Department of Midwifery, School of Nursing and Midwifery, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Midwifery, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Nemazee Square, Zand Blv., Shiraz, 7193613119, Iran.
Support Care Cancer. 2019 Apr;27(4):1325-1334. doi: 10.1007/s00520-019-04684-6. Epub 2019 Feb 7.
Vaginal atrophy is one of the most common side effects of using tamoxifen in women with breast cancer. Hormone therapy for vaginal atrophy is prohibited in these women. The present study was conducted to investigate the effect of vitamin D and E vaginal suppositories on vaginal atrophy in women with breast cancer receiving tamoxifen.
Women under breast cancer management receiving tamoxifen and showing symptoms of vaginal atrophy were randomized triple-blind to an 8-week trial on vaginal suppository vitamin E or vitamin D or placebo administered every night before bedtime. The genitourinary atrophy self-assessment tool was administered, and pH was measured in all three groups before the intervention and at the end of weeks 2, 4, and 8 of the intervention. The Vaginal Maturation Index (VMI) was also measured before the intervention and at the end of the eighth week. Data were analyzed with paired t tests, repeated measures analysis of variance, and chi-square test.
Thirty-two patients were randomized in each group. The results obtained showed an increase in the VMI by the end of the eighth week of the intervention in the groups receiving the vitamin D and E vaginal suppositories compared with the placebo group (P < 0.001). The vaginal pH also reduced in both groups compared with that in the placebo group (P < 0.001). The symptoms of self-reported genitourinary atrophy also improved in the two intervention groups compared with those in the placebo group by the end of the eighth week (P < 0.001).
These data support that vitamin D and E vaginal suppositories were beneficial in improving vaginal atrophy in women with breast cancer receiving tamoxifen. Given the prohibition on hormone therapy in these women, the suppositories can be used as an alternative therapy to improve these symptoms.
阴道萎缩是乳腺癌患者使用他莫昔芬的最常见副作用之一。这些女性禁止使用激素疗法治疗阴道萎缩。本研究旨在探讨维生素 D 和 E 阴道栓剂对接受他莫昔芬治疗的乳腺癌女性阴道萎缩的影响。
正在接受乳腺癌管理且出现阴道萎缩症状的接受他莫昔芬治疗的女性被随机分为三组，进行为期 8 周的阴道栓剂维生素 E 或维生素 D 或安慰剂每晚睡前治疗的三盲试验。所有三组均在干预前和干预后第 2、4 和 8 周进行泌尿生殖系统萎缩自我评估工具评估，并测量 pH 值。在干预前和第 8 周结束时还测量了阴道成熟指数（VMI）。采用配对 t 检验、重复测量方差分析和卡方检验进行数据分析。
每组 32 名患者被随机分配。结果表明，与安慰剂组相比，接受维生素 D 和 E 阴道栓剂治疗的组在干预结束时 VMI 增加（P<0.001）。与安慰剂组相比，两组的阴道 pH 值也降低（P<0.001）。与安慰剂组相比，两组在干预结束时自我报告的泌尿生殖系统萎缩症状也有所改善（P<0.001）。
这些数据支持维生素 D 和 E 阴道栓剂有益于改善接受他莫昔芬治疗的乳腺癌女性的阴道萎缩。鉴于这些女性禁止使用激素疗法，栓剂可作为改善这些症状的替代疗法。
