Sexual dysfunction is a common complication of menopause. Estrogen therapy, administered orally or vaginally, can reduce symptoms of vaginal atrophy and improve sexual function in postmenopausal women. However, estrogen therapy can be associated with serious side effects and may not be appropriate for some women. Effective alternative non-hormonal options are needed for postmenopausal women with sexual dysfunction. Fennel (Foeniculum vulgare, Apiaceae) seeds have been used medicinally for centuries and reported to have estrogenic effects. The purpose of this randomized, double-blind, placebo-controlled trial was to evaluate the effects of fennel vaginal cream on sexual function in postmenopausal women.
Postmenopausal women (n = 60, aged 45-65 years) were enrolled at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran. Included patients had confirmed menopause, lived with their husbands, were sexually active, and had sexual dysfunction (scoring < 26 on the Female Sexual Function Index [FSFI]). Excluded patients had vaginal bleeding, vaginal infection was taking phytoestrogens, or was receiving hormone therapy. Patients were randomly assigned to receive a vaginal cream containing fennel or placebo. They were instructed to use 5 g of cream every night for eight weeks. The fennel and placebo creams were prepared at the Pharmacology School Laboratory of Ahvaz Jundishapur University of Medical Sciences. The fennel cream was prepared with an 80% ethanolic extract of fennel seeds. The extract was incorporated at 5% into a cream base containing preservatives. The placebo cream had the same color and appearance as the fennel cream. Women completed a demographic questionnaire at baseline and completed the FSFI before and after the eight-week intervention. Vaginal atrophy symptoms and vaginal pH and cytology were also evaluated, and those results were published separately.
All 60 patients completed the study. There were no significant differences in demographic characteristics between the fennel and placebo groups at baseline. The total sexual function score on the FSFI improved significantly more in the fennel group compared to the placebo group (P < 0.001). Individual scores for each of the six domains in the FSFI (sexual desire, arousal, lubrication, orgasm, satisfaction, and pain) improved significantly more in the fennel group compared to the placebo group (all P < 0.001). No adverse events were reported by patients in either group.
In this study, the use of fennel vaginal cream improved several aspects of sexual function in postmenopausal women. The first part of the study (published separately) found beneficial effects of fennel cream on vaginal cytology, pH, and atrophy. The authors explain one limitation of the study is the relatively short duration. Interventions lasting longer than eight weeks are needed to better assess such treatment. Despite this limitation, the authors conclude that “fennel vaginal cream is an effective means to improve the sexual activity of postmenopausal women. The use of this product in women who have sexual dysfunction and contraindications for hormone therapy is recommended.” The authors disclose no conflicts of interest. The study was funded by Ahvaz Jundishapur University of Medical Sciences.
Abedi P, Najafian M, Yaralizadeh M, Namjoyan F. Effect of fennel vaginal cream on sexual function in postmenopausal women: A double-blind randomized controlled trial. J Med Life. January-March 2018;11(1):24-28.