Vaginal atrophy: an alternative to hormones

Posted by Liz on Aug 4, 2014 in vaginal atrophy, vaginal dryness, vaginal health | 4 comments

I have been a bit disturbed by the surge of attention in the menopause space to vaginal atrophy, i.e. thinning and drying of the lining of the vagina. Mind you, I don’t feel that impact that vaginal atrophy can have on a woman’s life should be marginalized, however, when I see my colleagues racing to write about hormones and ending the silent suffering of tens of thousands of women, all I can do is shake my head in disbelief; you see, my space is not for sale to any bidders. Let me be clear: vaginal atrophy affects roughly 43% of women during menopause and can lead to extreme discomfort, dryness, burning, itching, pain and lack of sexual desire. Since most women spend about a third of their lives in postmenopause, this can be a huge issue and one that warrants attention. However, to represent vaginal atrophy as an epidemic of epic and burgeoning proportions is simply irresponsible.

As I step off my soapbox, let me share the true reason for this post: Finnish researchers have discovered a potential treatment for vaginal atrophy for women who cannot use or choose to forgo systemic or topical estrogen therapy — sea buckthorn oil. Sea buckthorn oil is derived from the fruit of deciduous shrubs and has long been used in Central Asia to treat inflamed genital organs and uteri. When it is ingested, it has been shown in clinical studies to positively affect blood fats, dry eye, the aggregation of platelets that can cause heart disease and even reduce system-wide inflammation. Woo-woo? Hardly; my point is that sea buckthorn oil has been studied in scientifically-sound, clinical trials.

In a study published online in the journal Maturitas, 116 women were asked to take sea buckthorn oil (3 capsules, or 3 gm daily) or placebo for three months. Vaginal mucous membranes were examined both at the beginning of the trial and at the end and were analyzed for elasticity, integrity, moisture and fluid. The women were asked to score the severity of their symptoms — vaginal dryness, burning and itching — at the beginning, middle and end of the trial and also and also kept diaries on other menopausal symptoms.

Sea buckthorn oil was shown to significantly improve the integrity of the vaginal lining by about 50% compared to placebo; women taking the oil trended toward increases in their vaginal health index, which was a composite of all vaginal atrophy symptom scores (i.e. elasticity, integrity, moisture, fluid and pH). Sea buckthorn oil also appeared to decrease night sweats but did not appear to benefit other menopausal symptoms. Moreover, while the women taking the oil experienced improvements in their vaginal symptoms from the start to the end of the study, the difference compared to placebo was not significant enough to demonstrate the lack of a placebo effect and clearly, more research is needed. Another important finding was the lack of effect on cell types, which indicates that sea buckthorn oil does not have an estrogen effect. Finally, common side effects, which affected both groups about equally, included GI symptoms. Because sea buckthorn oil may slow clotting, it is not recommended that it be taken along with other agents that likewise, affect clotting, such as aspirin, ibuprofen and warfarin.

It is unclear whether or not topical use of sea buckthorn oil might provide greater comfort without some of the GI side effects. A quick search shows that it is readily available online and depending on the formulation, retails for anywhere from $12 to $30. As always, use caution and speak to a knowledgeable practitioner before starting any regimen with sea buckthorn oil. Most importantly, it is nice to know that researchers continue to explore avenues other than hormones for common conditions like vaginal atrophy.