Efficacy of Hormonal and Non-hormonal Vaginal Gel Preparations on Female Sexual Satisfaction Index in Postmenopausal Women with Sexual Dysfunction Syndrome

We aimed to compare efficacy of vaginal gel preparations versus placebo in postmenopausal women with sexual dysfunction syndrome. We searched electronic databases from inception to January 2023. We included trials reporting Female Sexual Function Index (FSFI) which compared hormonal (estrogen, oxytocin) and/or non-hormonal (chamomile, fennel) interventions versus placebo. We used Cochrane Risk of Bias assessment tool I to evaluate studies quality. Eight trials (N=672 participants) were included. Total FSFI endpoint score was higher in the vaginal gel preparations group (MD: 6.67; 95% CI: [3.79, 9.55]; p< 0.001) than placebo. Non-hormonal gel preparations had higher FSFI total score (MD: 6.73, 95% CI: [4.7, 8.76], p< 0.001) than hormonal preparations (MD: 2.75, 95% CI: [1.87,3.64], p< 0.001). Non-hormonal interventions increased all FSFI domains. We conclude that Chamomile and fennel vaginal gel preparations could improve overall FSFI six domains score, which reflects on postmenopausal women's sexual activity and satisfaction. Keywords: menopause, psychological sexual dysfunction, estrogen, Chamomile, Meta-analysis