Porterfield Laura, Wur Nyajuok, Delgado Zuleica Santiago, Syed Farha, Song Amanda, Weller Susan C
Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX, USA.
J Menopausal Med. 2022 Apr;28(1):9-16. doi: 10.6118/jmm.21028.
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.
绝经泌尿生殖综合征显著影响绝经后女性的生活质量，对于有禁忌证的女性，除阴道雌激素外几乎没有基于证据的替代方案。本系统评价评估了与安慰剂或阴道对照治疗相比，阴道用维生素E在减轻健康绝经后女性患者报告的泌尿生殖症状方面的疗效证据。本系统评价评估了2020年10月之前的随机对照试验，这些试验评估了维生素E阴道栓剂与健康绝经后女性对照组相比在减轻绝经后女性泌尿生殖症状方面的疗效。结局包括患者感知的泌尿生殖症状。在31项研究中，有4项符合纳入标准。一项为期8周的试验（n = 42）发现，1 mg维生素E组的阴道症状较安慰剂组显著减轻（均值差异为5.3；95%置信区间[CI]，4.4至6.2）。另一项为期8周的试验（n = 40）发现，5 mg阴道透明质酸优于1 mg维生素E（均值差异为-0.50，95% CI，-0.95至-0.05）。两项为期12周的试验（每项n = 52）发现，在健康绝经后女性中，0.5 g阴道雌激素与100 IU阴道维生素E之间无差异（均值差异：-0.19，95% CI，-4.4至4.0，以及-3.47，95% CI，-13.8至6.8）。来自小型、有限研究的证据表明，阴道用维生素E可能有效缓解绝经泌尿生殖综合征的症状；然而，需要更多高质量研究来确定疗效、理想剂量和长期安全性。
