Why consider vaginal drug administration?
Open accessAbstract
Objective To review the anatomy and physiology of the vagina, the merits of vaginal drug administration, and the currently available vaginal drug-administration systems.Design Review of basic and clinical research.Result(s) Although clinicians commonly use topically administered drugs in the vagina, this route for systemic drug administration is somewhat novel. Experience with a variety of products demonstrates that the vagina is a highly effective site for drug delivery, particularly in women's health. The vagina is often an ideal route for drug administration because it allows for the administration of lower doses, steady drug levels, and less frequent administration than the oral route. With vaginal drug administration, absorption is unaffected by gastrointestinal disturbances, there is no first-pass effect, and use is discreet. Knowledge of anatomy, physiology, histology, and immunology of the vagina should allow clinicians to reassure their patients concerning this mode of delivery. Greater understanding and experience by clinicians should lead to increased use and acceptance of the vagina as a route for drug administration.Conclusion(s) The safety and efficacy of vaginal administration have been well established. The vaginal route of drug delivery is acceptable and may even be a preferable route of administration for many drugs, particularly hormones, whether for contraception or postmenopausal estrogen therapy.
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Any drug is better than placebo for pain relief.
“Moreover, allocating suffering women to a placebo arm is ethically questionable, and it has already been repeatedly demonstrated that any drug is better than placebo for pain relief [102,103].”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [102]
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Flagged first, then by citations
Cited by
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- Authors
- Alexander, N. J., Baker, E., Kaptein, M., Karck, U., Miller, L., & Zampaglione, E.
- Affiliations
- Rutgers New Jersey Medical School (US)
- Klinikum Stuttgart (DE)
- University of Washington (US)
- Corresponding author
- Alexander, Nancy J
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2004-07
- Volume
- 82
- Issue
- 1
- Pages
- 1-12
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W1981676903
- Cited by
- 269
- References
- 116
- Citations by year
- 2026: 17 · 2025: 21 · 2024: 18 · 2023: 16 · 2022: 17 · 2021: 16 · 2020: 12 · 2019: 10 · 2018: 12 · 2017: 11 · 2016: 8 · 2015: 7 · 2014: 19 · 2013: 15 · 2012: 11
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advanced Drug Delivery Systems
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advancements in Transdermal Drug Delivery
- Keywords
- vaginal administration, vaginal absorption, first-pass metabolism avoidance, women's health, hormonal contraception, postmenopausal estrogen therapy
- MeSH terms
- Administration, Intravaginal, Contraceptive Devices, Female, Equipment Design, Female, Humans, Hydrogen-Ion Concentration, Immune System, Patient Acceptance of Health Care, Vagina, Estrogen Replacement Therapy, Drug Delivery Systems, History, 20th Century
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