Jonasson Aino Fianu, Edwall Lena, Uvnäs-Moberg Kerstin
Department of Obstetrics and Gynecology, Huddinge Hospital, Karolinska Institutet, Stockholm, Sweden.
Menopause Int. 2011 Dec;17(4):120-5. doi: 10.1258/mi.2011.011030. Epub 2011 Nov 25.
Oxytocin is a peptide hormone produced in the hypothalamus and it is best known for its role in labour and lactation. This double-blind, randomized study was performed at Huddinge Hospital of Karolinska Institutet, Stockholm in order to test the effectiveness of topical oxytocin gel in women with postmenopausal vaginal atrophy.
Twenty postmenopausal women (at least two years after menopause) with symptoms of vaginal atrophy such as vaginal dryness, pain, itching, discomfort and bleeding during intercourse were enrolled in the study when visual inspection of the vagina had confirmed that their mucosa was atrophic. The participants were randomized to intravaginal treatment with either oxytocin or placebo gel for seven days. Before and after treatment, a gynaecological examination and a visual and colposcopic inspection of the vagina were performed, biopsies from the vaginal mucosa were taken and blood samples were collected for analysis of circulating levels of estradiol and oxytocin.
Prior to treatment, visual and colposcopic inspection showed that all of the 20 participants had an atrophic vaginal mucosa. After treatment with the oxytocin gel, the examination showed that the vaginal epithelium of seven of the 10 participants in the oxytocin group had become healthier and normalized. No change in these parameters was observed among the 10 participants in the placebo group. This difference between the oxytocin and placebo groups was significant (P= 0.003). Seven participants in the active group and four in the placebo group reported relief of symptoms of vaginal atrophy after seven days of applying the gel. The effect of oxytocin to normalize the morphological appearance of the vaginal mucosa was almost significant when compared with the placebo group (P= 0.07). There was no significant difference between the circulating levels of estradiol and oxytocin in both the oxytocin and placebo groups before and after treatment. None of the participants reported any side-effects.
Topical treatment with oxytocin appears to improve vaginal atrophy in postmenopausal women. A limitation of this pilot study is that it was based on a small study population hence the results should be regarded with caution. Larger studies are in progress to establish the possibility of using oxytocin as a clinical treatment for vaginal atrophy.
催产素是一种在下丘脑产生的肽类激素，它在分娩和泌乳过程中的作用最为人熟知。这项双盲随机研究在斯德哥尔摩卡罗林斯卡学院胡丁厄医院进行，旨在测试局部使用催产素凝胶对绝经后阴道萎缩女性的有效性。
20名有阴道萎缩症状（如阴道干燥、疼痛、瘙痒、性交不适和出血）的绝经后女性（绝经至少两年）在阴道视诊确认其黏膜萎缩后被纳入研究。参与者被随机分为两组，分别接受阴道内催产素凝胶或安慰剂凝胶治疗，为期七天。治疗前后进行妇科检查、阴道视诊和阴道镜检查，采集阴道黏膜活检样本并采集血样，以分析雌二醇和催产素的循环水平。
治疗前，视诊和阴道镜检查显示所有20名参与者的阴道黏膜均萎缩。使用催产素凝胶治疗后，检查显示催产素组10名参与者中有7名的阴道上皮变得更健康且恢复正常。安慰剂组的10名参与者中这些参数未观察到变化。催产素组和安慰剂组之间的这种差异具有统计学意义（P = 0.003）。活性组7名参与者和安慰剂组4名参与者在使用凝胶七天后报告阴道萎缩症状有所缓解。与安慰剂组相比，催产素使阴道黏膜形态外观恢复正常的效果几乎具有统计学意义（P = 0.07）。治疗前后，催产素组和安慰剂组的雌二醇和催产素循环水平均无显著差异。没有参与者报告任何副作用。
局部使用催产素似乎可改善绝经后女性的阴道萎缩。这项初步研究的一个局限性是基于小样本研究人群，因此结果应谨慎看待。正在进行更大规模的研究以确定使用催产素作为阴道萎缩临床治疗方法的可能性。
