Fennel for postmenopausal sexual dysfunction

reference

Abedi P, Najafian M, Yaralizadeh M, Namjoyan F. Effect of fennel vaginal cream on sexual function in postmenopausal women: a double-blind, randomized, controlled study. j med life . 2018; 11 (1): 24-28.

objective

The effect of fennel vaginal cream on symptoms of sexual dysfunction in postmenopausal women should be assessed

draft

randomized, double blind, placebo -controlled study

participant

sixty Iranian women aged 45 to 65 with confirmed natural postmenopausal status (absence of menstruation> 1 year; FSH> 40 IE/L). All participants were married/sexually active and had a female sexual function index [fsfi] <26; Women with vaginal bleeding or infections and women who received hormone replacement therapy (HRT) or phytoestrogens were excluded from the study.

Intervention

Patients in the test group (n = 30) were instructed to use the vaginal cream with 5 % fennel (5 g) every night for 8 weeks, while patients in the control group (n = 30) were instructed to use a placebo cream every night.

The fennel cream was made from an 80%ethanol extraction of fennel seeds, which were stored for 3 days and then freezed. This dried extract was then mixed with a 5% emulsion cream base, which was preserved with methyl and propyl-savings, and mixed with a "real" carrier (not specified) on a concentration of 5%. The placebo cream was made with the same carrier and has a "similar color and look" as the fennel cream. Details about what "similar color and appearance" means were not given.

study parameters evaluated

fsfi, evaluated for all participants at the start of the course and after 8 weeks

primary result measurements

Changes of the FSFI and individual markers such as excitement, lubrication, orgasm ability, sexual satisfaction and pain after 8 weeks of fennel cream or placebo

important knowledge

All areas of the sexual function of the FSFI, including excitement, lubrication, orgasm, sexual satisfaction and pain, improved both in the fennel and the placebo group. However, the total FSFI value was higher in the fennel group than in the placebo group ( p <0.001). No adverse effects of the vaginal preparations were reported by both groups. There were no dropouts from this study.

practice implications

The FSFI is a clinical self -report tool that evaluates several dimensions of female sexual function and is often used in clinical studies to assess female sexual function. to assess sexual orientation. 1 It was found that it has a high validity and reliability for the diagnosis of female sexual disorders as well as for monitoring changes through treatment.

Menopause, defined as the absence of menstruation for at least 1 full year, is often associated with physical and symptomatic changes in sexual function in connection with urogenital symptoms of menopause (GSM), including drought, dyspare and bleeding. According to some estimates, around 50 % of women suffer within 7 to 10 years after menopause atrophic vulvovaginal changes, together with frequently reported changes in physical sexual function, including reduced excitement, sexual reaction and dryness or pain in sexual intercourse. Correling vulvovaginal atrophy and/or prolapse or not; Therefore, a clinically sensitive approach to questions about stress, sleep, relationship and personal well-being and other factors is required. Many women may also believe that these changes are a natural part of aging, and may not be aware that there are effective treatments.

This raises the question of whether there is clinical effects of a local topical preparation for menopausal sexual dysfunctions outside of their objective effects on local vaginal cytology and the pH value-essentially a positive placebo effect.

In conventional therapeutic agents, oral and/or topical applications of synthetic or bioidentical estrogens, as the data of the Women’s Health Initiative showed, oral estrog therapies caused the risk of increased coronary heart disease, breast cancer and uterine cancer over a period of 5 years. High. ^{5 While it is assumed that the topical vulvovaginal estrog therapy carries less of these risks, there are concerns about the ingredients in many commercial preparations, and individually composed preparations can be covered by health insurance or private insurance.}

It is assumed that phytoestrogens such as fennel have an insignificant to slightly positive effect on menopausal symptoms such as hot flashes, gsms and sexual function. Gifted.

using the same treatment and placebo groups, the authors of this study previously found that the nightly use of the topical 5%fennel compound in the vulvovaginal area led to statistically significant changes in the vaginal maturation index and a reduced vaginal pH value, which indicates reduced signs of atrophy over a period of 8 weeks in Comparison to the controls.

In this more comprehensive study on sexual function, however, both the placebo and treatment group reported improvements in all measured areas of sexual dysfunction, although the effects in the treatment group were larger. This raises the question of whether there is clinical effects of local topical preparation for menopausal sexual functional disorders outside of their objective objective Effects on local vaginal cytology and the pH-essentially a positive placebo effect.

An important potential confounder could, however, be the presence of an active ingredient in the placebo preparation. In view of the fact that the authors do not provide any details about the placebo preparation, except that it was produced using "the right wearer" and "a similar color and a similar color and a similar look like the fennel cream", the question arises whether a partial effect could be achieved in this study that was not specified in the placebo cream. In their method part, the authors stated that details on the manufacture of the placebos had previously been published; However, the cited literature office was only available as a summary and did not contain the relevant details.

Overall, this study raises some very interesting questions about whether the positive advantages of any topical treatments for postmenopausal sexual dysfunction (in contrast to effects on cellular vaginal atrophy). in itself ) are at least partially placebo effects. For patients who may have a higher risk of pelvic pathologies who may not want to tolerate vaginal estrogens or who want to avoid prescription hormone therapies, the use of a 5%topical phyto -Östrogen connection for connection either or by a pharmacy that is familiar with the delivery of natural products.