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Effect of a novel herbal vaginal suppository containing myrtle and oak gall in the treatment of vaginitis: a randomized clinical trial

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Abstract

Background

Uncomplicated infections such as candidiasis, bacterial vaginosis (BV), or trichomoniasis are easy to diagnose and treat. However, about 8% of patients will have a more complicated course with failure to respond to treatment or rapid recurrence of symptoms. There are many suggestions in Traditional Persian Medicine like myrtle (Myrtus communis L.) and oak gall (Quercus infectoria G.Olivier) for treatment of vaginitis.

Objectives

A clinical trial was designed to assess the efficacy of a novel herbal suppository, containing myrtle and oak gall (MOGS) in treatment of vaginitis.

Methods

In a parallel randomized clinical trial, 120 women with vaginitis were randomly assigned to MOGS, metronidazole, or placebo. Formulation was simulated from traditional Persian manuscripts and MGOS was prepared after pharmaceutical optimization processing as well as quantification of gallic acid by HPLC. The study was double-blind for MOGS and placebo and single-blind for metronidazole group.

Results

MOGS effectively improved vaginal discharge (p = 0.024 for BV and 0.018 for trichomoniasis) and pH (compared to placebo (p = 0.013) and metronidazole (p = 0.001)). Both MOGS and metronidazole could reverse whiff test. Metronidazole was the best medication for making Nugent score negative (p = 0.005) as well as the best therapy according to laboratory findings to treat BV in comparison with placebo (p = 0.021). While for trichomoniasis, MOGS could improve the disease more successfully (p = 0.001). Both MOGS and metronidazole treated mixed vaginitis (p = 0.002).

Conclusion

MOGS would be a chance for developing new treatment for trichomoniasis.

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Abbreviations

ADR:

Adverse Drug Reaction

BMI:

Body Mass Index

BV:

Bacterial vaginosis

CAM:

Complementary and Alternative Medicine

Dif:

difference

MOGS:

Myrtle and Oak Gall suppository

PEG:

Polyethylene glycol

TPM:

Traditional Persian Medicine

TV:

Trichomonas vaginitis

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Authors and Affiliations

  1. Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

    Sayyede Fatemeh Askari & Abdolali Mohagheghzadeh

  2. Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Bahia Namavar Jahromi & Afsoon Zarei

  3. Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Bahia Namavar Jahromi & Afsoon Zarei

  4. Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Amirreza Dehghanian

  5. Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mojgan Tansaz

  6. Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Parmis Badr, Amir Azadi & Abdolali Mohagheghzadeh

  7. Phytopharmaceutical Technology and Traditional Medicine Incubator, Shiraz University of Medical Sciences, Shiraz, Iran

    Parmis Badr

  8. Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

    Amir Azadi

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  1. Sayyede Fatemeh Askari
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Contributions

Design of the study, B.N.J., A.D., A.A., P.B. and A.M.; Lab work and acquisition clinical data, S.F.A.; Drafting the article and revising, S.F.A., B.N.J., M.T., A.D., A.A. and A.M.; Supervision, B.N.J., A.D., P.B., A.Z., A.A. and A.M. All authors are in agreement with the content of the manuscript.

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Correspondence to Abdolali Mohagheghzadeh.

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Festschrift in honor of late Professor Dr. Seyed Hadi Samsam-Shariat, Isfahan School of Pharmacy

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Askari, S.F., Jahromi, B.N., Dehghanian, A. et al. Effect of a novel herbal vaginal suppository containing myrtle and oak gall in the treatment of vaginitis: a randomized clinical trial. DARU J Pharm Sci 28, 603–614 (2020). https://doi.org/10.1007/s40199-020-00365-6

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