1
|
Buemann B. Does activation of oxytocinergic reward circuits postpone the decline of the aging brain? Front Psychol 2023; 14:1250745. [PMID: 38222845 PMCID: PMC10786160 DOI: 10.3389/fpsyg.2023.1250745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/20/2023] [Indexed: 01/16/2024] Open
Abstract
Oxytocin supports reproduction by promoting sexual- and nursing behavior. Moreover, it stimulates reproductive organs by different avenues. Oxytocin is released to the blood from terminals of oxytocinergic neurons which project from the hypothalamus to the pituitary gland. Concomitantly, the dendrites of these neurons discharge oxytocin into neighboring areas of the hypothalamus. At this location it affects other neuroendocrine systems by autocrine and paracrine mechanisms. Moreover, sensory processing, affective functions, and reward circuits are influenced by oxytocinergic neurons that reach different sites in the brain. In addition to its facilitating impact on various aspects of reproduction, oxytocin is revealed to possess significant anti-inflammatory, restoring, and tranquilizing properties. This has been demonstrated both in many in-vivo and in-vitro studies. The oxytocin system may therefore have the capacity to alleviate detrimental physiological- and mental stress reactions. Thus, high levels of endogenous oxytocin may counteract inadequate inflammation and malfunctioning of neurons and supportive cells in the brain. A persistent low-grade inflammation increasing with age-referred to as inflammaging-may lead to a cognitive decline but may also predispose to neurodegenerative diseases such as Alzheimer's and Parkinson. Interestingly, animal studies indicate that age-related destructive processes in the body can be postponed by techniques that preserve immune- and stem cell functions in the hypothalamus. It is argued in this article that sexual activity-by its stimulating impact on the oxytocinergic activity in many regions of the brain-has the capacity to delay the onset of age-related cerebral decay. This may also postpone frailty and age-associated diseases in the body. Finally, oxytocin possesses neuroplastic properties that may be applied to expand sexual reward. The release of oxytocin may therefore be further potentiated by learning processes that involves oxytocin itself. It may therefore be profitable to raise the consciousness about the potential health benefits of sexual activity particularly among the seniors.
Collapse
|
2
|
Farahat RA, Salamah HM, Mahmoud A, Hamouda E, Hashemy M, Hamouda H, Samir A, Chenfouh I, Marey A, Awad DM, Farag E, Abd-Elgawad M, Eldesouky E. The efficacy of oxytocin gel in postmenopausal women with vaginal atrophy: an updated systematic review and meta-analysis. BMC Womens Health 2023; 23:494. [PMID: 37716966 PMCID: PMC10505316 DOI: 10.1186/s12905-023-02645-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 09/08/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Genitourinary syndrome of menopause (GSM) is a common and disturbing issue in the postmenopausal period. Unlike vasomotor symptoms, it has a progressive trend. Our study aims to evaluate the efficacy and safety of oxytocin gel versus placebo gel in postmenopausal women with GSM. METHODS A systematic review and meta-analysis synthesizing randomized controlled trials (RCTs) from Web of Science, SCOPUS, PubMed, and Cochrane Central Register of Controlled Trials databases on January 18, 2023. Keywords such as "oxytocin," "intravaginal," "vaginal," "atrophic," and "atrophy" were used. We used Review Manager (RevMan) version 5.4 in our analysis. We used the risk ratio (RR) for dichotomous outcomes and the mean difference (MD) for continuous outcomes; both were presented with the corresponding 95% confidence interval (CI) and were calculated with the Mantel-Haenszel or inverse variance statistical method. Cochrane's Q test and the I2 statistic were used as measures of statistical inconsistency and heterogeneity. The Cochrane Risk of Bias Tool for RCTs was used for the quality assessment of the included studies. RESULTS Seven studies with 631 patients were included. Regarding the maturation index, there was a statistically insignificant increase in the oxytocin arm (MD = 12.34, 95% CI (-12.52-37.19), P = 0.33). Clinically assessed vaginal atrophy showed a statistically significant reduction in the oxytocin group (RR = 0.32, 95% CI (0.23 - 0.10), P < 0.00001). For dyspareunia, vaginal pH, and histological evaluation of vaginal atrophy, there was a statistically insignificant difference between the two groups (RR = 1.02, 95% CI (0.82-1.27), P = 0.84), (MD = -0.74, 95% CI (-1.58-0.10), P = 0.08), and (MD = -0.38, 95% CI (-0.82-0.06), P = 0.09), respectively. There was no significant difference in the safety profile between the two groups as measured by endometrial thickness (MD = 0.00, 95% CI (-0.23-0.23), P = 0.99). CONCLUSIONS Although oxytocin has been proposed as a viable alternative to estrogen in the treatment of GSM, our findings show the opposite. Larger, high-quality RCTs are needed to confirm or refute our results. TRIAL REGISTRATION PROSPERO registration number CRD42022334357.
Collapse
Affiliation(s)
| | | | | | - Esraa Hamouda
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | | | - Heba Hamouda
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Ali Samir
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Imane Chenfouh
- Faculty of Medicine and Pharmacy, Oujda, Oujda-Angad, Morocco
| | - Ahmed Marey
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Dina M Awad
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Elsayed Farag
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alazhar University, Cairo, Egypt
| | | | - Elsayed Eldesouky
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alazhar University, Cairo, Egypt
| |
Collapse
|
3
|
Moussa A, Moberg KU, Elgrahy I, Elsayied M, Abdel-Rasheed M, Farouk M, Saad H, Meshaal H. Effect of topical oxytocin gel on vaginal mucosa in postmenopausal Egyptian women: a clinical randomized trial. J Sex Med 2023; 20:177-183. [PMID: 36763919 DOI: 10.1093/jsxmed/qdac021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/18/2022] [Accepted: 10/24/2022] [Indexed: 01/13/2023]
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).
Collapse
Affiliation(s)
- Asem Moussa
- Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Kerstin Uvnäs Moberg
- Animal Environment and Health Department, Swedish University of Agricultural Sciences, Skara, Sweden
| | - Ismael Elgrahy
- Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohammad Elsayied
- Obstetrics and Gynecology Department, El Galaa Teaching Hospital, Cairo, Egypt
| | - Mazen Abdel-Rasheed
- Reproductive Health Research Department, National Research Centre, Cairo, Egypt
| | - Mohamed Farouk
- Clinical Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hany Saad
- Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hadeer Meshaal
- Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| |
Collapse
|
4
|
Sugisawa A, Toyoda Z, Tanabe Y, Uehara K, Oshiro A, Yamazato R, Sakamoto C, Yogi S, Kurima K, Kina S, Sakiyama M, Kinjo T. Cytological characteristics of premalignant cervical epithelial lesions in postmenopausal women based on endocrine indices and parakeratosis. Menopause 2023; 30:193-200. [PMID: 36696644 DOI: 10.1097/gme.0000000000002125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To identify useful cytological findings for detecting premalignant lesions in postmenopausal women, cervicovaginal smear samples were analyzed and compared between women with or without premalignant lesions based on endocrine indices and presence of parakeratosis (PK). METHODS The cervicovaginal smear samples of postmenopausal women with premalignant lesions (n = 94) and those who were without (n = 344), who were diagnosed between 2012 and 2014 were retrieved and analyzed. Women cytologically diagnosed with malignancy or those with suspicion of malignancy were excluded from this study. Cytological endocrine indices, such as the maturation index (MI) and eosinophilic index (EI) and the prevalence of PK were compared between the groups and analyzed using the 2 × 2 χ2 test. The association of endocrine indices combined with the presence of PK and histological findings was also evaluated. RESULTS Postmenopausal women with premalignant lesions had higher endocrine indices (EI of ≥11%; 65% vs. 43%, P < 0.01, f = 0.18) and a higher prevalence of PK positivity (PK ≥ 1; 46% vs. 7%, P < 0.01, f = 0.44) than those without lesions. Further analysis indicated that the combination of high EI and the presence of PK in postmenopausal women with cytological premalignant cases was highly associated with histological squamous intraepithelial lesions (SIL) (86% in women with premalignant lesions vs. 53% in those without; P = 0.01, f = 0.34). CONCLUSION Our research demonstrated that high EI and PK positivity were correlated with SIL in postmenopausal women. These cytological findings could provide potential diagnostic clues for detecting dysplasia.
Collapse
Affiliation(s)
| | | | - Yasuka Tanabe
- From the Division of Morphological Pathology, Department of Basic Laboratory Sciences, School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | - Karina Uehara
- From the Division of Morphological Pathology, Department of Basic Laboratory Sciences, School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | - Aya Oshiro
- From the Division of Morphological Pathology, Department of Basic Laboratory Sciences, School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | - Reo Yamazato
- From the Division of Morphological Pathology, Department of Basic Laboratory Sciences, School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | - Chiharu Sakamoto
- From the Division of Morphological Pathology, Department of Basic Laboratory Sciences, School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | | | - Kiyoto Kurima
- From the Division of Morphological Pathology, Department of Basic Laboratory Sciences, School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | - Shinichiro Kina
- Department of Molecular Pharmacology and Oncology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Michiyo Sakiyama
- the Lifestyle Related Disease Medical Center, Naha Medical Association, Okinawa, Japan
| | - Takao Kinjo
- From the Division of Morphological Pathology, Department of Basic Laboratory Sciences, School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| |
Collapse
|
5
|
Buemann B. Oxytocin Release: A Remedy for Cerebral Inflammaging. Curr Aging Sci 2022; 15:218-228. [PMID: 35431008 DOI: 10.2174/1874609815666220414104832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/22/2021] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
Oxytocin facilitates reproduction both by physiological and behavioral mechanisms. Oxytocinergic neurons emerging from the hypothalamus release oxytocin from the pituitary gland to the blood by axonal discharge to regulate reproductive organs. However, at the same time, oxytocin is secreted into neighboring areas of the hypothalamus from the dendrites of these neurons. Here, the peptide acts by autocrine and paracrine mechanisms to influence other neuroendocrine systems. Furthermore, oxytocinergic neurons project to many different locations in the brain, where they affect sensory processing, affective functions, and reward. Additional to its regulatory role, significant anti-inflammatory and restoring effects of oxytocin have been reported from many invivo and in-vitro studies. The pervasive property of the oxytocin system may enable it generally to dampen stress reactions both peripherally and centrally, and protect neurons and supportive cells from inadequate inflammation and malfunctioning. Animal experiments have documented the importance of preserving immune- and stem cell functions in the hypothalamus to impede age-related destructive processes of the body. Sexual reward has a profound stimulating impact on the oxytocinergic activity, and the present article therefore presents the hypothesis that frequent sexual activity and gratigying social experiance may postpone the onset of frailty and age-associated diseases by neural protection from the bursts of oxytocin. Furthermore, suggestions are given how the neuroplastic properties of oxytocin may be utilized to enhance sexual reward by learning processes in order to further reinforce the release of this peptide.
Collapse
Affiliation(s)
- Benjamin Buemann
- Retired. Copenhagen, Denmark. Previous Affiliation: Research Department of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen, Denmark
| |
Collapse
|
6
|
Mesbahi A, Mohammad-Alizadeh-Charandabi S, Ghorbani Z, Mirghafourvand M. The effect of intra-vaginal oxytocin on sexual function in breastfeeding mothers: a randomized triple-blind placebo-controlled trial. BMC Pregnancy Childbirth 2022; 22:62. [PMID: 35065634 PMCID: PMC8783987 DOI: 10.1186/s12884-022-04384-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 01/06/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Considering the importance of sexual function, high prevalence of sexual dysfunction (especially dyspareunia caused by atrophic vaginitis) in breastfeeding women, and lack of effective interventions, the present research aimed to determine the effect of oxytocin (OXT) vaginal gel on sexual function (primary outcome), sexual satisfaction, and depression (secondary outcomes) in the breastfeeding women. METHODS This randomized triple-blind controlled trial was conducted on 64 breastfeeding women who referred to health centers in the city of Tabriz, Iran, in 2020-21. Participants were equally assigned to intervention/control groups using block randomization. 200 IU of OXT vaginal gel was given to the participants in the intervention group daily for eight week and the same protocol was carried out for the control group with placebo. Standard questionnaires of Female Sexual Function Index (FSFI), Edinburgh Postpartum Depression Scale (EPDS) and Sexual satisfaction scale for women (SSSW) were completed at baseline and 8 weeks after intervention. ANCOVA test was used to compare post-intervention mean score of the groups, adjusted for the baseline values. RESULTS After intervention, there was no statistically significant difference between groups in terms of mean total score of FSFI (Adjusted Mean Difference (AMD): 1.14; 95% Confidence Interval (95% CI): -1.28 to 9.16; P= 0.349) and sexual satisfaction (AMD: 5.01; 95% CI: -0.53 to 10.56; P= 0.075). However, there was statistically significant difference between the groups in terms of mean scores of sexual contentment (AMD: 1.56; 95% CI: 0.29 to 2.83; P = 0.017) and depression (AMD: -1.90; 95% CI: -1.27 to -2.54; P < 0.001). One participant in the OXT group and one participant in the placebo group reported mild uterine contraction and one person in the placebo group reported vaginal burning sensations. CONCLUSIONS No evidence was found for the effects of OXT gel in the improvement of FSFI, even though, OXT significantly improved sexual satisfaction in the domain of contentment, and improved the symptoms of depression in comparison to the placebo group. However, a definite conclusion requires more research in this regard. TRIAL REGISTRATION the Iranian Registry of Clinical Trials (IRCT), code: IRCT20120718010324N55 , Date of registration: 27/05/2020, URL: https://en.irct.ir/user/trial/44986/view .
Collapse
Affiliation(s)
- Arezu Mesbahi
- Department of midwifery, Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of medical sciences, Tabriz, Iran
| | | | - Zahra Ghorbani
- Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
7
|
Santos LPA, Bonduki CE, Dardes RDCDM, Heinke T, Patriarca MT. Effects of oxytocin versus promestriene on genitourinary syndrome: a pilot, prospective, randomized, double-blind study. Clinics (Sao Paulo) 2022; 77:100116. [PMID: 36194923 PMCID: PMC9531039 DOI: 10.1016/j.clinsp.2022.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/23/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES In this pilot, prospective, randomized, double-blind study, the authors compared the efficacy of oxytocin with promestriene in improving vaginal atrophy of Genitourinary Syndrome of Menopause (GSM). METHODS A total of 51 postmenopausal women with symptoms of GSM were evaluated. They were randomized into two groups: oxytocin (25 patients) and promestriene (26 patients) and were evaluated before and after 90 days of treatment; the evaluation was based on the domains of the Female Sexual Function Index (FSFI) (lubrication, satisfaction, and pain during sexual intercourse), clinical visual examination, and vaginal wall thickness. RESULTS After the use of the medications, both groups showed significant improvement in the three evaluated FSFI domains (p < 0.05) and there was no significant difference between the groups (p > 0.05). On clinical examination, the medications improved all the evaluated parameters but without statistical significance (p > 0.05). The evaluation of the thickness of the vaginal epithelium showed that both treatments led to increase in the vaginal epithelium (p < 0.05); however, the efficacy of promestriene was higher than that of oxytocin (p < 0.05). CONCLUSIONS Both medications were effective, however, studies with larger samples and longer follow-ups are needed to confirm the clinical applicability.
Collapse
Affiliation(s)
| | - Claudio Emílio Bonduki
- Departamento de Ginecologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
| | | | - Thais Heinke
- Departamento de Patologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
| | | |
Collapse
|
8
|
Costa APF, Sarmento ACA, Vieira-Baptista P, Eleutério J, Cobucci RN, Gonçalves AK. Hormonal Approach for Postmenopausal Vulvovaginal Atrophy. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:783247. [PMID: 36303971 PMCID: PMC9580661 DOI: 10.3389/frph.2021.783247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/29/2021] [Indexed: 11/14/2022] Open
Abstract
Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve that significantly affects the genital tract. Although postmenopausal vulvovaginal atrophy primarily affects postmenopausal women, it is also seen in premenopausal women. The hypoestrogenic condition results in hormonal and anatomical changes, with the main symptoms, are dryness, burning and genital irritation, decreased lubrication, urinary urgency, dysuria, and recurrent urinary tract infections. This review aims to update hormone therapy for urogenital atrophy, both local and systemic, and discusses the importance of understanding and the need for active treatment of this condition. The main therapeutic objective is the relief of symptoms, and hormonal therapy (HT) is still the most effective choice for treating clinical manifestations, despite the side effects of its use. HT should be used in an individualized way to the needs of the women and appropriate to the stage in which she is menopausal, perimenopausal, or after menopause.
Collapse
Affiliation(s)
- Ana Paula Ferreira Costa
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- *Correspondence: Ana Paula Ferreira Costa
| | | | - Pedro Vieira-Baptista
- Lower Genital Tract Unit, Centro Hospitalar de São João, Porto, Portugal
- Hospital Lusíadas Porto, Porto, Portugal
| | - José Eleutério
- Department of Obstetrics and Gynecology, Federal University of Ceará, Fortaleza, Brazil
| | | | - Ana Katherine Gonçalves
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Department of Obstetrics and Gynaecology, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| |
Collapse
|
9
|
Non-oestrogenic modalities to reverse urogenital aging. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2021; 20:140-147. [PMID: 34703415 PMCID: PMC8525256 DOI: 10.5114/pm.2021.109772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/03/2021] [Indexed: 02/07/2023]
Abstract
Urogenital aging is a common process affecting all women in the post-menopausal period of their life, and it is substantially due to oestrogen deprivation after ovarian function cessation. These changes can lead to a progressive, chronic, and complex association of symptoms identified as the genitourinary syndrome of menopause, which has a significant impact on quality of life. Genitourinary syndrome and urogenital aging do not resolve spontaneously and usually recur when treatment is stopped. Therefore, appropriate long-term management is of paramount importance, and local oestrogen is the most effective treatment to reverse urogenital aging and to improve symptoms of genitourinary syndrome as replacement therapy. In some women, topical oestrogen may be inconvenient, it may not achieve complete response, or it may be contra-indicated. Several non-hormonal therapies have been investigated, but few treatments have been reported as potentially able to reverse the urogenital aging process similarly to exogenous oestrogens. Laser seems the most promising, although further studies to define its safety and efficacy are mandatory. Vitamin D and E, and phytotherapy have returned conflicting results and require further confirmation. Lifestyle modifications, physiotherapy, and electrical stimulation represent inexpensive and applicable treatments that might slow urogenital aging. Among the hormonal non-oestrogenic therapies, the use of vaginal oxytocin and dehydroepiandrosterone have been found to be effective compared to placebo, as well as the use of oral ospemifene, which partially relieves vulvovaginal atrophy.
Collapse
|
10
|
Buemann B, Marazziti D, Uvnäs-Moberg K. Can intravenous oxytocin infusion counteract hyperinflammation in COVID-19 infected patients? World J Biol Psychiatry 2021; 22:387-398. [PMID: 32914674 DOI: 10.1080/15622975.2020.1814408] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Based on its well-documented anti-inflammatory and restorative properties we propose trials with the natural hormone oxytocin for treatment of hospitalised Covid-19 patients. METHODS We searched for, retrieved, and commented on specific literature regarding multiple functions of oxytocin with a special focus on its modulation of inflammatory, immune, and restorative functions. RESULTS Available data gathered in animals and humans support the anti-inflammatory properties of oxytocin. The multiple anti-inflammatory effects of oxytocin have been demonstrated in vitro and in vivo in various animal models and also in humans in response to intravenous infusion of oxytocin. Furthermore, oxytocin has been documented to activate several types of protective and restorative mechanisms and to exert positive effects on the immune system. CONCLUSIONS In addition, to being anti-inflammatory, it may be hypothesised, that oxytocin may be less suppressive on adaptive immune systems, as compared with glucocorticoids. Finally, by its restorative effects coupled with its anti-stress and healing properties, oxytocin may shorten the recovery period of the Covid-19 patients.
Collapse
Affiliation(s)
| | - Donatella Marazziti
- Department of Experimental and Clinical Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Kerstin Uvnäs-Moberg
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden
| |
Collapse
|
11
|
Rudd AB, Davis A. A Call to Change the Narrative on Genitourinary Syndrome of Menopause. Nurs Womens Health 2020; 24:399-403. [PMID: 33157068 DOI: 10.1016/j.nwh.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 07/26/2020] [Accepted: 09/01/2020] [Indexed: 06/11/2023]
Abstract
Genitourinary syndrome of menopause affects up to 54% of postmenopausal women. Historically, women have been led to believe that symptoms such as vaginal dryness, dyspareunia, and vaginal itching were manifestations that they would just have to live with, but now, more than ever before, treatment options are available. More importantly, nurses are in a position to change the narrative of genitourinary syndrome of menopause by normalizing the conversation about menopause and its sequelae of genitourinary symptoms.
Collapse
|
12
|
Fianu Jonasson A, Bixo M, Sundström Poromaa I, Åstrom M. Safety and Efficacy of an Oxytocin Gel and an Equivalent Gel but Without Hormonal Ingredients (Vagivital ® Gel) in Postmenopausal Women with Symptoms of Vulvovaginal Atrophy: A Randomized, Double-Blind Controlled Study. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2020; 13:339-347. [PMID: 33116956 PMCID: PMC7547122 DOI: 10.2147/mder.s265824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/17/2020] [Indexed: 01/13/2023] Open
Abstract
Purpose The primary objective was to compare the efficacy of 12 weeks of daily treatment with Aqueous Hypromellose-based vaginal (Vagivital®) gel versus Aqueous Hypromellose-based vaginal gel plus 400 IU oxytocin gel in reducing the severity of the most bothersome vulvovaginal atrophy symptoms (MBS: itching, dysuria, bleeding, and pain/discomfort during vaginal sexual activity) observed at baseline. The secondary objectives were to evaluate the other vulvovaginal atrophy symptoms, vaginal pH, superficial squamous cells, and the safety and tolerability of both gels. Patients and Methods This double-blind, randomized study evaluated the safety and efficacy of subjects randomly assigned to 12 weeks of daily intravaginal oxytocin gel (n=79) or Aqueous Hypromellose-based vaginal gel (n=78). The efficacy evaluation was performed using data from all included subjects who fulfilled entry criteria. Results Both treatments induced statistically significant reductions in the severity of the MBS from baseline until 4 weeks (Vagivital mean reduction 0.90, p=0.0000; Oxytocin mean reduction 0.82, p=0.0000) and 12 weeks post baseline (Vagivital mean reduction 1.28, p=0.0000; Oxytocin mean reduction 1.16, p=0.0000), but the reduction of MBS severity was not significantly different between the treatment groups at either time point. No serious adverse events were reported in the Aqueous Hypromellose-based vaginal gel group during the treatment period, but one (breast cancer) was reported in the oxytocin gel group (assessed as unlikely related to the study compound). Conclusion Significant reductions in the severity of the MBS were seen in both the Aqueous Hypromellose-based vaginal gel and the oxytocin gel groups, but with no significant differences in severity reduction seen between the groups. Both gels were safe and well tolerated. Given the benefits of avoiding the use of hormones, Aqueous Hypromellose-based vaginal gel is an attractive first choice in the treatment of postmenopausal women with vulvovaginal atrophy symptoms.
Collapse
Affiliation(s)
- Aino Fianu Jonasson
- Department of Clinical Sciences, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden
| | - Marie Bixo
- Department of Clinical Sciences, Obstetrics and Gynecology, Umea University, Umea, Sweden
| | - Inger Sundström Poromaa
- Research Group; Reproductive Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | |
Collapse
|
13
|
Effect of Vitamin D Supplement on Vulvovaginal Atrophy of the Menopause. Nutrients 2020; 12:nu12092876. [PMID: 32967068 PMCID: PMC7551270 DOI: 10.3390/nu12092876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 12/31/2022] Open
Abstract
The effects of oral vitamin D supplements on vaginal health in postmenopausal women with vulvovaginal atrophy (VVA) was evaluated. A double-blinded, randomized placebo-controlled trial was conducted for 12 weeks to investigate changes on vaginal maturation index (VMI), vaginal pH, and the visual analog scale (VAS) of VVA symptoms. The vitamin D group received oral ergocalciferol, at 40,000 IU per week, while the placebo group received an identical placebo capsule. Eighty postmenopausal women were enrolled. There were no significant differences in baseline characteristics between both groups. In an intention-to-treat analysis, VMI, vaginal pH, and VAS of VVA symptoms showed no significant differences between both groups at the six and 12 weeks. However, the mean difference of VMI in the vitamin D group between baseline and at six weeks showed significant improvement (5.5 + 16.27, p <0.05). Moreover, the mean vaginal pH and VAS of VVA patients in the vitamin D group were significantly improved at both six and 12 weeks compared to baseline. The oral vitamin D supplementation for 12 weeks potentially improves vaginal health outcomes in postmenopausal women with VVA symptoms, demonstrated by the improved mean VMI, vaginal pH, and VAS at six and 12 weeks between baseline, however, no significant differences were observed from the placebo treatment.
Collapse
|
14
|
Ghorbani Z, Mirghafourvand M. The efficacy and safety of intravaginal oxytocin on vaginal atrophy: A systematic review. Post Reprod Health 2020; 27:30-41. [PMID: 32814499 DOI: 10.1177/2053369120946645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Genitourinary syndrome of menopause is a major issue in menopausal health. Because unlike vasomotor symptoms, it has a progressive trend. In this regard we conducted a systematic review to evaluate the efficacy of intravaginal oxytocin on postmenopausal vaginal atrophy. A search was performed for published studies in Cochrane Library, MEDLINE, Web of Science, Embase, Scopus, ProQuest, Google Scholar and Persian databases without time and language limitations. Only randomized controlled trials that compared intravaginal oxytocin with placebos were included. The outcome measures were objective and subjective assessed symptoms of vaginal atrophy. Statistical heterogeneity was evaluated using the I2. The standardized mean differences were pooled the fixed effects model. Of the five included studies, four studies meta-analysed. The meta-analysis in terms of the cytological analysis (standardized mean difference: 35.13, 95% confidence interval: 32.59-37.67, n = 218, I2 = 96%) was statistically significant. In terms of histological assessments (standardized mean difference: -0.38, 95% confidence interval: -0.94 to 0.17, n = 38, I2 = 0%) and endometrial thickness (standardized mean difference: 0.05, 95% confidence interval: -0.20 to -0.31, n = 95, I2 = 0%), there were no statistically significant differences between the groups. Three studies reported a statistically significant improvement in the subjective symptoms; however, we were unable to perform a meta-analysis. Four of the included studies assessed side effects, but only two studies reported them. Oxytocin as a nonestrogenic compound can be a suitable alternative for the treatment of vaginal atrophy, especially in women with contraindications for using estrogenic compounds. Further good quality clinical trials with long-term follow-ups are recommended to demonstrate the effects of intravaginal gel in the treatment of vaginal atrophy.
Collapse
Affiliation(s)
- Zahra Ghorbani
- 48432Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran
| | | |
Collapse
|
15
|
Zohrabi I, Abedi P, Ansari S, Maraghi E, Shakiba Maram N, Houshmand G. The effect of oxytocin vaginal gel on vaginal atrophy in postmenopausal women: a randomized controlled trial. BMC WOMENS HEALTH 2020; 20:108. [PMID: 32429977 PMCID: PMC7236919 DOI: 10.1186/s12905-020-00935-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 03/26/2020] [Indexed: 12/02/2022]
Abstract
Background Around 90% of postmenopausal women are suffering from vaginal atrophy. This study aimed to evaluate the effect of oxytocin vaginal gel on vaginal atrophy among postmenopausal women. Methods This was a randomized controlled trial that was conducted on 96 postmenopausal women who suffered from vaginal atrophy. The inclusion criteria were: literate women, age 40–60, at least 1 year passed from their last menstrual period or the level of FSH > 40 IU, monogamous women with the sexual relationship. Women in the intervention group, requested to use one applicator of 400 IU oxytocin gel per night and women in the placebo group used placebo each night. The subjective symptoms of vaginal atrophy, vaginal PH, maturation index were measured before and after the intervention. Results The number of superficial cells was increased significantly in the oxytocin group compared to placebo (38.7 ± 7.18 vs. 3.69 ± 2.76, p = 0.0001), while the number of parabasal cells was decreased significantly in the oxytocin compared to placebo after the intervention. The improvement of the maturation index was more dominant in the oxytocin group (increased from 7.76 ± 4.68 to 52.48 ± 7.54) in comparison to the placebo group (increased from 8.58 ± 4.35 to 13.25 ± 5.06). The PH of the vagina decreased significantly in the oxytocin group in comparison to the placebo group (p = 0.0001). After 8 weeks, 88.6 and 7.1% of women in the oxytocin and placebo groups did not show the severe symptoms of vaginal atrophy (p = 0.001). Conclusion The results of this study showed that eight- week intervention with oxytocin vaginal gel (400 IU) could significantly improve the vaginal maturation index, subjective symptoms of vaginal atrophy and reduce the PH of the vagina. Using this medication in women who have a contraindication for hormone therapy is recommended. Trial registration IRCT20160602028220N2.
Collapse
Affiliation(s)
- Ilnaz Zohrabi
- Menopause Andropause Research Center, Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Golestan Ave, Ahvaz, Iran
| | - Parvin Abedi
- Menopause Andropause Research Center, Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Golestan Ave, Ahvaz, Iran.
| | - Somayeh Ansari
- Menopause Andropause Research Center, Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Golestan Ave, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Shakiba Maram
- Pharmaceutics Department, Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Houshmand
- Department of Pharmacology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
16
|
Abedi P, Zohrabi I, Ansari S, Maraghi E, Maram NS, Houshmand G. The Impact of Oxytocin Vaginal Gel on Sexual Function in Postmenopausal Women: A Randomized Controlled Trial. JOURNAL OF SEX & MARITAL THERAPY 2020; 46:377-384. [PMID: 32169019 DOI: 10.1080/0092623x.2020.1738606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Many postmenopausal women suffer from sexual dysfunction mostly due to the vulvovaginal atrophy. The aim of this study was to assess the effect of vaginal oxytocin gel on sexual function of postmenopausal women. This study was conducted on 96 postmenopausal women with symptoms of vaginal atrophy and sexual dysfunction who were randomly recruited into two groups of oxytocin vaginal gel (400 IU, n = 48) or placebo (n = 48). The PH, vaginal maturation index, and sexual function (using Female Sexual Function Index) of the participants were measured at the beginning of the study and eight weeks later. The vaginal maturation index and the PH of the vagina improved in the oxytocin group compared to those of the placebo. All domains of sexual function including desire, arousal, lubrication, pain, sexual satisfaction, and total score of sexual function improved significantly in the oxytocin gel compared to the control group (p < 0.0001). The results of this study showed that the administration of oxytocin vaginal gel could significantly improve vaginal atrophy as well as sexual function in postmenopausal women. Therefore, using vaginal oxytocin gel for sexual dysfunction in postmenopausal women who are not interested in hormone therapy is recommended.
Collapse
Affiliation(s)
- Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ilnaz Zohrabi
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Somayeh Ansari
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Faculty of Public Health, Department of Biostatistics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Shakiba Maram
- Pharmaceutics Department, Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Houshmand
- Department of Pharmacology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
17
|
Buemann B, Uvnäs-Moberg K. Oxytocin may have a therapeutical potential against cardiovascular disease. Possible pharmaceutical and behavioral approaches. Med Hypotheses 2020; 138:109597. [PMID: 32032912 DOI: 10.1016/j.mehy.2020.109597] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/11/2020] [Accepted: 01/22/2020] [Indexed: 12/22/2022]
Abstract
Based on the ancient role of oxytocin and its homologues as amplifiers of reproduction we argue for an evolutionary coupling of oxytocin to signaling pathway which support restorative mechanisms of cells and tissue. In particular, the survival and function of different categories of stem cells and primordial cells are enhanced by mitogen-activated protein kinase (MAPK) pathways. Furthermore, oxytocin stimulates the AMP-activated protein kinase pathway (AMPK) in numerous of cell types which promotes the maintenance of different cell structures. This involves autophagic processes and, in particular, may support the renewal of mitochondria. Mitochondrial fitness may protect against oxidative and inflammatory stress - a well-documented effect of oxytocin. The combined specific trophic and protective effects oxytocin may delay several degenerative phenomena including sarcopenia, type-2 diabetes and atherosclerosis. These effects may be exerted both on a central level supporting the function and integrity of the hypothalamus and peripherally acting directly on blood vessels, pancreas, heart, skeletal muscles and adipose tissue etc. Furthermore, in the capacity of being both a hormone and neuromodulator, oxytocin interacts with numerous of regulatory mechanisms particularly the autonomic nervous system and HPA-axis which may reduce blood pressure and affect the immune function. The potential of the oxytocin system as a behavioral and molecular target for the prevention and treatment of cardiovascular disease is discussed. Focus is put on the affiliative and sexual significance and the different options and limitations associated with a pharmaceutical approach. MeSH: Aging, Atherosclerosis, Heart, Hypothalamus, Inflammation, Love, Orgasm, Oxytocin.
Collapse
Affiliation(s)
| | - Kerstin Uvnäs-Moberg
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden
| |
Collapse
|
18
|
Critical analysis of methods for assessing genitourinary syndrome of menopause used in clinical trials. ACTA ACUST UNITED AC 2019; 26:1436-1442. [DOI: 10.1097/gme.0000000000001406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
|
20
|
Horta M, Kaylor K, Feifel D, Ebner NC. Chronic oxytocin administration as a tool for investigation and treatment: A cross-disciplinary systematic review. Neurosci Biobehav Rev 2019; 108:1-23. [PMID: 31647964 DOI: 10.1016/j.neubiorev.2019.10.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 09/10/2019] [Accepted: 10/18/2019] [Indexed: 12/18/2022]
Abstract
Oxytocin (OT) subserves various physiological, behavioral, and cognitive processes. This paired with the ability to administer OT with minimal and inconsistent side effects has spurred research to explore its therapeutic potential. Findings from single-dose studies indicate that OT administration may be beneficial, at least under certain circumstances. The state of the field, however, is less clear regarding effects from chronic OT administration, which more closely resembles long-term treatment. To address this gap, this review synthesizes existing findings on the use of chronic OT administration in animal and human work. In addition to detailing the effects of chronic OT administration across different functional domains, this review highlights factors that have contributed to mixed findings. Based on this review, a basic framework of interrelated regulatory functions sensitive to chronic OT administration is offered. The paper also identifies future research directions across different contexts, populations, and outcomes, specifically calling for more systematic and standardized research on chronic OT administration in humans to supplement and expand what is currently known from preclinical work.
Collapse
Affiliation(s)
- Marilyn Horta
- Department of Psychology, University of Florida, Gainesville, FL, USA.
| | - Kathryn Kaylor
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - David Feifel
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Natalie C Ebner
- Department of Psychology, University of Florida, Gainesville, FL, USA; Institute on Aging, Department of Aging & Geriatric Research, University of Florida, Gainesville, FL, USA
| |
Collapse
|
21
|
Torky HA, Taha A, Marie H, El-Desouky E, Raslan O, Moussa AA, Ahmad AM, Abo-Louz A, Zaki S, Fares T, Eesa A. Role of topical oxytocin in improving vaginal atrophy in postmenopausal women: a randomized, controlled trial. Climacteric 2018; 21:174-178. [PMID: 29347848 DOI: 10.1080/13697137.2017.1421924] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE AND DESIGN Prospective randomized controlled trial to test the effectiveness of topical oxytocin gel to improve vaginal atrophy in postmenopausal women. PATIENTS AND METHODS A total of 140 postmenopausal women presenting with vaginal atrophy and who satisfied the inclusion and exclusion criteria were randomized into two groups each of 70 patients; they received intravaginal oxytocin gel or placebo gel for 30 days. Serum estrogen level, visual, colposcopic and histological vaginal examination were performed before and after treatment. RESULTS Forty-seven out of 70 women in the oxytocin gel group improved after treatment and none in the placebo group (p = 0.001). Forty-five participants in the oxytocin group and seven in the placebo group reported relief of dyspareunia (p = 0.001). Thirty-four participants in the oxytocin group and seven in the placebo group reported relief of soreness (p = 0.001). There was no significant difference between the circulating levels of estradiol in both groups before and after treatment (p = 0.4 and 0.6 for the oxytocin group and the placebo group, respectively). CONCLUSION Oxytocin gel is useful in the restoration of the vaginal epithelium in cases of postmenopausal atrophic vaginitis. Further studies with a longer follow-up period are required to test the long-term effects of oxytocin as a treatment for vaginal atrophy.
Collapse
Affiliation(s)
- H A Torky
- a Department of Obstetrics and Gynecology , October 6th University , Cairo , Egypt
| | - A Taha
- b Department of Obstetrics and Gynecology , Al-Azhar University , Cairo , Egypt
| | - H Marie
- c Department of Obstetrics and Gynecology , Cairo University , Cairo , Egypt
| | - E El-Desouky
- b Department of Obstetrics and Gynecology , Al-Azhar University , Cairo , Egypt
| | - O Raslan
- b Department of Obstetrics and Gynecology , Al-Azhar University , Cairo , Egypt
| | - A A Moussa
- b Department of Obstetrics and Gynecology , Al-Azhar University , Cairo , Egypt
| | - A M Ahmad
- d Department of Obstetrics and Gynecology , Al-Galaa Teaching Hospital , Cairo , Egypt
| | - A Abo-Louz
- a Department of Obstetrics and Gynecology , October 6th University , Cairo , Egypt
| | - S Zaki
- c Department of Obstetrics and Gynecology , Cairo University , Cairo , Egypt
| | - T Fares
- b Department of Obstetrics and Gynecology , Al-Azhar University , Cairo , Egypt
| | - A Eesa
- e Department of Pathology , Cairo University , Cairo , Egypt
| |
Collapse
|
22
|
Klinische Relevanz des urogenitalen Syndroms der Menopause. GYNAKOLOGISCHE ENDOKRINOLOGIE 2017. [DOI: 10.1007/s10304-017-0155-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
23
|
Nielsen EI, Al-Saqi SH, Jonasson AF, Uvnäs-Moberg K. Population Pharmacokinetic Analysis of Vaginally and Intravenously Administered Oxytocin in Postmenopausal Women. J Clin Pharmacol 2017; 57:1573-1581. [DOI: 10.1002/jcph.961] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/15/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Elisabet I. Nielsen
- Department of Pharmaceutical Biosciences; Uppsala University; Uppsala Sweden
| | - Shahla H. Al-Saqi
- Department of Clinical Science; Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - Aino F. Jonasson
- Department of Clinical Science; Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - Kerstin Uvnäs-Moberg
- Department of Animal Environment and Health; Swedish University of Agricultural Sciences; Skara Sweden
| |
Collapse
|
24
|
Kallak TK, Uvnäs-Moberg K. Oxytocin stimulates cell proliferation in vaginal cell line Vk2E6E7. Post Reprod Health 2017; 23:6-12. [PMID: 28381099 DOI: 10.1177/2053369117693148] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective During and after menopause, the symptoms of vaginal atrophy cause great discomfort and necessitate effective treatment options. Currently, vaginally applied oxytocin is being investigated as a treatment for the symptoms of vaginal atrophy in postmenopausal women. To clarify the mechanisms behind oxytocins effects on vaginal atrophy, the present study investigated the effects of oxytocin on cell proliferation in the cells of the Vk2E6E7 line, a non-tumour vaginal cell line. The study also compared the effects of oxytocin with those of estradiol (E2). Study design The effects of both oxytocin and E2 on the proliferation of Vk2E6E7 cells were investigated using Cell Proliferation ELISA BrdU Colorimetric Assay. The expression of both oxytocin and oxytocin receptor was studied in Vk2E6E7 cells using quantitative real-time polymerase chain reaction and immunofluorescent staining. Main outcome measures Cell proliferation and gene expression. Results Oxytocin increased cell proliferation both time dependently and dose dependently. This differed from the effect pattern observed in cells treated with E2. In addition, in oxytocin-treated cells, the oxytocin receptor was found to be co-localized with caveolin-1, indicating pro-proliferative signalling within the cell. Conclusions Oxytocin stimulates cell proliferation and the co-localization of oxytocin receptor with caveolin-1 in oxytocin-treated cells, supporting the role of oxytocin signalling in cell proliferation. In addition, these findings suggest that increased cell proliferation is one mechanism by which local vaginal oxytocin treatment increases vaginal thickness and relieves vaginal symptoms in postmenopausal women with vaginal atrophy.
Collapse
Affiliation(s)
- Theodora K Kallak
- 1 Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kerstin Uvnäs-Moberg
- 2 Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden.,3 School of Life Science, University of Skövde, Skövde, Sweden
| |
Collapse
|
25
|
Gandhi J, Chen A, Dagur G, Suh Y, Smith N, Cali B, Khan SA. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. Am J Obstet Gynecol 2016; 215:704-711. [PMID: 27472999 DOI: 10.1016/j.ajog.2016.07.045] [Citation(s) in RCA: 209] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/15/2016] [Accepted: 07/20/2016] [Indexed: 02/06/2023]
Abstract
Genitourinary syndrome of menopause, a new term for a condition more renowned as atrophic vaginitis, is a hypoestrogenic condition with external genital, urological, and sexual implications that affects >50% of postmenopausal women. Due to sexual embarrassment and the sensitive nature of discussing symptoms, genitourinary syndrome of menopause is greatly underdiagnosed. The most up-to-date literature pertaining to clinical manifestations, pathophysiology, etiology, evaluation, and management of genitourinary syndrome of menopause is comprehensively reviewed. Early detection and individually tailored pharmacologic (eg, estrogen therapy, selective estrogen receptor modulator, synthetic steroid, oxytocin, and dehydroepiandrosterone) and/or nonpharmacologic (eg, laser therapies, moisturizers and lubricants, homeopathic remedies, and lifestyle modifications) treatment is paramount for not only improving quality of life but also for preventing exacerbation of symptoms in women with this condition.
Collapse
|
26
|
Future Targets for Female Sexual Dysfunction. J Sex Med 2016; 13:1147-65. [DOI: 10.1016/j.jsxm.2016.05.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 05/22/2016] [Accepted: 05/27/2016] [Indexed: 12/18/2022]
|
27
|
Faubion SS, Loprinzi CL, Ruddy KJ. Management of Hormone Deprivation Symptoms After Cancer. Mayo Clin Proc 2016; 91:1133-46. [PMID: 27492917 DOI: 10.1016/j.mayocp.2016.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/03/2016] [Accepted: 04/05/2016] [Indexed: 02/08/2023]
Abstract
Cancer survivors often experience symptoms related to hormone deprivation, including vasomotor symptoms, genitourinary symptoms, and sexual health concerns. These symptoms can occur due to natural menopause in midlife women, or they can be brought on by oncologic therapies in younger women or men. We searched PubMed for English-language studies from January 1990 through January 2016 to identify relevant articles on the management of hormone deprivation symptoms, including vasomotor, genitourinary, and sexual symptoms in patients with cancer. The search terms used included hormone deprivation, vasomotor symptoms, hot flash, vaginal dryness, sexual dysfunction, and breast cancer. This manuscript provides a comprehensive description of data supporting the treatment of symptoms associated with hormone deprivation.
Collapse
Affiliation(s)
- Stephanie S Faubion
- Women's Health Clinic, Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.
| | - Charles L Loprinzi
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN
| | - Kathryn J Ruddy
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN
| |
Collapse
|
28
|
Al-Saqi SH, Jonasson AF, Naessén T, Uvnäs-Moberg K. Oxytocin improves cytological and histological profiles of vaginal atrophy in postmenopausal women. Post Reprod Health 2016; 22:25-33. [PMID: 26883689 DOI: 10.1177/2053369116629042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate if topical oxytocin can reverse vaginal atrophy, as assessed by cytological and histological examination of the vaginal mucosal epithelium, in postmenopausal women after 12 weeks of treatment as compared to placebo. STUDY DESIGN Sixty-eight postmenopausal women diagnosed with vaginal atrophy were randomized for this multicenter, double-blinded, placebo-controlled trial. Thirty-three women received 600 IU vagitocin, an oxytocin containing gel, and 35 women received a placebo gel intravaginally. The dose was 600 IU daily for the first two weeks and thereafter 600 IU twice a week for 10 weeks. All participant women underwent four visits and a subgroup of 20 women had a further fifth visit. Vaginal smears for cytological evaluation were collected at all visits. Vaginal biopsies were taken in 20 women before and after 12 weeks of treatment for histological analysis. In these women a vaginal smear was also collected after 14 weeks. RESULTS The increase in the percentage of superficial cells between 0 and 2 weeks was significantly greater after treatment with vagitocin in comparison with placebo (p = 0.04). The difference in the maturation value between 0 and 12 weeks was significantly higher in the vagitocin than in the placebo group (p = 0.01). The reduction in the scores of atrophy was according to the histological investigation significantly greater in the vagitocin group than in the placebo group at 12 weeks (p < 0.04). CONCLUSION Daily intravaginal treatment with vagitocin 600 IU improves expressions of vaginal atrophy as recorded by cytological investigation of vaginal smears and histological analysis of vaginal biopsies. Treatment twice weekly seems to be less effective regarding the increase in superficial cells.
Collapse
Affiliation(s)
- Shahla Hamza Al-Saqi
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Aino Fianu Jonasson
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Tord Naessén
- Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kerstin Uvnäs-Moberg
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden School of Life Science, University of Skövde, Skövde, Sweden
| |
Collapse
|