Efficacy and Safety of Intravaginal Isoflavone Gel versus Estriol Cream for the Treatment of Genitourinary Syndrome of Menopause

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 397–408

DOI: 10.46882/2026/IJOG/000510

Original Research Article

Title: Efficacy and Safety of Intravaginal Isoflavone Gel versus Estriol Cream for the Treatment of Genitourinary Syndrome of Menopause

Names of Authors: Mariam T. Bello¹, Grace E. Effiong²

Authors’ Affiliations:
¹ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University Hospital, Ibadan, Nigeria
² Department of Public Health, University of Calabar, Calabar, Nigeria

Abstract:
Genitourinary Syndrome of Menopause (GSM) is characterized by chronic vulvovaginal atrophy that requires effective local therapy. This randomized active-controlled trial compared the non-hormonal efficacy of an intravaginal isoflavone gel against topical estriol cream for mitigating GSM symptoms in postmenopausal women with contraindications to systemic hormone therapies. One hundred and sixty postmenopausal patients presenting with moderate-to-severe vaginal dryness or dyspareunia were randomized into two equal groups (n = 80 per group) to apply either 4% isoflavone gel or 0.1% estriol cream three times weekly for 12 weeks. Primary outcomes included changes in the Vaginal Health Index (VHI) score, vaginal pH, and subjective symptom relief. After 12 weeks of treatment, the mean VHI score increased significantly in both groups (isoflavone: 12.4 ± 1.5 to 19.8 ± 2.1, p < 0.001; estriol: 12.1 ± 1.4 to 21.4 ± 2.3, p < 0.001). Mean vaginal pH dropped below 5.0 in both arms (p < 0.001). Subjective improvement in vaginal dryness was reported by 78.8% of the isoflavone cohort and 85.0% of the estriol cohort, demonstrating non-inferiority of the phytoestrogen gel (p = 0.31). No significant variations in endometrial thickness were noted on transvaginal ultrasound in either group (p > 0.05). Local burning sensations were slightly more frequent in the estriol cream cohort (p = 0.042). Intravaginal isoflavone gel represents an effective, safe non-hormonal alternative that successfully restores vaginal epithelial health and mitigates genitourinary symptoms in postmenopausal women.

Keywords: Genitourinary Syndrome of Menopause; Phytoestrogens; Isoflavone Gel; Estriol Cream; Vulvovaginal Atrophy; Vaginal pH.

Manuscript Timeline: Received: June 03, 2026; Revised: July 22, 2026; Accepted: August 07, 2026; Published: August 26, 2026.

Citation: Bello MT, Effiong GE. Efficacy and Safety of Intravaginal Isoflavone Gel versus Estriol Cream for the Treatment of Genitourinary Syndrome of Menopause. International Journal of Obstetrics and Gynecology. 2026; 14(8): 397–408.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 409–420

DOI: 10.46882/2026/IJOG/000511

Original Research Article

Title: Evaluation of Single-Incision Laparoscopic Surgery versus Conventional Laparoscopy for Total Hysterectomy in Benign Uterine Disease

Names of Authors: Chidi E. Eze¹, Aisha M. Umar²

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
² Department of Obstetrics and Gynecology, Federal Medical Centre, Katsina, Nigeria

Abstract:
Single-Incision Laparoscopic Surgery (SILS) aims to minimize operative entry morbidity by consolidating access ports within a single umbilical incision. This prospective randomized trial compared the perioperative results, postoperative pain patterns, and cosmetic satisfaction scores of SILS total laparoscopic hysterectomy (TLH) against standard multi-port conventional laparoscopy (CL) for benign uterine conditions. One hundred and forty women requiring hysterectomy for symptomatic uterine fibroids or adenomyosis (uterine size ≤ 14 weeks) were randomized to either the SILS-TLH group (n = 70) or the CL-TLH group (n = 70). The mean operative time was significantly longer in the SILS cohort due to instrument crowding and restricted triangulation features (84.5 ± 15.2 minutes vs. 62.8 ± 11.4 minutes, p < 0.001). However, SILS-TLH patients experienced significantly lower visual analog scale pain scores at 12 hours post-surgery (2.4 ± 0.6 vs. 3.8 ± 1.1, p < 0.001), leading to a 30.0% reduction in postoperative ward analgesic use. The cosmetic outcome score evaluated 6 weeks postoperatively was significantly higher in the single-incision arm (9.6 ± 0.4 vs. 7.8 ± 0.9, p < 0.001). The frequencies of vault hematoma, wound infection, and secondary readmissions did not show clinical divergence between the groups (p > 0.05). SILS for total laparoscopic hysterectomy is a technically demanding yet safe procedure that increases operative duration but offers lower early postoperative pain and superior cosmetic outcomes compared to conventional multi-port laparoscopy.

Keywords: Single-Incision Laparoscopic Surgery; Total Laparoscopic Hysterectomy; Benign Uterine Disease; Postoperative Pain; Cosmetic Satisfaction; Port Morbidity.

Manuscript Timeline: Received: June 05, 2026; Revised: July 24, 2026; Accepted: August 08, 2026; Published: August 30, 2026.

Citation: Eze CE, Umar AM. Evaluation of Single-Incision Laparoscopic Surgery versus Conventional Laparoscopy for Total Hysterectomy in Benign Uterine Disease. International Journal of Obstetrics and Gynecology. 2026; 14(8): 409–420.

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