Effect of Persian traditional medicine based herbal vaginal gel in vaginal atrophy

Elahe Naderi-Afshar; Mahboubeh Valiani; Mojgan Tansaz; Shirin Fahimi; Zahra Allameh; Maryam Ranjbar; Mohammad Mazaheri

doi:10.1016/j.jaim.2025.101193

Effect of Persian traditional medicine based herbal vaginal gel in vaginal atrophy

J Ayurveda Integr Med. 2026 May-Jun;17(3):101193. doi: 10.1016/j.jaim.2025.101193. Epub 2026 Apr 1.

Authors

Elahe Naderi-Afshar¹, Mahboubeh Valiani², Mojgan Tansaz³, Shirin Fahimi⁴, Zahra Allameh⁵, Maryam Ranjbar¹, Mohammad Mazaheri⁶

Affiliations

¹ Department of Persian Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
² Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
³ Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Traditional Medicine and Materia Medica Research Center and Department of Traditional Pharmacy, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Traditional Pharmacy and Persian Medicine, Faculty of Pharmacy and Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
⁵ Department of Obstetrics and Gynecology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
⁶ Department of Persian Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: Mazaherimohammad@yahoo.com.

Abstract

Background: Vaginal atrophy is a common condition in postmenopausal women due to low estrogen causing dryness, irritation, infections, and painful intercourse. Treatments include non-hormonal (moisturizers, lubricants) and hormonal options (vaginal estrogens, phytoestrogens) Moreover, Traditional Persian medicine suggests plants as a potential remedy for vaginal atrophy. Auriculotherapy is also gaining popularity as a non-invasive and efficient treatment option.

Objective: To evaluate the effect of a vaginal herbal gel and auriculotherapy compared to a placebo on vaginal atrophy of postmenopausal women.

Materials and methods: In a single-blind, randomized trial, 90 menopausal women with vaginal atrophy symptoms were divided into Herbal gel, Auriculotherapy, and placebo groups (30 each). The study measured subjective symptoms (SSS-VVA), sexual function (FSFI), and quality of life (MENQOL) before, at four-, and eight-weeks post intervention.

Results: Comparison of SSS-VVA showed significant improvement in vaginal itching, dryness, and pain in all groups compared to baseline. The herbal gel group demonstrated a more significant reduction in atrophic vaginitis indicators compared to placebo (P < 0.001) and greater decrease in vaginal dryness than auriculotherapy (P = 0.006). Additionally, both herbal gel and auriculotherapy groups exhibited significant improvements in FSFI, with desire (p = 0.038), orgasm (p < 0.001), and satisfaction (p = 0.004) showing greater improvement with herbal gel than auriculotherapy. Regarding MENQOL, both interventions improved patients' condition, with auriculotherapy showing overall greater improvement than herbal gel.

Conclusion: Both interventions effectively reduced symptoms and improved quality of life, but the herbal gel outperformed auriculotherapy in reducing dryness and enhancing sexual function.

Keywords: Alcea digitate Alef.; Auriculotherapy; Malva Sylvestris L.; Matricaria Chamomilla L.; Persian medicine; Rosa damascene Herrm; Vaginal atrophy.