114.
    1. Sturdee DW. Hormone replacement therapy preparations. Br Menopause Soc 2000; 6: 34.
    1. Sismondi P and Biglia N. Critical review of the article by Colditz et al. on ‘The use of estrogens and progestins and the risk of breast cancer in postmenopausal women' published in the N.E.J.M. 1995, 332: 1589. Pharmacol Res 1995; 32: 329–330.
    1. Varas-Lorenzo C, Garcia-Rodriguez LA, Cattaruzzi C, et al. Hormone replacement therapy and the risk of hospitalization for venous thromboembolism: a population-based study in southern Europe. Am J Epidemiol 1998; 147: 387–390.
    1. Manson JE. Postmenopausal hormone therapy and atherosclerotic disease. Am Heart J 1994; 128: 1337–1343.
    1. Lippert TH, Mueck AO, Seeger H, et al. Effects of oxytocin outside pregnancy. Horm Res 2003; 60: 262–271.
    1. Gutkowska J, Jankowski M, Mukaddam-Daher S, et al. Oxytocin is a cardiovascular hormone. Brazilian J Med Biol Res 2000; 33: 625–633.
    1. Jonasson AF, Edwall L, Uvnas-Moberg K. Topical oxytocin reverses vaginal atrophy in postmenopausal women: a double-blind randomized pilot study. Menopause Int 2011; 17: 120–125.
    1. Petersson M, Lundeberg T, Sohlstrom A, et al. Oxytocin increases the survival of musculocutaneous flaps. Naunyn Schmiedebergs Arch Pharmacol 1998; 357: 701–714.
    1. Lauritzen C. Clinical use of oestrogens and progestogens. Maturitas 1990; 12: 199–214.
    1. Cassoni P, Sapino A, Negro F, et al. Oxytocin inhibits proliferation of human breast cancer cell lines. Virchows Arch 1994; 425: 467–472.
    1. Shifren JL, Schiff I. Role of hormone therapy in the management of menopause. Obstet Gynecol 2010; 115: 839–855.
    1. Beral V, Reeves G, Bull D, et al. Breast cancer risk in relation to the interval between menopause and starting hormone therapy. J Natl Cancer I 2011; 103: 296–305.
    1. Krolik M, Milnerowicz H. The effect of using estrogens in the light of scientific research. Adv Clin Exp Med 2012; 21: 535–543.
    1. Archer DF. Efficacy and tolerability of local estrogen therapy for urogenital atrophy. Menopause 2010; 17: 194–203.
    1. Santen RJ. Vaginal administration of estradiol: effects of dose, preparation and timing on plasma estradiol levels. Climacteric 2014; 18: 1–14.
    1. Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database System Rev 2006; 18: CD001500.
    1. Strunecka A, Hynie S, Klenerova V. Role of oxytocin/oxytocin receptor system in regulation of cell growth and neoplastic processes. Folia Biol 2009; 55: 159–165.
    1. Cassoni P, Fulcheri E, Carcangiu ML, et al. Oxytocin receptors in human adenocarcinomas of the endometrium: presence and biological significance. J Pathol 2000; 190: 470–477.
    1. Morita T, Shibata K, Kikkawa F, et al. Oxytocin inhibits the progression of human ovarian carcinoma cells in vitro and in vivo. Int J Cancer 2004; 109: 525–532.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe