CellMed

Menopause, also known as climacteric, marks the end of the menstrual cycle and reproductive ability and typically occurs between 45 and 55 years of age.¹ Physiologically, menopause is characterized by a decrease in estrogen and progesterone hormone production by the ovaries. In the years leading up to menopause, menstrual cycles become irregular, with symptoms like hot flashes, mood swings, vaginal dryness, and sleep disturbances. During menopause, estrogen levels show significant fluctuations and can be 20-30% higher. Post-menopause, a decrease in estrogen causes thinning of the epithelial cells and an increase in vaginal pH levels.² Hormonal changes can trigger vaginal dryness, commonly seen in postmenopausal women.^3,4 Menopause, while not a disease or disability, is a natural phase of life. However, when the accompanying physical and psychological changes substantially interfere with a woman's daily life, seeking treatment may be appropriate. In the context of hormone therapy for menopausal symptoms, women who have had their uterus removed typically receive estrogen-only treatment. Conversely, those who still have their uterus are prescribed a regimen that combines both estrogen and progesterone, tailored to their unique physiological needs. Although these treatments can be suitable for treating menopausal symptoms like hot flashes, it has been reported to increase the risk of stroke and thrombosis.^5,6

The patient in this case experienced severe vaginal dryness post-menopause, causing discomfort in daily life. This report aims to discuss the application of OCNT to such symptoms.

1. Subject

A case of a patient with vaginal dryness was studied.

1) Name: Park O O (Female/54)

2) Diagnosis: Vaginal Dryness

3) Onset date: January 2023

4) Treatment period: From July 17, 2023, to present

5) Symptoms: Vaginal Dryness

6) Past medical history: None

7) Social history: None

8) Family history: None

9) Current medical condition and medication: Synthroid and iodine for hypothyroidism

2. Method

- OCNT Details

Cyaplex A Granule (101, twice daily, one sachet each time)

Eufaplex Alpha Capsule (303, twice daily, three pills each time)

Bioplex (101, twice daily, one sachet)

After noticing improvement in symptoms, continued only with Bioplex (001, once daily, one sachet).

The patient had been experiencing severe vaginal dryness since early 2023, post-menopause. She visited the pharmacy to purchase lubricants, which provided only temporary relief. Thus, she sought a more fundamental solution. About 10 days after starting OCNT, the symptoms improved, and the patient felt better overall. Later, constipation developed, and additional OCNT was implemented, which successfully alleviated this discomfort.

It is natural for reproductive capacity to decrease with aging, especially in middle-aged women. Vaginal dryness during menopause is linked to estradiol concentration.⁷ Symptoms like vaginal dryness are more frequent in women with postmenopausal blood estradiol levels below 50 pg/ml. Estradiol, along with estrone and estriol, is classified as estrogen and is considered the most potent, playing a functional role. Various studies have shown that hormone replacement therapy supplying estrogen has positive effects on menopausal symptoms like vaginal dryness.^8-11 Such estrogen therapy has been shown to improve symptoms and quality of life in postmenopausal women. Studies have reported that taking oral estrogen for a month reduced menopausal symptoms like hot flashes, sleep disturbances, and vaginal dryness, with effects lasting about two years.¹²

Linolenic acid in Eufaplex has been reported to increase blood estradiol levels in rats undergoing oophorectomy.¹³ Linolenic acid, which must be ingested through diet, is beneficial for postmenopausal women's health and is metabolized into eicosanoids such as arachidonic acid, prostaglandins, leukotrienes, and thromboxanes.^14,15 Eicosanoids are known to perform various functions like regulating blood vessel and muscle contraction and expansion, blood clotting, lipid metabolism in the blood, fever, inflammation, and pain in response to injury and infection.¹⁶ Thus, linolenic acid supplementation could potentially contribute to increasing postmenopausal decreased estrogen levels and alleviate symptoms like vaginal dryness. Antioxidants protect the body from damage caused by oxidation. Recent studies have shown that estrogen regulates the expression of antioxidant enzymes. Postmenopausal women receiving estrogen showed increased resistance to oxidative stress and atherosclerosis risk, indicating that they generally experience a decline in antioxidant capabilities due to estrogen loss. Cyaplex A contains powerful antioxidants like anthocyanins, which can help boost antioxidant power in patients suffering from estrogen deficiency.¹⁷

The patient in this case study represents a single case and may not apply to all patients but showed relatively quick improvement in symptoms. Using OCNT to resolve constipation symptoms significantly improved the patient's quality of life. This report is presented with the patient's consent.