Effect of Persian traditional medicine based herbal vaginal gel in vaginal atrophy

BACKGROUND: Vaginal atrophy is a common condition in postmenopausal women due to low estrogen causing dryness, irritation, infections, and painful intercourse. Treatments include non-hormonal (moisturizers, lubricants) and hormonal options (vaginal estrogens, phytoestrogens) Moreover, Traditional Persian medicine suggests plants as a potential remedy for vaginal atrophy. Auriculotherapy is also gaining popularity as a non-invasive and efficient treatment option. OBJECTIVE: To evaluate the effect of a vaginal herbal gel and auriculotherapy compared to a placebo on vaginal atrophy of postmenopausal women. MATERIALS AND METHODS: In a single-blind, randomized trial, 90 menopausal women with vaginal atrophy symptoms were divided into Herbal gel, Auriculotherapy, and placebo groups (30 each). The study measured subjective symptoms (SSS-VVA), sexual function (FSFI), and quality of life (MENQOL) before, at four-, and eight-weeks post intervention. RESULTS: Comparison of SSS-VVA showed significant improvement in vaginal itching, dryness, and pain in all groups compared to baseline. The herbal gel group demonstrated a more significant reduction in atrophic vaginitis indicators compared to placebo (P < 0.001) and greater decrease in vaginal dryness than auriculotherapy (P = 0.006). Additionally, both herbal gel and auriculotherapy groups exhibited significant improvements in FSFI, with desire (p = 0.038), orgasm (p < 0.001), and satisfaction (p = 0.004) showing greater improvement with herbal gel than auriculotherapy. Regarding MENQOL, both interventions improved patients' condition, with auriculotherapy showing overall greater improvement than herbal gel. CONCLUSION: Both interventions effectively reduced symptoms and improved quality of life, but the herbal gel outperformed auriculotherapy in reducing dryness and enhancing sexual function.