{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T02:19:42Z","timestamp":1768357182207,"version":"3.49.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004748","name":"Mashhad University of Medical Sciences","doi-asserted-by":"publisher","award":["4012284"],"award-info":[{"award-number":["4012284"]}],"id":[{"id":"10.13039\/501100004748","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Human sexuality is an important aspect of functionality, and many patients believe that it determines their quality of life. Sexual dysfunction can lead to stress, strained relationships, and a decrease in self-esteem. The majority of modern medical treatments for improving female sexual function are associated with significant side effects and high costs. Traditionally, M. communis has been used to treat sexual impotence. Here, we present the protocol of an interventional clinical phase II study to test the hypothesis that vaginal gel containing Myrtus communis extract can improve sexual function in women of reproductive age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods\/Design<\/jats:title>\n                    <jats:p>In a prospective, randomized, placebo-controlled and highly blind clinical phase II trial, 80 women aged 18--40 years with sexual dysfunction meeting the inclusion criteria will be randomized to an intervention group receiving a vaginal gel containing myrtle leaf extract (n\u2009=\u200938) or an active control group receiving a placebo gel with an identical appearance (n\u2009=\u200938). Randomization will be performed via a permuted block technique with random allocation software. This study will be conducted at the women\u2019s clinic of Imam Reza Hospital in Mashhad. Blinded assessments of outcome variables will be conducted twice: before treatment and one month after treatment. The primary outcome measure was sexual function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This randomized controlled clinical trial evaluates the efficacy of the vaginal gel Myrtus communis on the sexual function of married women during reproductive age. The study design presented here fulfills the criteria of a high-quality clinical phase II trial of sexual function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>IRCT.behdasht.gov.ir Identifier: IRCT20230723058892N1<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0338732","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T18:39:20Z","timestamp":1768329560000},"page":"e0338732","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effects of vaginal gel from Myrtus communis on the sexual function of married women during reproductive aging: A study protocol for a randomized controlled trial"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-4240","authenticated-orcid":true,"given":"Bahareh","family":"khajehpour","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6323-7249","authenticated-orcid":true,"given":"Raheleh","family":"Babazadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roshanak","family":"Salari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamshid","family":"Jamali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malihe","family":"Mahmoudinia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"pone.0338732.ref001","article-title":"Therapeutic interventions conducted on improving women\u2019s sexual satisfaction and function during reproductive ages in Iran: A systematic review","author":"E Ahmadnia","year":"2023","journal-title":"Journal Title Abbreviation Needed"},{"issue":"6","key":"pone.0338732.ref002","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1097\/YCO.0000000000000362","article-title":"Affective disorders and sexual function: from neuroscience to clinic","volume":"30","author":"BC Barata","year":"2017","journal-title":"Curr Opin Psychiatry"},{"issue":"2","key":"pone.0338732.ref003","doi-asserted-by":"crossref","first-page":"227","DOI":"10.4314\/ahs.v18i2.5","article-title":"Effect of pregnancy on sexual function of couples","volume":"18","author":"ZB Khalesi","year":"2018","journal-title":"Afr Health Sci"},{"issue":"4","key":"pone.0338732.ref004","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.mcna.2019.02.008","article-title":"Female sexual dysfunction","volume":"103","author":"AH Clayton","year":"2019","journal-title":"Med Clin North Am"},{"key":"pone.0338732.ref005","article-title":"Physiology of female sexual function and dysfunction","author":"JR Berman","year":"2005","journal-title":"Int J Impot Res"},{"issue":"6","key":"pone.0338732.ref006","doi-asserted-by":"crossref","first-page":"378","DOI":"10.5455\/msm.2014.26.378-381","article-title":"A review of affecting factors on sexual satisfaction in women","volume":"26","author":"Z Shahhosseini","year":"2014","journal-title":"Mater Sociomed"},{"issue":"1","key":"pone.0338732.ref007","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/S1697-2600(14)70038-9","article-title":"A systematic review of sexual satisfaction","volume":"14","author":"M S\u00e1nchez-Fuentes M del","year":"2014","journal-title":"International Journal of Clinical and Health Psychology"},{"issue":"2","key":"pone.0338732.ref008","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1080\/00224499.2020.1784827","article-title":"Female Sexual Satisfaction and Sexual Identity","volume":"58","author":"LL Holt","year":"2021","journal-title":"J Sex Res"},{"issue":"19","key":"pone.0338732.ref009","doi-asserted-by":"crossref","first-page":"11921","DOI":"10.3390\/ijerph191911921","article-title":"Sexual Dysfunction in Women with Cancer: A Systematic Review of Longitudinal Studies","volume":"19","author":"T Sousa Rodrigues Guedes","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"pone.0338732.ref010","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s00737-015-0535-y","article-title":"An update on sexual function and dysfunction in women","volume":"18","author":"M Khajehei","year":"2015","journal-title":"Arch Womens Ment Health"},{"key":"pone.0338732.ref011","unstructured":"Farahmand M, Tehrani FR. The effect of medicinal plants in the treatment of sexual disorders: a narrative review. 2021."},{"issue":"2","key":"pone.0338732.ref012","doi-asserted-by":"crossref","first-page":"114","DOI":"10.52547\/ismj.25.2.114","article-title":"Prevalence of and Factors Affecting Sexual Dysfunction in Women of Reproductive Age","volume":"25","author":"F Ahmadi","year":"2022","journal-title":"Iran South Med J"},{"issue":"6","key":"pone.0338732.ref013","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/j.jsxm.2020.01.029","article-title":"Female Orgasm and Overall Sexual Function and Habits: A Descriptive Study of a Cohort of U.S. Women","volume":"17","author":"O Shaeer","year":"2020","journal-title":"J Sex Med"},{"key":"pone.0338732.ref014","first-page":"346","article-title":"Surveying the relationship between adult attachment style to parents with female sexual function","volume":"13","author":"P Salari","year":"2011","journal-title":"Journal of Fundamentals of Mental Health"},{"key":"pone.0338732.ref015","first-page":"62","article-title":"The Effect of the medicinal plants on sexual function in Postmenopausal Women in Iran: a systematic review of clinical trials","volume":"30","author":"FZ Karimi","year":"2023","journal-title":"Journal of Sabzevar University of Medical Sciences"},{"issue":"42","key":"pone.0338732.ref016","first-page":"23","article-title":"The effect of sexual health education on couples\u2019 sexual satisfaction","volume":"15","author":"A Karimi","year":"2013","journal-title":"The Iranian Journal of Obstetrics, Gynecology and Infertility"},{"issue":"4","key":"pone.0338732.ref017","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.ogc.2006.10.003","article-title":"Categories of female sexual dysfunction","volume":"33","author":"P Amato","year":"2006","journal-title":"Obstet Gynecol Clin North Am"},{"issue":"7","key":"pone.0338732.ref018","first-page":"66","article-title":"The effect of pomegranate peel gel on orgasm and sexual satisfaction of women in reproductive age: A tripleblind, randomized, controlled clinical trial","volume":"22","author":"F Mohammadzadeh","year":"2019","journal-title":"The Iranian Journal of Obstetrics, Gynecology and Infertility"},{"key":"pone.0338732.ref019","unstructured":"Aradmehr M, Senobari M. Effect of medicinal plant of roses on sexual dysfunction of female and male subjects: a systematic review of clinical trials. 2020."},{"issue":"8","key":"pone.0338732.ref020","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1002\/ptr.5122","article-title":"Review of pharmacological effects of Myrtus communis L. and its active constituents","volume":"28","author":"G Alipour","year":"2014","journal-title":"Phytother Res"},{"issue":"14","key":"pone.0338732.ref021","doi-asserted-by":"crossref","DOI":"10.14814\/phy2.15770","article-title":"A review of the biological effects of Myrtus communis","volume":"11","author":"MM Dabbaghi","year":"2023","journal-title":"Physiol Rep"},{"issue":"4","key":"pone.0338732.ref022","first-page":"239","article-title":"Effect of hydro alcoholic leaf extract of Myrtus communis on pituitary-gonad axis in adult male rat","volume":"2","author":"M Shariati","year":"2018","journal-title":"Journal of Alternative Veterinary Medicine"},{"key":"pone.0338732.ref023","first-page":"8","article-title":"The effect of phoenix dactylifera (date-palm) pit powder on testosterone level and germ cells in adult male rats","volume":"15","author":"M Shariati","year":"2007","journal-title":"Journal of Advances in Medical and Biomedical Research"},{"issue":"9","key":"pone.0338732.ref024","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1002\/ptr.5188","article-title":"Review of the botanical characteristics, phytochemistry, and pharmacology of Astragalus membranaceus (Huangqi)","volume":"28","author":"J Fu","year":"2014","journal-title":"Phytother Res"},{"issue":"3","key":"pone.0338732.ref025","first-page":"45","article-title":"Tannins are astringent","volume":"1","author":"PK Ashok","year":"2012","journal-title":"Journal of Pharmacognosy and Phytochemistry"},{"key":"pone.0338732.ref026","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.jep.2016.09.054","article-title":"Myrtus communis L. and its application in treatment of Recurrent Aphthous Stomatitis","volume":"193","author":"M Mahboubi","year":"2016","journal-title":"J Ethnopharmacol"},{"issue":"6","key":"pone.0338732.ref027","doi-asserted-by":"crossref","first-page":"3365","DOI":"10.1002\/ptr.7056","article-title":"Morus nigra L. extract prolongs survival of rats with hepatocellular carcinoma","volume":"35","author":"S Hooshmand","year":"2021","journal-title":"Phytother Res"},{"issue":"2","key":"pone.0338732.ref028","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1111\/j.1743-6109.2011.02553.x","article-title":"The Female Sexual Function Index: translation and validation of an Iranian version","volume":"9","author":"A Fakhri","year":"2012","journal-title":"J Sex Med"},{"issue":"2","key":"pone.0338732.ref029","first-page":"269","article-title":"Validity of the Persian version of female sexual function index-FSFI scale as the female sexual function index","volume":"7","author":"K Mohammadi","year":"2008","journal-title":"J Payesh"},{"key":"pone.0338732.ref030","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1002\/jclp.21908","article-title":"The Depression Anxiety Stress Scales-21 (DASS-21): further examination of dimensions, scale reliability, and correlates","volume":"68","author":"A Osman","year":"2012","journal-title":"J Clin Psychol"},{"issue":"10","key":"pone.0338732.ref031","first-page":"57","article-title":"Effect of squill on the sexual function among women of reproductive age","volume":"21","author":"M Abbasi Pirouz","year":"2018","journal-title":"The Iranian Journal of Obstetrics, Gynecology and Infertility"},{"issue":"36","key":"pone.0338732.ref032","doi-asserted-by":"crossref","first-page":"3762","DOI":"10.2174\/1381612827666210719104950","article-title":"Female Sexual Dysfunction: A Problem Hidden in the Shadows","volume":"27","author":"KP Imprialos","year":"2021","journal-title":"Curr Pharm Des"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0338732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T18:39:26Z","timestamp":1768329566000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0338732"}},"subtitle":[],"editor":[{"given":"Akingbolabo Daniel","family":"Ogunlakin","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,13]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0338732","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,13]]}}}