Vaginal Vitamin E for Treatment of Genitourinary Syndrome of Menopause: A Systematic Review of Randomized Controlled Trials
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Genitourinary syndrome of menopause significantly affects the quality of life in postmenopausal women with few evidence-based alternatives to vaginal estrogen for women with contraindications. This systematic review evaluates the evidence for vaginal vitamin E efficacy in reducing patient-reported genitourinary symptoms in healthy postmenopausal women compared to placebo or vaginal control therapy. This systematic review evaluated randomized controlled trials before October 2020 that assessed the efficacy of vitamin E vaginal suppositories in reducing genitourinary symptoms in postmenopausal women compared with a control group of healthy postmenopausal women. Outcomes included patient-perceived genitourinary symptoms. Of the 31 studies, four met the inclusion criteria. One 8-week trial (n = 42) found a significant reduction in vaginal symptoms in the 1 mg vitamin E group than the placebo group (difference in means, 5.3; 95% confidence interval [CI], 4.4 to 6.2). Another 8-week trial (n = 40) found 5 mg vaginal hyaluronic acid superior to 1 mg vitamin E (difference in means –0.50, 95% CI, –0.95 to –0.05). Two 12-week trials (n = 52 in each) found no difference between 0.5 g vaginal estrogen and 100 IU vaginal vitamin E in healthy postmenopausal women (difference in means: –0.19, 95% CI, –4.4 to 4.0, and −3.47, 95% CI, −13.8 to 6.8). Evidence from small, limited studies suggests that vaginal vitamin E may be effective in alleviating symptoms of genitourinary syndrome of menopause; however, additional high-quality studies are needed to determine efficacy, ideal dosing, and long-term safety.
Abstract
Genitourinary syndrome of menopause significantly affects the quality of life in postmenopausal women with few evidence-based alternatives to vaginal estrogen for women with contraindications. This systematic review evaluates the evidence for vaginal vitamin E efficacy in reducing patient-reported genitourinary symptoms in healthy postmenopausal women compared to placebo or vaginal control therapy. This systematic review evaluated randomized controlled trials before October 2020 that assessed the efficacy of vitamin E vaginal suppositories in reducing genitourinary symptoms in postmenopausal women compared with a control group of healthy postmenopausal women. Outcomes included patient-perceived genitourinary symptoms. Of the 31 studies, four met the inclusion criteria. One 8-week trial (n = 42) found a significant reduction in vaginal symptoms in the 1 mg vitamin E group than the placebo group (difference in means, 5.3; 95% confidence interval [CI], 4.4 to 6.2). Another 8-week trial (n = 40) found 5 mg vaginal hyaluronic acid superior to 1 mg vitamin E (difference in means –0.50, 95% CI, –0.95 to –0.05). Two 12-week trials (n = 52 in each) found no difference between 0.5 g vaginal estrogen and 100 IU vaginal vitamin E in healthy postmenopausal women (difference in means: –0.19, 95% CI, –4.4 to 4.0, and −3.47, 95% CI, −13.8 to 6.8). Evidence from small, limited studies suggests that vaginal vitamin E may be effective in alleviating symptoms of genitourinary syndrome of menopause; however, additional high-quality studies are needed to determine efficacy, ideal dosing, and long-term safety.
참고문헌 (33)
- Mastroianni J, "Improving the identification of genitourinary syndrome of menopause through the utilization of the Day-to-Day Impact of Vaginal Aging questionnaire", Menopause, 27, pp.1295~1301 (2020)
- Gandhi J, "Genitourinary syndrome of menopause : an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management", Am J Obstet Gynecol, 215, pp.704~711 (2016)
- 김현경, "The Recent Review of the Genitourinary Syndrome of Menopause", 대한폐경학회지, 21(2), pp.65~71 (2015), 대한폐경학회
- "The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society", Menopause, 27, pp.976~992 (2020)
- Gabes M, "Measurement properties of patient-reported outcome measures(PROMs)for women with genitourinary syndrome of menopause : a systematic review", Menopause, 26, pp.1342~1353 (2019)
- DiBonaventura M, "The association between vulvovaginal atrophy symptoms and quality of life among postmenopausal women in the United States and Western Europe", J Womens Health (Larchmt), 24, pp.713~722 (2015)
- Nappi RE, "Women's voices in the menopause : results from an international survey on vaginal atrophy", Maturitas, 67, pp.233~238 (2010)
- Parish SJ, "Impact of vulvovaginal health on postmenopausal women : a review of surveys on symptoms of vulvovaginal atrophy", Int J Womens Health, 5, pp.437~447 (2013)
- Sturdee DW, "Recommendations for the management of postmenopausal vaginal atrophy", Climacteric, 13, pp.509~522 (2010)
- Palma F, "Vaginal atrophy of women in postmenopause. Results from a multicentric observational study: the AGATA study", Maturitas, 83, pp.40~44 (2016)
- Shifren JL, "Women's experience of vulvovaginal symptoms associated with menopause", Menopause, 26, pp.341~349 (2019)
- Karakoç H, "Genitourinary syndrome of menopause : effects on related factors, quality of life, and self-care power", Prz Menopauzalny, 18, pp.15~22 (2019)
- Constantine GD, "Behaviours and attitudes influencing treatment decisions for menopausal symptoms in five European countries", Post Reprod Health, 22, pp.112~122 (2016)
- Nachtigall LE, "Clinical trial of the estradiol vaginal ring in the U.S", Maturitas, 22(Suppl), pp.S43~S47 (1995)
- Bygdeman M, "Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women", Maturitas, 23, pp.259~263 (1996)
- Eriksen PS, "Low-dose 17 beta-estradiol vaginal tablets in the treatment of atrophic vaginitis : a double-blind placebo controlled study", Eur J Obstet Gynecol Reprod Biol, 44, pp.137~144 (1992)
- Lethaby A, "Local oestrogen for vaginal atrophy in postmenopausal women", Cochrane Database Syst Rev, 2016, pp.CD001500~ (2016)
- Manson JE, "Why the product labeling for low-dose vaginal estrogen should be changed", Menopause, 21, pp.911~916 (2014)
- Burton GW, "Is vitamin E the only lipidsoluble, chain-breaking antioxidant in human blood plasma and erythrocyte membranes?", Arch Biochem Biophys, 221, pp.281~290 (1983)
- Szczeklik A, "Dietary supplementation with vitamin E in hyperlipoproteinemias : effects on plasma lipid peroxides, antioxidant activity, prostacyclin generation and platelet aggregability", Thromb Haemost, 54, pp.425~430 (1985)
- Costantino D, "Effectiveness and safety of vaginal suppositories for the treatment of the vaginal atrophy in postmenopausal women : an open, non-controlled clinical trial", Eur Rev Med Pharmacol Sci, 12, pp.411~416 (2008)
- Parnan Emamverdikhan A, "A survey of the therapeutic effects of Vitamin E suppositories on vaginal atrophy in postmenopausal women", Iran J Nurs Midwifery Res, 21, pp.475~481 (2016)
- Ziagham S, "Effect of vitamin E vaginal suppository on atrophic vaginitis among postmenopausal women", Jundishapur J Chronic Dis Care, 2, pp.11~19 (2013)
- Moher D, "Preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement", PLoS Med, 6, pp.e1000097~ (2009)
- Davila GW, "Are women with urogenital atrophy symptomatic?", Am J Obstet Gynecol, 188, pp.382~388 (2003)
- "Randomised Controlled Trials (RCT) critical appraisal sheet" (2021)[URL]
- Ziagham S, "Effect of hyaluronic acid and vitamin E vaginal tablets on atrophic vaginitis : a randomized controlled trial", Afr J Pharm Pharmacol, 6, pp.3124~3129 (2012)
- Golmakani N, "Vitamin E as alternative local treatment in genitourinary syndrome of menopause : a randomized controlled trial", Int Urogynecol J, 30, pp.831~837 (2019)
- Parnan Emamverdikhan A, "Comparing two treatment methods of vitamin E suppository and conjugated estrogen vaginal cream on the quality of life in menopausal women with vaginal atrophy", J Midwifery Reprod Health, 2, pp.253~261 (2014)
- Dalton JE, "Publication bias : the elephant in the review", Anesth Analg, 123, pp.812~813 (2016)
- Ekin M, "The comparison of hyaluronic acid vaginal tablets with estradiol vaginal tablets in the treatment of atrophic vaginitis : a randomized controlled trial", Arch Gynecol Obstet, 283, pp.539~543 (2011)
- Weller SC, "Sample size estimation : the easy way", Field Methods, 27, pp.333~347 (2015)
- Hirschberg AL, "Topical estrogens and non-hormonal preparations for postmenopausal vulvovaginal atrophy : an EMAS clinical guide", Maturitas, 148, pp.55~61 (2021)