The effectiveness of vitamin D as an alternative to FDA ‐approved treatment and other therapies for managing vulvovaginal atrophy and sexual inactivity in postmenopausal women. A systematic review and meta‐analysis
Abstract
BACKGROUND: Vulvovaginal atrophy (VVA) and sexual inactivity (SI) are prevalent among postmenopausal women (PMW). While hormonal therapies show significant improvement, non-hormonal therapies are considered the first-line for breast cancer women. However, vaginal hormonal therapies are unavailable in all countries, particularly developing countries such as the middle east, and there are no studies that have tested these therapies in women either with a history of breast cancer or those taking endocrine therapies for their cancer. OBJECTIVE: We conducted this meta-analysis to evaluate the effectiveness of vitamin D (VD), whether alone or in combination with other therapies, in managing VVA and SI in PMW. SEARCH STRATEGY: A systematic literature search was undertaken on four electronic databases (Web of Science, PubMed, Cochrane, and Scopus) from inception until June 2023. SELECTION CRITERIA: The randomized controlled trials (RCTs) that used the vaginal maturation index (VMI) and vaginal pH to measure VVA and vaginal dryness and the female sexual function index (FSFI) to measure SI were included in the meta-analysis. MAIN RESULTS: Eight RCTs (608 PMW) were included, and 222 were assigned to the VD arm. For the oral VD subgroup, there was no statistically significant improvement in the mean difference (MD) of VMI (MD -7.62, 95% confidence interval [CI]: -23.84, 8.59). However, VMI's topical VD subgroup was statistically significant (25.16; 95% CI: 18.74, 31.59). For topical…
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