A Review of Pharmacological Treatments for Vaginal Atrophy in Postmenopausal Women in Iran
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Vaginal atrophy is one of the most common menopausal complications and is often overlooked. There are various pharmacological and non-pharmacological treatment approaches to reduce vaginal atrophy; however, no comprehensive study on a convenient, affordable, inexpensive, and noninvasive treatment with fewer complications has been conducted so far. Thus, the current study aimed to provide a systematic review of pharmacological treatment for vaginal atrophy in postmenopausal women in Iran. In this systematic review, all Iranian articles published in Persian or English during 2009 to 2019 were collected and analyzed by searching the Scopus, PubMed, Web of Science, Magiran, Iranian Registry of Clinical Trials (IRCT), and Cochrane Library databases. The inclusion criteria were clinical trials for vaginal atrophy and menopause. Based on the selection criteria, articles with a Jadad scale score of 3 and above were included in the study and qualitatively analyzed. Overall, 15 clinical trials met the inclusion criteria. In total, 12 articles examined the efficacy of pharmacological treatments (including three herbal medicines, three vitamins and dietary supplements, and two chemical drugs) in treating vaginal atrophy in postmenopausal women. Various types of medication have been used to improve vaginal atrophy, and effective treatments include licorice, chamomile, royal jelly, vitamin E, vitamin D, hyaluronic acid, and Vagifem; however, the results of studies on fennel have been inconsistent. However, considering the small number of studies reviewed, further studies with a stronger methodology are needed to confirm the efficacy of these medications.
Abstract
Vaginal atrophy is one of the most common menopausal complications and is often overlooked. There are various pharmacological and non-pharmacological treatment approaches to reduce vaginal atrophy; however, no comprehensive study on a convenient, affordable, inexpensive, and noninvasive treatment with fewer complications has been conducted so far. Thus, the current study aimed to provide a systematic review of pharmacological treatment for vaginal atrophy in postmenopausal women in Iran. In this systematic review, all Iranian articles published in Persian or English during 2009 to 2019 were collected and analyzed by searching the Scopus, PubMed, Web of Science, Magiran, Iranian Registry of Clinical Trials (IRCT), and Cochrane Library databases. The inclusion criteria were clinical trials for vaginal atrophy and menopause. Based on the selection criteria, articles with a Jadad scale score of 3 and above were included in the study and qualitatively analyzed. Overall, 15 clinical trials met the inclusion criteria. In total, 12 articles examined the efficacy of pharmacological treatments (including three herbal medicines, three vitamins and dietary supplements, and two chemical drugs) in treating vaginal atrophy in postmenopausal women. Various types of medication have been used to improve vaginal atrophy, and effective treatments include licorice, chamomile, royal jelly, vitamin E, vitamin D, hyaluronic acid, and Vagifem; however, the results of studies on fennel have been inconsistent. However, considering the small number of studies reviewed, further studies with a stronger methodology are needed to confirm the efficacy of these medications.
참고문헌 (40)
- Nappi RE, "Women's voices in the menopause : results from an international survey on vaginal atrophy", Maturitas, 67, pp.233~238 (2010)
- 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)
- Castiglione C, "Representation of future changes in menopausal women", Procedia, 116, pp.4993~4997 (2014)
- "Management of symptomatic vulvovaginal atrophy: 2013 position statement of the North American Menopause Society", Menopause, 20, pp.888~902 (2013)
- Nilsson K, "The vaginal epithelium in the postmenopause--cytology, histology and pH as methods of assessment", Maturitas, 21, pp.51~56 (1995)
- Karimi Afshar H, "Clinical evaluation of bucoadhesive paste containing trigonella foenum graecum liquid extract in comparison to control", pp.2015
- Poluzzi E, "Phytoestrogens in postmenopause : the state of the art from a chemical, pharmacological and regulatory perspective", Curr Med Chem, 21, pp.417~436 (2014)
- Lima SM, "Effective treatment of vaginal atrophy with isoflavone vaginal gel", Maturitas, 74, pp.252~258 (2013)
- Jong-Myon Bae, "The Role of Menopausal Hormone thrapy in Reducing All-cause Mortality in Postmenopausal Women Younger than 60 Years: An Adaptive Meta-analysis", 대한폐경학회지, 24(3), pp.139~142 (2018), 대한폐경학회[DOI]
- Bygdeman M, "Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women", Maturitas, 23, pp.259~263 (1996)
- Tadayon M, "The effect of vitamin D suppository on atrophic vaginal mucosa in menopausal women", Armaghane Danesh, 17, pp.187~195 (2012)
- Peter Takacs, "Zinc-containing Vaginal Moisturizer Gel Improves Postmenopausal Vulvovaginal Symptoms: A Pilot Study", 대한폐경학회지, 25(1), pp.63~68 (2019), 대한폐경학회[DOI]
- Naumova I, "Current treatment options for postmenopausal vaginal atrophy", Int J Womens Health, 10, pp.387~395 (2018)
- Lavinia Domenici, "Comparison of Anogenital Distance and Correlation with Vulvo-vaginal Atrophy: A Pilot Study on Premenopausal and Postmenopausal Women", 대한폐경학회지, 24(2), pp.108~112 (2018), 대한폐경학회
- Yaralizadeh M, "Effect of Foeniculum vulgare(fennel)vaginal cream on vaginal atrophy in postmenopausal women : a double-blind randomized placebocontrolled trial", Maturitas, 84, pp.75~80 (2016)
- Ghazanfarpour M, "Effect of Foeniculum vulgare(fennel)on vaginal atrophy in postmenopausal women : a double-blind, randomized, placebo-controlled trial", Post Reprod Health, 23, pp.171~176 (2017)
- Sadeghi M, "Effect of Glycyrrhiza glabra vaginal cream on the mental symptoms of vaginal atrophy in postmenopausal women", Iran J Obstet Gynecol Infertil, 21, pp.53~61 (2018)
- Bosak Z, "Evaluation of the effect of chamomile vaginal gel on subjective symptoms of vaginal atrophy in postmenopausal women : a randomized clinical controlled trial", Iran J Obstet Gynecol Infertil, 22, pp.23~31 (2019)
- Seyyedi F, "Comparison between vaginal royal jelly and vaginal estrogen effects on quality of life and vaginal atrophy in postmenopausal women : a clinical trial study", Electron Physician, 8, pp.3184~3192 (2016)
- 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)
- Ryan KJ, "Kistner's gynecology and women's health" (1999), Mosby
- Malone PM, "Drug information: a guide for pharmacists" (2006), McGraw-Hill, Medical Pub
- Rad P, "The effect of vitamin D on vaginal atrophy in postmenopausal women", Iran J Nurs Midwifery Res, 20, pp.211~215 (2015)
- Ziagham S, "Comparison of hyaluronic acid with vitamin E vaginal pessaries on maturation of vaginal epithelium in postmenopausal women", Jundishapur Sci Med J, 11, pp.393~401 (2012)
- Jokar A, "Comparison of the hyaluronic acid vaginal cream and conjugated estrogen used in treatment of vaginal atrophy of menopause women : a randomized controlled clinical trial", Int J Community Based Nurs Midwifery, 4, pp.69~78 (2016)
- Rahimi R, "Medicinal properties of Foeniculum vulgare Mill. in traditional Iranian medicine and modern phytotherapy", Chin J Integr Med, 19, pp.73~79 (2013)
- Hosseinzadeh P, "A comparative study of vaginal estrogen cream and sustained-release estradiol vaginal tablet(Vagifem)in the treatment of atrophic vaginitis in Isfahan, Iran in 2010-2012", J Res Med Sci, 20, pp.1160~1165 (2015)
- Talat Khadivzadeh, "Effect of Fennel on the Health Status of Menopausal Women: A Systematic and Meta-analysis", 대한폐경학회지, 24(1), pp.67~74 (2018), 대한폐경학회
- Barnes J, "Herbal medicines: a guide for healthcare professionals" (2002), Pharmaceutical Press
- Kesmati M, "Effect of Matricaria chamomilla hydroalcoholic extract on locomotor activity in the presence and absence of sex glands in male and female adult mice", Shahid Chamran Univ J Sci, (17), pp.73~83 (2007)
- Azizi M, "Study of four improved cultivars of Matricaria chamomilla L. in climatic condition of Iran", Iran J Med Aromat Plants, 22, pp.386~396 (2007)
- Avis NE, "Longitudinal changes in sexual functioning as women transition through menopause : results from the Study of Women's Health across the Nation", Menopause, 16, pp.442~452 (2009)
- Raymundo N, "Treatment of atrophic vaginitis with topical conjugated equine estrogens in postmenopausal Asian women", Climacteric, 7, pp.312~318 (2004)
- Morali G, "Open, non-controlled clinical studies to assess the efficacy and safety of a medical device in form of gel topically and intravaginally used in postmenopausal women with genital atrophy", Arzneimittelforschung, 56, pp.230~238 (2006)
- Francis RM, "A comparison of the effects of alfacalcidol treatment and vitamin D2 supplementation on calcium absorption in elderly women with vertebral fractures", Osteoporos Int, 6, pp.284~290 (1996)
- Yildirim B, "The effects of postmenopausal Vitamin D treatment on vaginal atrophy", Maturitas, 49, pp.334~337 (2004)
- Hatami L, "The effects of hydroalcoholic extract of Matricaria recutita on the hormonal pituitary-testis axis and testis tissue changes of mature male rats", J Fasa Univ Med Sci, 3, pp.56~62 (2013)
- Goa KL, "A review of its pharmacology and use as a surgical aid in ophthalmology, and its therapeutic potential in joint disease and wound healing", Drugs, 47, pp.536~566 (1994)
- Manonai J, "The effect of estradiol vaginal tablet and conjugated estrogen cream on urogenital symptoms in postmenopausal women : a comparative study", J Obstet Gynaecol Res, 27, pp.255~260 (2001)
