Grand Rounds

Does pH-Balanced Vaginal Gel Improve Dyspareunia in Breast Cancer Survivors?

BACKGROUND AND PURPOSE:

Dyspareunia and sexual dysfunction often occur in breast cancer survivors following adjuvant therapy
Vaginal gels can be used as treatment for dyspareunia
This study by Kim et al. (Obstetrics & Gynecology, 2017) sought to determine if pH-balanced vaginal gel using allayed the symptoms of dyspareunia in breast cancer survivors who were premenopausal at the time of diagnosis

Randomized Controlled Trial
Breast cancer survivors, who were diagnosed when they were premenopausal, and who experienced dyspareunia, were included in the study
- 69 women were randomized to receive pH-balanced gel containing lactic acid
- 67 women were randomized to receive a lactate-free placebo gel
The gel was applied 3 times weekly before bed, as well as before intercourse, for eight weeks

Both groups demonstrated the following benefits although there were no differences between groups
- Significant decrease in pain during intercourse
- Significant improvement in overall Female Sexual Function Index score
- Improvement in sexual dysfunction
In the pH-balanced group but not the placebo group:
- Vaginal pH (indicator strip) decreased slightly (median from 6.5 to 5.5; P<.01)
- Vaginal maturation index (sum of percentages of superficial cells, intermediate cells, and parabasal cells on smear) increased slightly (from 46.0 to 48.5; P<.01).
Neither group experienced severe adverse events

pH-balanced vaginal gel is no better than a placebo gel for improving sexual function and dyspareunia in breast cancer survivors who were premenopausal at time of diagnosis

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