The effect of intra-vaginal Oxytocin on sexual function in nursing mothers: A randomized double-blinded controlled trial

Abstract

ABSTRACT Background: Sexual desire changes at different times in a woman's life, and it can be said that one of these periods that changes sexual function is the postpartum period. In the postpartum period, changes such as pain during intercourse, lack of sexual desire, vaginal dryness and not reaching orgasm occur, which can affect a woman's sexual response cycle. Considering the importance of sexual relationship during breastfeeding, the high prevalence of sexual dysfunction during this period (especially dyspareunia caused by atrophic vaginitis), lack of effective interventions, the present research determined the effect of oxytocin (OXT) vaginal gel on sexual function (primary outcome), sexual satisfaction, depression, and the side effects (secondary outcomes) in the breastfeeding mothers. Methods: This randomized triple-blinded controlled trial was conducted on 64 breastfeeding meother who referred to health centers in the city of Tabriz, Iran, in 2020-21. Participants were randomly assigned to intervention/control groups using block randomization. 200 units of OXT vaginal gel was given to the participants in the intervention group daily for eight week and the same protocol was carried out for the control group with placebo. Standard questionnaires of Female Sexual Fucetion Index (FSFI), Edinburgh Postpartum Depression Scale (EPDS) and Sexual satisfaction scale for women (SSSW) were completed before and 8 weeks after intervention. Independent t-test and ANCOVA were used to compare difference between groups before and after intervention. Results: The total score of FSFI was increased eight week after the intervention in both groups, comparing the mean of the two groups was not statistically significant after adjusting the baseline value (Adjusted Mean Difference (AMD): 1.14; 95% Confidence Interval (95% CI): -1.28 to 9.16; P= 0.349). The mean sexual satisfaction in all domains was slightly increased after the intervention in both groups. However, the sexual contentment was increased significantly more in the OXT group than in the placebo group after intervention in comparison to all other domains (AMD: 1.56; 95% CI: 0.29 to 2.83; P=0.017). The mean depression score in the OXT group was significantly lower than that of the placebo group after intervention with adjusting the baseline value (AMD: -1.90; 95% CI: -1.27 to -2.54; P<0.001). One participant in the OXT group and one participant in the placebo group reported mild uterine contraction and one person in the placebo group reported vaginal burning sensations. Conclusions: The results of this study do not support the effects of OXT gel in the improvement of FSFI, even though, OXT significantly improved sexual satisfaction in the domain of contentment, and improved the symptoms of depression in comparison to the placebo group. However, a definite conclusion requires more research in this regard.