Effect of Alcea on sexual function in postmenopausal women: a randomized, controlled clinical trial

Document Type : Original Article

Authors

1 PhD student of Persian Medicine, Department of Persian Medicine, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.

2 Assistant professor, Department of Persian Medicine, Clinical Research Development Unit, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.

3 Assistant professor, Department of Persian Pharmacy, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Associate professor, Department of Biostatistics, School of Health, Golestan University of Medical Sciences, Gorgan, Iran.

6 PhD of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: One of the complaints of menopausal period is sexual problems and dyspareunia. According to Persian Medicine, Alcea has a moisturizing and softening effect. This study was performed with aim to determine the effect of Alcea herbal product on sexual function in postmenopausal women.
Methods: This double-blind clinical trial was performed in 2019 on 60 postmenopausal women with sexual dysfunction referred to Omolbanin Hospital in Mashhad. The subjects were randomly divided into two groups of treatment and placebo (n=30 in each group). Alcea vaginal suppository 5% or placebo was administered every night for 2 weeks and then every other night for 6 weeks. The FSFI (Female Sexual Function Index) questionnaire was completed at the beginning and end of the intervention. Data were analyzed by SPSS software (version 18) and Independent T-test, Man Whitney, Chi-square and Wilcoxon. P<0.05 was considered statistically significant.
Results: Mean score of all domains of sexual function increased after 8 weeks of intervention in the treatment group, which was significantly higher than placebo group. The mean total score of the questionnaire before the intervention in the treatment group reached from 17.45±5.25 to 26.21±4.01 (P=0.0001) and in the placebo group from 21.93±5.65 to 23.89±5.06 (P =0.001).
Conclusion: Alcea herbal product has a beneficial effect on sexual function in postmenopausal women, so it can be suggested as an alternative treatment.

Keywords


  1. Speroff L, Glass RH, Kase NG. Clinical gynecologic endocrinology and infertility. Baltimore: Wiliams & Wilkins; 2003. Morphological and Immunohistochemical Especially of Stilled Pregnancy the First Trimester Nauk [Pathology of endometrium and placenta during miscarriage]. Saratov, 2012.—25 s. Serov VN, Prilepskaja VN, Ovsjannikova TV Ginekolog-9. icheskaja jendokrinologija [Gynecological Endocrinology].
  2. Berek JS. Berek and Novak's gynecology. 15nd ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2012.
  3. Blumel JE, Castelo-Branco C, Binfa L, Gramegna G, Tacla X, Aracena B, et al. Quality of life after the menopause: a population study. Maturitas 2000; 34(1):17-23.
  4. World Health Organization. Tracking universal health coverage: first global monitoring report. World Health Organization; 2015 Jul 21.
  5. Walton B, Thorton T. Female sexual dysfunction. Current Women's Health Reports 2003; 3(4):319-26.
  6. Khayatan J, Iravani M, Moghimipour E, Haghighizadeh MH, Jelodarian P. The effect of red clover vaginal cream on sexual function in postmenopausal women: A randomized, controlled clinical trial. Iran J Obstet Gynecol Infertil 2019; 22(8):26-34.
  7. Van der Laak JA, de Bie LM, de Leeuw H, de Wilde PC, Hanselaar AG. The effect of Replens® on vaginal cytology in the treatment of postmenopausal atrophy: cytomorphology versus computerised cytometry. Journal of clinical pathology 2002; 55(6):446-51.
  8. Stuenkel CA, Davis SR, Gompel A, Lumsden MA, Murad MH, Pinkerton JV, et al. Treatment of symptoms of the menopause: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism 2015; 100(11):3975-4011.
  9. Jameson JL, Kasper DL, Longo DL, Fauci AS, Hauser SL, Loscalzo J. Harrison's principles of internal medicine. New York: McGraw-Hill Education; 2018.
  10. Izzo AA, Hoon‐Kim S, Radhakrishnan R, Williamson EM. A critical approach to evaluating clinical efficacy, adverse events and drug interactions of herbal remedies. Phytotherapy Research 2016; 30(5):691-700.
  11. Golmakani N, SharifiSistani N, Taghi Shakeri M, Hasanzade Mofrad M, Sajadi Tabassi A. Comparing two treatment methods of vitamin E suppository and conjugated estrogen vaginal cream on the quality of life in menopausal women with vaginal atrophy. Journal of Midwifery and Reproductive Health 2014; 2(4):253-61.
  12. Rad P, Tadayon M, Abbaspour M, Latifi SM, Rashidi I, Delaviz H. The effect of vitamin D on vaginal atrophy in postmenopausal women. Iranian journal of nursing and midwifery research 2015; 20(2):211.
  13. Ziagham S, Abbaspour Z, Abbaspour MR. The comparison betweenthe effects of hyaluronic acid vaginal suppository and vitamin E on the treatment of atrophic vaginitis in menopausal women. Journal of Arak University of Medical Sciences 2012; 15(6):57-64.
  14. Novak E. Berek & Novak's gynecology: Lippincott Williams & Wilkins; 2007.
  15. Al-Snafi AE. The pharmaceutical importance of Althaea officinalis and Althaea rosea: A review. Int J Pharm Tech Res 2013; 5(3):1387-5.
  16. Kianitalaei A, Feyzabadi Z, Hamedi S, Qaraaty M. Althaea Officinalis in Traditional Medicine and modern phytotherapy. Journal of Advanced Pharmacy Education & Research 2019; 9(S2):155.
  17. Nekouei Nasim, Emami Ahmad, Shams Ardakani M, Mehregan I. Phytotherapy "Treatment of diseases by plants". Tehran: Entesharate Rahe Kamal; 1383.
  18. Ibn Nafis Ali Ibn AH. Alshamel fi sanawat-al tabie. Tehran: Iran Univercity of Medicine; 2009.
  19. Falahat F, Tavakkoli M, Mokaberinejad R, Ayati S, Feyzabadi Z. Natural treatments of oligomenorrhea based on persian medicine. Iran J Obstet Gynecol Infertil 2018; 21(Supple):55-66.
  20. Mahjour M, Tavakkoli Kakhki M, Feyzabadi Z. A review on oral herbal drugs affecting chloasma based on Persian Medicine and Conventional Medicine. Iran J Obstet Gynecol Infertil 2019; 22(1):60-8.
  21. Siyahpoush M. Six essential principles of Iranian traditional medicine for maintaining health from the Quran’s point of view. Quran and teb 2016.; 1(3):101-7.
  22. Gilani MK. Hefz Al-Sehe Nasseri. Tehran, Iran: Almaee. 2009.
  23. Kavousi M, Khadem Ghaebi N, Tansaz M, Bioos S, Feyzabadi Z. Comparison of the causes of infertility induced by ovulation disorders in Persian medicine and traditional medicine. The Iran J Obstet Gynecol Infertil 2018; 21(6):80-91.
  24. Jorjani EH. Zakhire Kharazmshahi. Qom: Ehya Teb Tabiee Institute; 2012.
  25. Alavi Shirazi A IMHM. Aghili treatments. Tehran:: Iran University of Medical Sciences; 2008.
  26. MohammadiKh HM, Faghihzade S. Validity ofthe Persian version of the female sexual function index (FSFI) as an indicatorof women's sexualfunction. Payesh 2008; 7(3):269-78.
  27. Ameri A, Heydarirad G, Mahdavi Jafari J, Ghobadi A, Rezaeizadeh H, Choopani R. Medicinal plants contain mucilage used in traditional Persian medicine (TPM). Pharm Biol 2015; 53(4):615-23.
  28. Guarnieri A, Chiarini A, Burnelli S, Amorosa M. Mucilage of Althaea officinalis. Il Farmaco; edizione pratica 1974; 29(2):83-91.
  29. Heydarirad G, Choopani R, Mehdi P, Jafari JM. Medical Mucilage Used in Traditional Persian Medicine Practice. Iran J Med Sci 2016; 41(3 Suppl):S41.
  30. Jean B. Pharmacognosie, phytochimie, plantes médicinales (4e éd.). Lavoisier; 2009 Oct 2.
  31. Mozaffarian V. Identification of medicinal and aromatic plants of Iran; 2013.
  32. Jafarimanesh H. The effect of Alcea Althea on latex allergy among operating room staffs in Arak Hospitals, Iran. Complementary Medicine Journal 2015; 4(4):954-67.
  33. Ameri A, Heydarirad G, Rezaeizadeh H, Choopani R, Ghobadi A, Gachkar L. Evaluation of Efficacy of an Herbal Compound on Dry Mouth in Patients With Head and Neck Cancers: A Randomized Clinical Trial. J Evid Based Complementary Altern Med 2016; 21(1):30-3.
  34. Nosál'ova G, Strapková A, Kardosová A, Capek P, Zathurecký L, Bukovská E. Antitussive Wirkung des Extraktes und der Polysaccharide aus Eibisch (Althaea officinalis L., var. robusta) [Antitussive action of extracts and polysaccharides of marsh mallow (Althea officinalis L., var. robusta)]. Pharmazie 1992; 47(3):224-6.
  35. Sutovska M, Capek P, Franova S, Joskova M, Sutovsky J, Marcinek J, et al. Antitussive activity of Althaea officinalis L. polysaccharide rhamnogalacturonan and its changes in guinea pigs with ovalbumine-induced airways inflammation. Bratisl Lek Listy 2011; 112(12):670-5.
  36. Curnow A, Owen SJ. An evaluation of root phytochemicals derived from althea officinalis (Marshmallow) and astragalus membranaceus as potential natural components of UV protecting dermatological formulations. Oxidative medicine and cellular longevity 2016; 2016.
  37. Ayatollahi Mousavi SA, Abdollahi H, Kazemipour N. Investigation of antifungal activity of 10 methanol extracts of medicinal Herbs. J Kerman Univ Med Sci 1996; 3(3):115-22.
  38. Rashidi A, Mousavi B, Rahmani MR, Rezaee MA, Hosaini W, Motaharinia Y, et al. Evaluation of antifungal effect of Lavandula officinalis, Salvia officinalis L., Sumac, Glycyrrhiza glabra, and Althaea officinalis extracts on Aspergillus niger, Aspergillus fumigatus, and Aspergillus flavus species. Journal of Medicinal Plants Research 2012; 6(2):309-13.
  39. Haghgoo R, Mehran M, Afshari E, Zadeh HF, Ahmadvand M. Antibacterial Effects of Different Concentrations of Althaea officinalis Root Extract versus 0.2% Chlorhexidine and Penicillin on Streptococcus mutans and Lactobacillus (In vitro). J Int Soc Prev Community Dent 2017; 7(4):180-185.
  40. Rezaei M, Dadgar Z, Noori-Zadeh A, Mesbah-Namin SA, Pakzad I, Davodian E. Evaluation of the antibacterial activity of the Althaea officinalis L. leaf extract and its wound healing potency in the rat model of excision wound creation. Avicenna J Phytomed 2015; 5(2):105-12.
  41. Abedi P, Najafian M, Yaralizadeh M, Namjoyan F. Effect of fennel vaginal cream on sexual function in postmenopausal women: A double blind randomized controlled trial. J Med Life 2018; 11(1):24-28.
  42. Mazalzadeh F, Hekmat K, Namjoyan F, SakiMalehi A. Effect of fenugreek vaginal cream on dyspareunia and sexual satisfaction in menopausal women: a randomized clinical trial. Iran J Obstet Gynecol Infertil 2018; 21(3):22-30.
  43. Golmakani N, Parnan Emamverdikhan A, Zarifian A, Sajadi Tabassi SA, Hassanzadeh M. Vitamin E as alternative local treatment in genitourinary syndrome of menopause: a randomized controlled trial. Int Urogynecol J 2019; 30(5):831-837.
  44. Abdali K, Dowran P, Emamghoreishi M, Kasraian M, Tabatabaei H. Comparison of the effect of Foeniculum vulgare and St John’s wort (Hypericum perforatum) on the climacteric symptoms and sexual activity in menopausal woman. Int J Adv Biotechnol Res 2016; 7(7):148-54.