Abstract

The effects of oral vitamin D supplements on vaginal health in postmenopausal women with vulvovaginal atrophy (VVA) was evaluated. A double-blinded, randomized placebo-controlled trial was conducted for 12 weeks to investigate changes on vaginal maturation index (VMI), vaginal pH, and the visual analog scale (VAS) of VVA symptoms. The vitamin D group received oral ergocalciferol, at 40,000 IU per week, while the placebo group received an identical placebo capsule. Eighty postmenopausal women were enrolled. There were no significant differences in baseline characteristics between both groups. In an intention-to-treat analysis, VMI, vaginal pH, and VAS of VVA symptoms showed no significant differences between both groups at the six and 12 weeks. However, the mean difference of VMI in the vitamin D group between baseline and at six weeks showed significant improvement (5.5 + 16.27, p <0.05). Moreover, the mean vaginal pH and VAS of VVA patients in the vitamin D group were significantly improved at both six and 12 weeks compared to baseline. The oral vitamin D supplementation for 12 weeks potentially improves vaginal health outcomes in postmenopausal women with VVA symptoms, demonstrated by the improved mean VMI, vaginal pH, and VAS at six and 12 weeks between baseline, however, no significant differences were observed from the placebo treatment.

Highlights

  • Vulvovaginal atrophy (VVA) is common, many postmenopausal women are not aware of this problem

  • vulvovaginal atrophy (VVA) symptoms are a component of Genitourinary Syndrome of Menopause (GSM), a new terminology defined by the International Society for the Study of Women’s Sexual Health and the North American

  • This study aimed to evaluate the effect of oral vitamin D2 supplementation on VVA in postmenopausal women by measuring the vaginal maturation index (VMI), cytological changes in vaginal smear such as a shift from superficial squamous cells towards intermediate epithelial cells, vaginal pH, and the visual analog scale (VAS) of VVA symptoms

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Summary

Introduction

Vulvovaginal atrophy (VVA) is common, many postmenopausal women are not aware of this problem. This condition results from the changes in the female reproductive system during menopause, after cesstion of ovulation and the accompanying reduction in estrogen levels. The vaginal microbiota among postmenopausal women is typically shifted from predominantly Lactobacillus species to the higher proportions of anaerobic organisms, including Mobiluncus species and Atopobium vaginae. These changes in the vaginal bacterial community are associated with the severity of the VVA symptoms [4]. This is, especially the case in the Eastern countries where the reported prevalence of VVA was very low, varying from 6-80% among studies conducted in

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