Comparison of the Effect of Vitamins D and E with Conjugated Estrogen Vaginal Cream on Menopausal Vulvovaginal Symptoms: A Randomized Control Trials

Menopausal vulvovaginal symptoms are common among postmenopausal women. Owing to the contraindications and limited availability of standard treatments, there is an increasing demand for alternative therapies. This study aimed to assess the effectiveness of vitamin D and E in comparison to conjugated estrogen vaginal cream in alleviating menopause-related vulvovaginal symptoms. This double-blind clinical trial included 66 postmenopausal women at the Shahid Beheshti Medical Training Center in Kashan, Iran. Participants were randomly assigned to three groups: vitamin D, vitamin E, and control. Subjective vaginal atrophy symptoms were measured using a four-point scale on days 1 and 56. Vaginal cytology was used to assess the severity of atrophy, and serum vitamin D levels were measured. Statistical analysis was performed using SPSS version 20 software. The study found that vitamin D and E levels improved in postmenopausal women. Estrogen was effective for most symptoms except for vaginal discharge. No significant differences were observed between the groups at 28 and 56 days post-intervention, except for dyspareunia, which was worse in the vitamin D group on day 56. All groups showed an increased Vaginal Maturation Index (VMI) after 56 days with lower vitamin D levels. Vitamin D levels had no significant associations with symptoms or cell maturation. This study demonstrated the efficacy of pharmaceutical interventions in alleviating vulvovaginal symptoms and improving VMI after 56 days of treatment. These findings highlight the potential of these interventions in managing vulvovaginal symptoms, necessitating further comprehensive research in the context of menopausal care.