The efficacy of oxytocin gel in postmenopausal women with vaginal atrophy: an updated systematic review and meta-analysis

被引:1
作者
Farahat, Ramadan Abdelmoez [1 ]
Salamah, Hazem Mohamed [2 ]
Mahmoud, Abdelrahman [3 ]
Hamouda, Esraa [4 ]
Hashemy, Mahmoud [5 ]
Hamouda, Heba [4 ]
Samir, Ali [6 ]
Chenfouh, Imane [7 ]
Marey, Ahmed [8 ]
Awad, Dina M. [8 ]
Farag, Elsayed [9 ]
Abd-Elgawad, Mohamed [10 ]
Eldesouky, Elsayed [9 ]
机构
[1] Kafrelsheikh Univ, Fac Med, Kafrelsheikh, Egypt
[2] Zagazig Univ, Fac Med, Zagazig 44519, Egypt
[3] Minia Univ, Fac Med, Menia, Egypt
[4] Menoufia Univ, Fac Med, Menoufia, Egypt
[5] Cairo Univ, Fac Med, Giza, Egypt
[6] Assiut Univ, Fac Med, Assiut, Egypt
[7] Fac Med & Pharm, Oujda, Oujda Angad, Morocco
[8] Alexandria Univ, Fac Med, Alexandria, Egypt
[9] Al Azhar Univ, Fac Med, Dept Obstet & Gynecol, Cairo, Egypt
[10] Fayoum Univ, Fac Med, Al Fayyum, Egypt
关键词
Oxytocin; Postmenopausal; Post-menopause; Atrophy; GSM; Genitourinary; Maturation; Vaginal; GENITOURINARY SYNDROME; MENOPAUSE; SYMPTOMS; HEALTH;
D O I
10.1186/s12905-023-02645-0
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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.
引用
收藏
页数:15
相关论文
共 34 条
[1]   The Impact of Oxytocin Vaginal Gel on Sexual Function in Postmenopausal Women: A Randomized Controlled Trial [J].
Abedi, Parvin ;
Zohrabi, Ilnaz ;
Ansari, Somayeh ;
Maraghi, Elham ;
Maram, Nader Shakiba ;
Houshmand, Gholamreza .
JOURNAL OF SEX & MARITAL THERAPY, 2020, 46 (04) :377-384
[2]  
Al-Saqi Shahla H, 2015, Post Reprod Health, V21, P88, DOI 10.1177/2053369115577328
[3]  
Al-Saqi Shahla Hamza, 2016, Post Reprod Health, V22, P25, DOI 10.1177/2053369116629042
[4]   The Genitourinary Syndrome of Menopause: An Overview of the Recent Data [J].
Angelou, Kyveli ;
Grigoriadis, Themos ;
Diakosavvas, Michail ;
Zacharakis, Dimitris ;
Athanasiou, Stavros .
CUREUS JOURNAL OF MEDICAL SCIENCE, 2020, 12 (04)
[5]  
Banks E, 2003, LANCET, V362, P419, DOI 10.1016/S0140-6736(03)14065-2
[6]  
Berger A., 2011, Cochrane Handb Syst Rev Interv, V1st, P3, DOI DOI 10.1002/9781444346022.CH1
[7]   Oxytocin and oxytocin receptors in cancer cells and proliferation [J].
Cassoni, P ;
Sapino, A ;
Marrocco, T ;
Chini, B ;
Bussolati, G .
JOURNAL OF NEUROENDOCRINOLOGY, 2004, 16 (04) :362-364
[8]   Bias in meta-analysis detected by a simple, graphical test [J].
Egger, M ;
Smith, GD ;
Schneider, M ;
Minder, C .
BMJ-BRITISH MEDICAL JOURNAL, 1997, 315 (7109) :629-634
[9]   Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management [J].
Gandhi, Jason ;
Chen, Andrew ;
Dagur, Gautam ;
Suh, Yiji ;
Smith, Noel ;
Cali, Brianna ;
Khan, Sardar Ali .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2016, 215 (06) :704-711
[10]  
Ghorbani Zahra, 2021, Post Reprod Health, V27, P30, DOI 10.1177/2053369120946645