Vaginal Vitamin E for Treatment of Genitourinary Syndrome of Menopause: A Systematic Review of Randomized Controlled Trials

Abstract

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.

A practical guide to managing genitourinary syndrome of menopause in primary care

“…16 Compared with vaginal estrogen, vitamin E was not inferior at 8 and 12 weeks and was inferior compared with vaginal hyaluronic acid. 16 Because of concerns about study design and rigor, more studies need to be done before vitamin E can be recommended.…”

“…15 Vitamin E Menopause societies in the United States and Europe do not recommend isolated, vaginal vitamin E use in their guidelines, but patients may ask about using it. 16 Vitamin E, an antioxidant, protects tissues from oxidation and cell damage. Several small studies have evaluated vitamin E vaginal suppositories as an alternative, nonhormonal therapy for patients experiencing GSM.…”

“…Several small studies have evaluated vitamin E vaginal suppositories as an alternative, nonhormonal therapy for patients experiencing GSM. 16 Vitamin E may be particularly appealing for patients who are unable or unwilling to use hormones or who desire a more natural approach. A recent systematic review of randomized controlled trials found that vitamin E was superior to placebo in alleviating GSM symptoms-irritation, itching, vaginal dryness, and dyspareunia.…”

“…Menopause societies in the United States and Europe do not recommend isolated, vaginal vitamin E use in their guidelines, but patients may ask about using it 16. Vitamin E, an antioxidant, protects tissues from oxidation and cell damage.…”

The effect of conjugated estrogens vaginal cream and a combined vaginal cream of vitamins D and E in the treatment of genitourinary syndrome

“…(2018)[ 33 ] and Porterfield et al . (2022)[ 34 ]in their study stated that using vaginal suppositories of vitamin E and conjugated vaginal estrogen can improve libido, orgasm, and vaginal lubrication. Contrary to the results of the present study, in another study, Herold et al .…”