Mucoadhesive Drug Delivery Systems for Vaginal Administration

The vaginal route of drug administration offers significant advantages for both local and systemic therapy due to its large absorptive surface area, rich vascularization, avoidance of first-pass hepatic metabolism, and reduced gastrointestinal degradation. However, conventional vaginal dosage forms such as creams, gels, tablets, and suppositories often exhibit limited therapeutic effectiveness because of rapid mucus turnover, vaginal self-cleansing, pH variability, formulation leakage, and poor patient compliance. To overcome these limitations, mucoadhesive drug delivery systems (MDDS) have emerged as a promising approach to improve vaginal drug delivery outcomes. By establishing prolonged and intimate contact with the vaginal mucosa through physicochemical interactions between polymers and mucin, mucoadhesive systems enhance formulation residence time. This review provides a comprehensive overview of vaginal anatomy and physiology, challenges in vaginal drug delivery, mechanisms of mucoadhesion, and the role of mucoadhesive polymers. Various mucoadhesive dosage forms, evaluation parameters, therapeutic applications, recent advancements, and future clinical and regulatory challenges are also discussed.