Oral pilocarpine can moisten a dry vagina

Pilocarpine is a medicine used to treat dryness of the mouth, throat and the eyes, considered by the World Health Organisation as an essential medicine.

Dryness is usually caused by cancer treatment or Sjogren’s syndrome and the drug works by increasing the amount of saliva or natural lubricant. Pilocarpine is a prescribed drug usually in oral tablet form but comes in eye drops.

What the research says

The 12-week study was conducted on four perimenopausal women with vaginal dryness primarily caused by chemotherapy. They made sure that the women who participated had a minimum of two months of vaginal dryness.

The women were given 5mg of oral pilocarpine four times a day, with assessments done during week six and twelve, measured on a standard ‘visual analogue scale’ or VAS.

Side effects of pilocarpine

Side effects were considered ‘mild’ and were already known for the drug, and didn’t interfere with treatment, however, that is not to say they were enjoyable or not an issue: side effects vary from person to person.

For pilocarpine, the known side effects may include a general ‘moistening’ of everything: runny nose, sweating, increased urge to urinate, but can include chills, flushing, dizziness, weakness or diarrhoea.

Each of the four participants reported marked clinical improvement in their vaginal condition and reduced vaginal dryness. The expectation was 25mm VAS improvement after the study, but all four reported more.

Three recorded 40mm or more, one recorded 28mm. It was concluded in this particular study that oral pilocarpine was able to stimulate moisture production in the vaginal area. Pilocarpine is prescription-only.

References

Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 22, No 14S (July 15 Supplement), 2004: 8099  

Loprinzi CL, Balcueva EP, Liu H, et al. A phase III randomized, double-blind, placebo-controlled study of pilocarpine for vaginal dryness: North Central Cancer Treatment group study N04CA. J Support Oncol. 2011;9(3):105-112. doi:10.1016/j.suponc.2011.02.005

Oral pilocarpine to treat vaginal xerosis associated with chemotherapy-induced amenorrhea in pre-menopausal womenF. G. Le Veque and S. HendrixJournal of Clinical Oncology 2004 22:14_suppl, 8099-8099



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Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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