Reviews From Women Who Have Used Vitamin E Suppositories
J Menopausal Med. 2019 Dec; 25(3): 109–116.
Effect of Vitamin D on the Vaginal Health of Menopausal Women: A Systematic Review
Hedyeh Riazi
1Department of Midwifery and Reproductive Health, Schoolhouse of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Masumeh Ghazanfarpour
iiDepartment of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Islamic republic of iran.
Mahboubeh Taebi
3Section of Midwifery and Reproductive Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Somayeh Abdolahian
4Educatee Enquiry Committee, Department of Midwifery and Reproductive Wellness, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Received 2019 February 10; Revised 2019 Jun 2; Accepted 2019 Jun 24.
Abstruse
Menopause is associated with the onset of climacteric symptoms due to low estradiol levels, which may cause insufficient maturation of the vaginal mucosa. Vitamin D may regulate the growth and differentiation of cells that are adversely afflicted due to depression estradiol levels, thereby restoring vaginal health. The objective of this systematic review, the first on this subject, was to investigate the event of vitamin D on the vaginal health of menopausal women. PubMed, Embase, Scopus, Web of Science, and Google Scholar databases and reference lists of hand-searched articles were searched for published studies from February 2000 to Nov 2018. The selection criteria were as follows: randomized or quasi-randomized trials that compared the effects of vitamin D or related compounds, alone or with calcium, on vaginal wellness (growth and differentiation of epithelial cells, dryness, acerbity [pH]) outcomes in menopausal women. The methodological quality of these studies was examined using the Cochrane tool checklist past ii contained investigators, following which the data were extracted. Of six examined studies, two showed that vitamin D administration improved the growth and differentiation of vaginal epithelial cells, improved vaginal pH, and decreased vaginal dryness in menopausal women. Although the level of evidence for the furnishings of vitamin D on vaginal health is low in our report, nosotros concluded that vitamin D may improve the vaginal health of women, especially during menopause.
Keywords: Menopause, Systematic review, Vitamin D
Graphical Abstract
INTRODUCTION
Description of the condition
Menopause is an of import period in the life of women; 1 reason being the numerous bug it may cause, affecting the quality of life of women [1,two]. One common trouble is vaginal discomfort [iii], and it is estimated that up to 40% of post-menopausal women experience this problem [four], leading to loss of collagen, elastin, and smoothen muscles in the vagina [5]. Low estradiol levels, which menopausal women commonly experience, tin cause a scarce maturation of vaginal mucosa [6]. This condition is clinically presented by dryness, irritation, itch, and dyspareunia [7] and information technology could touch daily activities, sexuality, relationships, and quality of life [8]. To evaluate vaginal health, it is necessary to appraise vaginal epithelial prison cell measurement, vaginal dryness, and vaginal acerbity (pH).
Clarification of the intervention
Handling approaches that are used for vaginal health comeback in menopausal women are hormonal therapy and complementary therapy [6,ix].
Such treatments are ordinarily based on local hormonal therapy, in the form of vaginal creams, tablets, or suppositories [x,11], although other routes of hormone assistants take also proven to be successful. Despite the fact that the benefits of estrogen replacement in preventing vaginal complications and reducing the incidence of related symptoms are well established [12], hormonal therapy has various limitations and contraindications [13].
Vitamins D and E have been used for the treatment of menopausal disorders and vaginal discomfort [xiv,fifteen]. Vitamin D is involved in the regulation of growth and differentiation of many cells, especially tissues lining the stratified squamous epithelium [sixteen], which are nowadays in the vagina and are regulated by Vitamin D [17]. Vitamin D3 binds to an intracellular receptor that is a fellow member of the steroid-thyroid hormone receptor family. Vitamin D3 and its receptors form a complex that binds to the Vitamin D3 response element of genes and either positively or negatively affects the transcription of that gene [xviii,19].
The importance of this review: Being free of sexual problems tin improve the confidence and mental country of women [20]; therefore, it is important to resolve sexual bug associated with menopause. Accordingly, vitamin D may be useful in vaginal discomfort in menopause women [7,21,22,23]; however, some experimental results are controversy [24,25].
Objective
Review of the literature showed that at that place was no report that summarized the effects of vitamin D on vaginal health in menopausal women; therefore, the aim of this systematic review study was to evaluate and summarize the furnishings of vitamin D on vaginal wellness in menopausal women.
MATERIALS AND METHODS
In this narrative systematic review the post-obit criteria were used to make up one's mind their eligibility into our study.
Inclusion criteria: we performed a screening of titles or abstracts followed by a total-text review. Studies were considered eligible if they met the following criteria: they were clinical randomized, placebo-controlled, double-bullheaded, single-blind, non-blinded trials, or cohort trials published in the English biomedical journals until 2019; they were quasi-randomized trials, the written report populations were menopausal women; vitamin D supplementation alone or plus calcium was studied; the study was published in English language journals without reference to a scientific quality alphabetize; and all clinically-used dosages and durations of vitamin D assistants in menopausal women were considered.
Exclusion criteria: vitamin D was used in combination with other drugs except calcium, information was insufficient, studies were conducted on animals or in in vitro models, and the diagnostic criteria were not practical to the written report subjects. Example reports and articles on non-vaginal wellness were excluded.
Participants are menopausal women. Types of intervention are use of vitamin D supplementation alone or plus calcium. Exposure is vaginal wellness such as vaginal epithelial cells, vaginal dryness and vaginal pH in menopausal women. Types of outcome measures are functioning-based; event measure was the Vaginal Maturation Index and vaginal pH and vaginal dryness. Chief outcomes are change in vaginal epithelial cells in menopausal women. Secondary outcomes are modify in vaginal pH and vaginal dryness.
Search methods for identification of studies
The electronic search engines included PubMed, Web of Science, Scopus, Google scholar, and Embase using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline.
Search strategy: the search strategy included a combination of primal words, and medical subject headings: vitamin D, vaginal, and menopause. We checked all titles and abstracts. Total text copies were obtained when the studies were considered possibly relevant. Searching other resources: gray literature and the reference list of articles.
Data drove and analysis
Selection of studies
2 review authors independently screened titles and abstracts for inclusion of all potential studies, and subsequently they were identified they were then coded as 'recall' (eligible or potentially eligible/unclear) or 'do not call up'. Next, the full-text studies coded every bit 'recollect' were obtained and the two review authors independently screened the total-texts and identified studies for inclusion, and identified and recorded reasons for exclusion of the ineligible studies.
Data extraction and management
The following data were extracted (if bachelor): writer, publication year, and methodology (including criteria for menopause diagnosis, sample size, study pattern, dosage of intervention, duration of intervention, and primary outcomes). We resolved any disagreement through discussion or, if required, nosotros consulted a 3rd person and used the consensus strategy. We identified and excluded duplicates and collated multiple reports of the same study. We recorded the selection process in sufficient detail to consummate a PRISMA flow diagram.
Assessment of gamble of bias in included studies
One reviewer assessed the quality of the included studies according to criteria for selection, methods of outcome assessment, and data analysis, using the Cochrane scale. If there were disagreements betwixt the ii reviewers during the process of report choice, the issues were resolved through word amongst multiple investigators.
Measures of handling effect
For vaginal health outcomes we used the epithelial cells score (%) or number of participants with vaginal health comeback afterwards intervention or after comparing with the control group.
Dealing with missing data
To complete the data that was unavailable from the published reports, we contacted the researchers of the relevant studies and they provided the missing information.
Assessment of heterogeneity
Methodological diversity such equally variability in the report design and risk of bias were observed during this review. Some variations in the materials and methods such as varied drug forms of vitamin D, different inclusion criteria, or measurement calibration in some studies led to no meta-analysis of the review.
RESULTS
A full of 351 studies seemed to exist potentially relevant in the first search. However, 340 studies were excluded (irrelevant subjects) after screening the titles and/or abstracts. Finally, full texts of the remaining xi studies were evaluated in depth, 6 trials with a total of 391 participants met the inclusion criteria. Table 1 shows the diagram of the retrieved manufactures included in the systematic review.
Table 1
The characteristics of articles included in the systematic review
| Author (y) | Sample | Intervention (type & duration) | Outcome | Result |
|---|---|---|---|---|
| Rad et al. (2015) [23] | Total 44 22 case 22 command | Case: vitamin D suppository, daily control: no treatment for 8 weeks | Maturation Index Vaginal pH | Mean MI score in the case group vs. control group was not significantly different (P = 0.01). |
| Mean superficial, intermediate, Para basal cells in the example grouping vs control grouping were significantly unlike (P = 0.001). | ||||
| Mean vaginal Ph in the example group vs command group was significantly different (P < 0.001). | ||||
| Bala et al. (2016) [21] | Full 200 100 cases 100 command | Oral administration of weekly 60,000 IU cholecalciferol granules or tablets in 10 weeks | Modified Vaginal Health Index (MVHI) | Mean MVHI in the case vs. control group afterward half dozen months was insignificantly dissimilar (P = 0.046). |
| Checa et al. (2005) [24] | 40 case (before–after) | 500 mg elemental calcium + 400 IU vitamin D3 daily for 48 weeks | Vaginal maturation value (VMV), vaginal dryness | Mean of VMV score differences after half-dozen months and after 12 months vs. baseline were significantly decrease. |
| Differences of vaginal dryness reporting after 6 and 12 months vs. baseline were non-significant. | ||||
| Mucci et al. (2006) [28] | 45 cases (earlier–afterwards) | 141 mg calcium + 400 IU vitamin D daily for 24 weeks | Likert calibration for vaginal dryness | Vaginal dryness afterwards intervention vs. baseline was insignificantly different (P = 0.01). |
| Saeideh et al. (2010) [26] | 50 cases (before–later on) | 500 mg calcium + 200 IU vitamin D daily for 24 weeks | VMV, vaginal dryness (% proportion of cases) | The difference of VMV hateful score of the case grouping later on intervention vs. baseline was not significant (P > 0.05). |
| Carranz-Lira (2012) [27] | 12 cases (earlier–after) | 1,000 IU calctriol + 500 mg calcium for eight weeks | Maturation Alphabetize (MI), vaginal dryness visual analogue calibration, vaginal pH (pH test strip) | The differences of MI % mean score, vaginal dryness, and vaginal pH later on intervention vs. baseline were not pregnant (P > 0.05). |
Description of studies
Results of the search
The search was updated from Feb 2000 to Nov 2018. We screened a total of 351 records from the following databases: Spider web of Science (7), PubMed (17), EMBASE (vii), Google Scholar (31), Scopus (289). Overall, this review has a total of vi trials, 23 duplicated, 5 animal studies, 50 breast cancer studies that were excluded, 11 studies selected for full text cess in which vi studies were excluded. Run into Effigy. 1 for the study menstruum diagram. 6 trials were included in this review: two studies were individually randomized controlled trials (RCTs) [21,23] and 4 were quasirandomized [24,26,27,28]. A total of 391 participants were part of the 6 trials. Overall, the included trials fall into ii main groups: vitamin D solitary and vitamin D plus calcium. See Table two for excluded studies [seven,15,22,29,xxx] and their reason.
Table ii
Characteristics of excluded studies
| Study (y) | Reason for exclusion |
|---|---|
| Kaur et al. (2017) [22] | RCT: aforementioned method and result, and writer with Bala et al. [21]'s study |
| LeBlanc et al. (2014) [29] | Nested case control study |
| LeBlanc et al. (2015) [30] | Nested instance control study |
| Lee et al. (2017) [15] | Example control study |
| Yildirim et al. (2004) [7] | Cross–sectional study |
Gamble of bias in included studies
Allocation (selection bias)
Table iii shows the results for the random sequence generation and allocation concealment for the Cochrane Hazard of Bias tool. For random sequence generation, 6 trials were deemed to be at low risk and for allocation concealment and 6 trials were at unclear risk.
Table 3
Risk of Bias score in included studies
| Study (y) | Sequence generation | Allotment darkening | Blinding of participants and personnel | Blinding of outcome assessment | Incomplete result data | Selective issue reports | Other bug (compared with baseline) |
|---|---|---|---|---|---|---|---|
| Mucci et al. (2006) [28] | Low | Unclear | High | Unclear | Depression | Unclear | Low |
| Rad et al. (2015) [23] | Low | Unclear | Low | Low | Low | Depression | Depression |
| Bala et al. (2016) [21] | Low | Unclear | High | Loftier | Low | Low | Loftier |
| Checa et al. (2005) [24] | Low | Unclear | Low | Depression | Unclear | Low | Depression |
| Saeideh et al. (2010) [26] | Low | Unclear | High | High | Depression | Low | Depression |
| Carranz-Lira (2012) [27] | Depression | Unclear | High | High | Unclear | Depression | Low |
Blinding (operation bias and detection bias)
Four trials did not report any attempt to blind assessors to handling assignment [21,26,27,28]. In 2 trial reports, the participants or providers, or both, were blinded to treatment allocation [23,24].
Incomplete consequence data (attrition bias)
Two trials did not provide information about the number of participants allocated to groups via randomization [24,27] and 4 trials reported attrition bias.
The potential sources of bias
In 6 studies, the inclusion and exclusion criteria and selective outcomes were clearly divers. The intervention and control groups were demonstrably comparable in 2 trials [21,23].
Effects of interventions
Vitamin D solitary versus placebo or no treatment
Two studies used vitamin D alone vs. a placebo or no treatment. In the study of Rad et al. [23], 1,000 IU doses of vitamin D vaginal suppository were used with for viii weeks, but in Bala et al. [21]'s study sixty,000 IU doses of vitamin D were administered orally and weekly. In two studies that included 244 menopausal women, both studies showed vitamin D was effective in the vaginal wellness of these women.
Vitamin D plus calcium versus baselin
Four studies used vitamin D plus calcium and compared the results versus baseline [24,26,27,28]. In the study of Checa et al. [24], xl menopausal women used 500 mg of elemental calcium plus 400 IU vitamin D3 for 24 weeks. In Mucci et al. [28]'s method, 141 mg calcium plus 400 IU of vitamin D were used daily, for 24 weeks in 45 women. In Carranza-Lira et al. [27]'s study, 12 women used chiliad IU of calcitriol plus 500 mg of calcium daily for viii weeks, and in the study of Saeideh et al. [26], l cases used 500 mg of calcium plus 200 IU of vitamin D daily, for 24 weeks. The 4 studies included 147 women. Ane study showed vitamin D plus calcium effectiveness in vaginal health [28] and 3 showed no positive result regarding vaginal health [24,26,27].
Epithelial cell
Rad et al. [23] showed that apply of vitamin D tin ameliorate the superficial, intermediate, parabasal of vaginal cells. Too, the mean vaginal maturation score between the case and control group was significantly increased. Bala et al. [21] reported that use of vitamin D significantly afflicted the vaginal wellness index such as vaginal epithelial integrity. Checa et al. [24] reported vaginal maturation mean score later on 24 weeks (−38.7%; afterward 12 months, −51.8% significantly decreased). Saeideh et al. [26] showed vaginal maturation mean score was not pregnant betwixt the before intervention (27.51 ± 18.98) vs. after intervention (29.41 ± xviii.75). In Carranza-Lira et al. [27]'s study, the mean % score change maturation index and parabasal and intermediate cells were not pregnant just the mean % score in superficial cells before intervention two.five ± iv.5% vs. after intervention 10.0 ± 8.5% was significantly inverse. Three studies reported vitamin D can positively bear on vaginal epithelial especially in superficial cells [21,23,27], although ii other studies were inconsistent regarding this result [24,26].
Vaginal pH
Vaginal acidity (pH) was afflicted in two studies and pH mean score was significantly decreased in the vitamin D group. In the written report of Carranza-Lira et al. [27], the mean score of the pH strip test (1.5 ± i.ii vs. one.7 ± 1.0) did not significantly change before and afterwards the intervention. Two studies reported significant modify in vaginal pH [21,23] and one study upshot was negative [27].
Vaginal dryness
Bala et al. [21] found that apply of vitamin D orally significantly affected vaginal moisture and consistency. Checa et al. [24] showed that after 24 weeks, 21.iv% of cases and after 12 months, 15.8% of cases suffered from vaginal dryness, but this modify was non significant (P= 0.5). In Mucci et al. [28]'south study, 13.3% of cases reported improvement after intervention vs. baseline and 39% of the vaginal dryness mean score decreased and this change was significant (P= 0.01). Saeideh et al. [26] reported the number of vaginal dryness before intervention was 36 cases and later on intervention was 37 cases, and Carranza-Lira et al. [27] reported severity mean score using the visual analogue calibration earlier intervention (58.5 ± 24.0) vs. later intervention (64.4 ± 27.ii) was not significant. Two studies showed vitamin D tin better vaginal dryness [21,28] and three studies were inconsistent [24,26,27].
DISCUSSION
Summary of main results
Vitamin D lonely versus placebo or no treatment
Vitamin D alone, in the high doses tested or vaginaluse format, appears to be have an effect on vaginal epithelial cells especially superficial cells and vaginal pH decrease (2 trials, 244 participants) [21,23]. Use of vitamin D alone in the vaginal formats and 1,000 IU doses tested daily appears not to be able to reduce vaginal dryness (1 study, 44 participants). Duration time of utilize of vitamin D was 8–10 weeks, which seems sufficient time for vaginal health improvement except for vaginal dryness.
Vitamin D plus calcium versus baseline
Although there was no business firm bear witness that vitamin D (including 25-hydroxy vitamin D) with calcium was more constructive than vitamin D alone for vaginal health in menopausal women, merely one study (calcium plus vitamin D) reported positive vaginal health results [28] while three studies did non study whatever positive results [24,26,27]. The calcium dose in all of the studies was 500 mg daily except for one study [28] that used a low dose (141 mg daily). The dose of vitamin D in two studies [24,28] was the same (400 IU), simply their results were different. The written report with low dose calcium and 400 IU vitamin D was constructive in reducing vaginal dryness [28]. Intervention durations were different, such as viii weeks [27], 24 weeks [26,28] and the longest existence 48 weeks [24]. Only 24 weeks duration of vitamin D plus calcium had positive results in vaginal dryness [28].
Adverse furnishings
Three trials reported adverse effects [24,26,28], which was mostly gastric discomfort. Overall, none of the trials reported the result of vitamin D on mortality; however, use of calcium and vitamin D for a long time is dangerous and is non recommended for menopausal women, only in another report [31], which was not included in our study, the use of vitamin D and calcium was associated with a reduction in mortality (chance ratios 0.94, 95% CI 0.89 to 0.99). It is highly recommended to measure the level of vitamin D before high doses are administered and it is better to prescribe the supplement based on blood vitamin D levels [32]. Calcium supplements could increase the risk of myocardial infarction [33], particularly in people with a higher dietary calcium intake. Supplements of calcium and vitamin D could also increment the risk of myocardial infarction and stroke [34] but might also decrease the risk of breast cancer [35].
Overall completeness and applicability of prove
This review included an bear witness base from six trials that examined vitamin D (including 25-hydroxy vitamin D) with or without calcium in the improvement of vaginal wellness in menopausal women with a hateful age of fifty years or over. Vitamin D was administered in a diversity of formats and doses (oral daily, oral weekly, and vaginal suppository). However, three of the trials in this review tested daily vitamin D3 in doses greater than 800 IU [21,23,27] and one of these trials recruit participants with very low (mean < 12 ng/mL) baseline 25-hydroxy vitamin D claret levels [21]. American Geriatric Society suggests that a minimum blood vitamin D level of 30 ng/mL (75 nmol/L) is necessary in older adults to minimize the risk of menopause complications. It has been suggested that college doses of vitamin D are required in women with vitamin D insufficiently [36], and vitamin D level testing earlier intervention is necessary for future studies in vaginal health in menopausal women.
Mean duration of 24 weeks for oral use with a depression dose of calcium [28] and high dose vitamin D alone [21,23] is optimal for vaginal wellness in menopause women.
Quality of the testify
This review included a small body of evidence from six trials with 391 participants. Our assessments of chance of bias and quality cess are presented in Tabular array 3.
Potential biases in the review process
We believe that selection bias is very low in this review. We accept searched a wide range of databases for relevant journals. 1 report of studies that was published at a different fourth dimension but using the aforementioned method and result was excluded [22]. We only included RCTs and the other low quality evidences such as observational or case-control were excluded.
Agreements and disagreements with other studies or reviews
Although the results of ii included studies [23,27] and two excluded studies [15,37] showed improved superficial vaginal cells by using vitamin D, another study reported that vitamin D was not associated with menopausal related symptoms in menopausal women [29].
The Cochrane review reported that supplements of vitamin D and calcium may prevent hip or other types of fracture [38] and another report suggested that high intakes of dietary vitamin D and calcium may exist modestly associated with a lower risk of early menopause [39].
Even so, the use of complementary therapy such herbal medicine and supplements is beneficial for menopause symptoms such as hot flashes [40], but the results of a meta-assay report conducted in 2017 showed that oral phytoestrogen cannot be constructive in astringent vaginal atrophy [41]. Other treatments for vaginal atrophy in postmenopausal women may be the use of laser therapy, in which a study published in 2017, constitute the effectiveness of this method in improving vaginal health in postmenopausal women and improving their sexual quality, but the use of this method is not recommended due to demand of advanced equipment that comes with a loftier price [42].
Limitations
One of the limitations of this systematic review was using varied drug forms of vitamin D in the evaluated studies. Other limitations were the different ages of the menopausal women and dissimilar inclusion criteria in the studies. The weak methodology of some studies used in our systematic review is also a limitation of this written report. Small-scale sample sizes, inadequate treatment allocation, unclear blinding method, and unmentioned randomization technique tin can dethrone the validity of the results. Since in that location was big variation on the methodology of examined studies, it was impossible to practise a meta-analysis.
Implications for practice
Vitamin D lone in the high doses and combined formulations that have been used in some studies appears to be effective in vaginal wellness in menopausal women.
Implications for research
At that place is a need to ostend vitamin D treatment effects on vaginal health using longitudinal studies.
Effect of this report show that the superficial epithelial cell tin be improved with vitamin D. It has been suggested that the topical use of vitamin D in futurity studies be also compared with vaginal estrogen and vitamin D suppository.
ACKNOWLEDGMENTS
This study was supported by the educatee research committee of Shahid Beheshti University of Medical Sciences, Tehran, Islamic republic of iran.
Footnotes
Conflict of Interest: No potential disharmonize of involvement relevant to this commodity was reported.
References
i. Ghazanfarpour M, Abdolahian Due south, Zare Thou, Shahsavari Due south. Association between anthropometric indices and quality of life in menopausal women. Gynecol Endocrinol. 2013;29:917–920. [PubMed] [Google Scholar]
2. Ghazanfarpour Grand, Kaviani Grand, Abdolahian South, Bonakchi H, Najmabadi Khadijeh M, Naghavi Yard, et al. The relationship between women'south attitude towards menopause and menopausal symptoms amongst postmenopausal women. Gynecol Endocrinol. 2015;31:860–865. [PubMed] [Google Scholar]
three. Huang AJ, Moore EE, Boyko EJ, Scholes D, Lin F, Vittinghoff E, et al. Vaginal symptoms in postmenopausal women: self-reported severity, natural history, and risk factors. Menopause. 2010;17:121–126. [PMC gratis article] [PubMed] [Google Scholar]
4. Weber MA, Limpens J, Roovers JP. Assessment of vaginal atrophy: a review. Int Urogynecol J. 2015;26:fifteen–28. [PubMed] [Google Scholar]
5. Tersigni C, Di Simone N, Tempestilli Eastward, Cianfrini F, Russo R, Moruzzi MC, et al. Non-hormonal treatment of vulvo-vaginal atrophy-related symptoms in post-menopausal women. J Obstet Gynaecol. 2015;35:835–838. [PubMed] [Google Scholar]
half dozen. Naumova I, Castelo-Branco C. Electric current treatment options for postmenopausal vaginal atrophy. Int J Womens Health. 2018;10:387–395. [PMC free article] [PubMed] [Google Scholar]
7. Yildirim B, Kaleli B, Düzcan E, Topuz O. The effects of postmenopausal Vitamin D treatment on vaginal cloudburst. Maturitas. 2004;49:334–337. [PubMed] [Google Scholar]
8. Palma F, Volpe A, Villa P, Cagnacci A. Vaginal atrophy of women in postmenopause. Results from a multicentric observational written report: The AGATA written report. Maturitas. 2016;83:40–44. [PubMed] [Google Scholar]
9. Ballagh SA. Vaginal hormone therapy for urogenital and menopausal symptoms. Semin Reprod Med. 2005;23:126–140. [PubMed] [Google Scholar]
x. Dessie SG, Armstrong K, Small AM, Hacker MR, Hota LS. Effect of vaginal estrogen on pessary use. Int Urogynecol J. 2016;27:1423–1429. [PMC free article] [PubMed] [Google Scholar]
11. Lynch C. Vaginal estrogen therapy for the treatment of atrophic vaginitis. J Womens Health (Larchmt) 2009;eighteen:1595–1606. [PubMed] [Google Scholar]
12. Gambacciani Thou, Levancini K. Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Prz Menopauzalny. 2014;13:213–220. [PMC complimentary commodity] [PubMed] [Google Scholar]
13. Castelo-Branco C, Cancelo MJ, Villero J, Nohales F, Juliá MD. Management of post-menopausal vaginal atrophy and atrophic vaginitis. Maturitas. 2005;52 Suppl 1:S46–S52. [PubMed] [Google Scholar]
xiv. Parnan emamverdikhan A, Golmakani North, SharifiSistani Due north, Taghi Shakeri Chiliad, Hasanzade Mofrad Yard, Sajadi Tabassi A. Comparison two handling 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. 2014;2:253–261. [Google Scholar]
15. Lee A, Lee MR, Lee HH, Kim YS, Kim JM, Enkhbold T, et al. Vitamin D proliferates vaginal epithelium through RhoA expression in postmenopausal atrophic vagina tissue. Mol Cells. 2017;40:677–684. [PMC free article] [PubMed] [Google Scholar]
sixteen. Welsh J. Cellular and molecular effects of vitamin D on carcinogenesis. Arch Biochem Biophys. 2012;523:107–114. [PMC free article] [PubMed] [Google Scholar]
17. Irwýng MF, Thomas BF. Fitzpatrick'due south dermatology in full general medicine. fifth ed. New York: McGraw-Loma; 1999. [Google Scholar]
18. Kim Th, Lee HH, Park J. Immunohistochemical detection of the ane,25-dihydroxy vitamin D receptor in the human vagina. Iran J Reprod Med. 2014;12:805–810. [PMC complimentary commodity] [PubMed] [Google Scholar]
19. Superhighway JW, Meyer MB. The vitamin D receptor: new paradigms for the regulation of gene expression past 1,25-dihydroxyvitamin D(three) Endocrinol Metab Clin N Am. 2010;39:255–269. [PMC free article] [PubMed] [Google Scholar]
xx. Riazi H, Alaei S, Emamhadi M, Nazparvar B, Salmani F. The comparison of spiritual health and self-esteem in women with and without sexual violence. Electron Doctor. 2017;9:5705–5711. [PMC free article] [PubMed] [Google Scholar]
21. Bala R, Kaur H, Nagpal M. Authenticity of vitamin D in modified vaginal health alphabetize in geriatric subjects. Int J Reprod Contracept Obstet Gynecol. 2016;5:4119–4122. [Google Scholar]
22. Kaur H, Bala R, Nagpal One thousand. Role of Vitamin D in urogenital health of geriatric participants. J Midlife Health. 2017;8:28–35. [PMC free article] [PubMed] [Google Scholar]
23. Rad P, Tadayon M, Abbaspour M, Latifi SM, Rashidi I, Delaviz H. The result of vitamin D on vaginal atrophy in postmenopausal women. Islamic republic of iran J Nurs Midwifery Res. 2015;xx:211–215. [PMC free article] [PubMed] [Google Scholar]
24. Checa MA, Garrido A, Prat M, Conangla M, Rueda C, Carreras R. A comparison of raloxifene and calcium plus vitamin D on vaginal atrophy subsequently discontinuation of long-continuing postmenopausal hormone therapy in osteoporotic women. A randomized, masked-evaluator, one-year, prospective study. Maturitas. 2005;52:seventy–77. [PubMed] [Google Scholar]
25. Zareai M. Effect of vitamin E on the vaginal atrophy of postmenopausal women. Value Health. 2014;17:A750 [PubMed] [Google Scholar]
26. Saeideh Z, Raziyeh M, Soghrat F. Comparison the effects of continuous hormone replacement therapy and tibolone on the genital tract of menopausal women; a randomized controlled trial. J Reprod Infertil. 2010;xi:183–187. [PMC gratis commodity] [PubMed] [Google Scholar]
27. Carranza-Lira S, Amador-Pérez C, Macgregor-Gooch AL, Estrada-Moscoso I. [Changes in maturation index and vaginal dryness in postmenopausal women who utilize or not calcitriol] Rev Med Inst Mex Seguro Soc. 2012;50:537–540. Spanish. [PubMed] [Google Scholar]
28. Mucci M, Carraro C, Mancino P, Monti M, Papadia LS, Volpini G, et al. Soy isoflavones, lactobacilli, Magnolia bark extract, vitamin D3 and calcium. Controlled clinical report in menopause. Minerva Ginecol. 2006;58:323–334. [PubMed] [Google Scholar]
29. LeBlanc ES, Desai M, Perrin Due north, Wactawski-Wende J, Manson JE, Cauley JA, et al. Vitamin D levels and menopause-related symptoms. Menopause. 2014;21:1197–1203. [PMC complimentary commodity] [PubMed] [Google Scholar]
30. LeBlanc ES, Hedlin H, Qin F, Desai Grand, Wactawski-Wende J, Perrin N, et al. Calcium and vitamin D supplementation do not influence menopause-related symptoms: Results of the Women's Health Initiative Trial. Maturitas. 2015;81:377–383. [PMC gratis article] [PubMed] [Google Scholar]
31. Avenell A, Gillespie WJ, Gillespie LD, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Database Syst Rev. 2009;(2):CD000227. [PubMed] [Google Scholar]
32. Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc. 2010;85:752–757. quiz 757-8. [PMC gratuitous commodity] [PubMed] [Google Scholar]
33. Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Take chances GD, et al. Event of calcium supplements on chance of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010;341:c3691. [PMC free commodity] [PubMed] [Google Scholar]
34. Bolland MJ, Grayness A, Avenell A, Chance GD, Reid IR. Calcium supplements with or without vitamin D and hazard of cardiovascular events: reanalysis of the Women's Health Initiative express admission dataset and meta-assay. BMJ. 2011;342:d2040. [PMC free article] [PubMed] [Google Scholar]
35. Bolland MJ, Grayness A, Gamble GD, Reid IR. Calcium and vitamin D supplements and health outcomes: a reanalysis of the Women's Health Initiative (WHI) express-access information set. Am J Clin Nutr. 2011;94:1144–1149. [PMC costless commodity] [PubMed] [Google Scholar]
36. Bischoff-Ferrari HA, Shao A, Dawson-Hughes B, Hathcock J, Giovannucci E, Willett WC. Benefit-adventure assessment of vitamin D supplementation. Osteoporos Int. 2010;21:1121–1132. [PMC free article] [PubMed] [Google Scholar]
37. Zeyneloglu HB, Oktem M, Haberal NA, Esinler I, Kuscu E. The effect of raloxifene in association with vitamin D on vaginal maturation index and urogenital symptoms in postmenopausal osteoporotic women. Fertil Steril. 2007;88:530–532. [PubMed] [Google Scholar]
38. Avenell A, Mak JC, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014;(4):CD000227. [PMC costless article] [PubMed] [Google Scholar]
39. Purdue-Smithe Ac, Whitcomb BW, Szegda KL, Boutot ME, Manson JE, Hankinson SE, et al. Vitamin D and calcium intake and risk of early menopause. Am J Clin Nutr. 2017;105:1493–1501. [PMC free article] [PubMed] [Google Scholar]
40. Ghazanfarpour M, Sadeghi R, Abdolahian South, Latifnejad Roudsari R. The efficacy of Iranian herbal medicines in alleviating hot flashes: a systematic review. Int J Reprod Biomed (Yazd) 2016;fourteen:155–166. [PMC free article] [PubMed] [Google Scholar]
41. Chen MN, Lin CC, Liu CF. Efficacy of phytoestrogens for menopausal symptoms: a meta-assay and systematic review. Climacteric. 2015;eighteen:260–269. [PMC free article] [PubMed] [Google Scholar]
42. Tadir Y, Gaspar A, Lev-Sagie A, Alexiades M, Alinsod R, Bader A, et al. Light and free energy based therapeutics for genitourinary syndrome of menopause: consensus and controversies. Lasers Surg Med. 2017;49:137–159. [PMC complimentary article] [PubMed] [Google Scholar]
Articles from Journal of Menopausal Medicine are provided hither courtesy of The Korean Society of Menopause
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952708/
Post a Comment for "Reviews From Women Who Have Used Vitamin E Suppositories"