Comparison of the Effects of Fenugreek Vaginal Cream and Ultra Low-Dose Estrogen on Atrophic Vaginitis

Introduction: Atrophic vaginitis is a common problem in postmenopausal women and results from decreased levels of blood estrogen. It is associated with symptoms of itching, burning, dyspareunia, and postmenopausal bleeding. The present study evaluated effects of fenugreek extract on atrophic vaginitis.

Materials and methods: This randomized controlled clinical trial was performed on 60 postmenopausal women in Ardabil, Iran, in 2018. The participants were selected using block randomization with the allocation ratio 1:1. Those in the intervention group received 0.5g (the applicator filled to the half-full mark) fenugreek vaginal cream 5% twice a week for 12 weeks. The control group received conjugated estrogens vaginal cream at the dose of 0.625 mg (the applicator filled to the half-full mark) containing 0.3 mg of conjugated estrogens. Atrophic vaginitis was evaluated before and after the treatment through clinical examination, clinical signs, and measurement of vaginal maturation index (VMI).

Findings: After the 12-week intervention and modification of the baseline score, the mean (standard error) score for atrophic vaginitis signs was 3.100 (1.43-4.75). This difference was statistically significant in intragroup comparison and in favor of the control group in intergroup comparison (p=0.001). VMI was less than 49 in 86.7% and 46.7% of the participants in the intervention and control groups, respectively. This was a significant difference in favor of the control group (p=0.001).

Conclusion: The results of this study showed that total fenugreek extract could be effective in treating signs of atrophic vaginitis but it was not as effective as ultra-low-dose estrogen.

Keywords: Atrophic vaginitis; estrogen vaginal cream; fenugreek vaginal cream; vaginal maturation index..