A survey of the therapeutic effects of Vitamin E suppositories on vaginal atrophy in postmenopausal women

Aazam Parnan Emamverdikhan, Nahid Golmakani, Sayyed ASajadi Tabassi, Malihe Hassanzadeh, Nooriyeh Sharifi, Mohammad Taghi Shakeri



Background: Menopause is associated with various complications such as depression, sleep disorders, and genitourinary atrophy. Vaginal atrophy occurs due to the loss of steroid hormones, and its major symptoms include vaginal dryness, itching, dyspareunia, and bleeding after intercourse. According to the literature, vitamin E plays a key role in estrogen stability. The aim of this study was to compare the  effects of vitamin E suppositories and conjugated estrogen vaginal cream on vaginal atrophy.
Materials and Methods: In this clinical trial, 52 postmenopausal women, who were referred to a gynecology clinic in 2013, were recruited and randomly divided into two groups (26 cases per group). One group received 100 IU of vitamin E suppositories (n = 26), whereas the other group applied 0.5 g of conjugated estrogen cream for 12 weeks. Vaginal maturation value (VMV) was compared between the two groups before and after the intervention. VMV ≤ 55 was regarded as a cut‑off point for vaginal atrophy. Treatment success was defined as a 10‑unit increase in VMV, compared to the baseline value. Data were analyzed by Friedman test and Mann–Whitney test. P value less than 0.05 was considered statistically significant.
Results: The mean VMV in the vitamin E group before the treatment and after 4, 8, and 12 weeks of treatment was 43.78 ± 13.75, 69.07 ± 22.75, 77.86 ± 21.79, and 80.59 ± 19.23, respectively. The corresponding values in the estrogen cream group were 42.86 ± 14.40, 86.98 ± 12.58, 92.65 ± 15, and 91.57 ± 14.10, respectively. VMV significantly improved in both the treatment groups after the intervention, compared to the preintervention period (P < 0.001). Treatment success was reported in both groups, although estrogen cream (100%) appeared to be more effective after 4 weeks of treatment, compared to vitamin E suppositories (76.9%) (P = 0.01).
Conclusions: Based on the findings, use of vitamin E suppositories could improve the laboratory criteria for vaginal atrophy and treatment success. Therefore, vitamin E suppositories are suggested for relieving the symptoms of vaginal atrophy, especially in women who are unable to use hormone therapy or cope with the associated side effects.


Conjugated estrogen; vitamin E; vaginal atrophy

Full Text:



Noroozi E, Kasiri DN, Eslami A, Hassanzadeh A, Davari S. Knowledge and attitude of 40‑45 year old women toward menopause. J Health Sys Res 2011;7:460‑8.

Baghdari N. Effect of Flaxseed on hot flashes in women at the climacteric, Mashhad University of Medical Sciences, School of Nursing and Midwifery, 2007.

Berek JS, Novak E. Berek and Novak’s Gynecology, 14th ed. Philadelphia: Lippincott Williams & Wilkins; 2012. p. 522‑9.

Blake J. Menopause: Evidence‑based practice. Best Pract Res Clin Obstet Gynaecol 2006;20:799‑83.

Ziagham Z, Abbaspoor Z, Abbaspour MR, Rashidi I, Haghighizadeh M. The comparison between the effects of hyaluronic acid vaginal suppository and vitamin E on vaginal maturation index in menopausal women. AJUMS 2013;11:393‑401.

Maasoumi R, Zieaie S, Faghihzade S. Comparing the effects of tibolone and continuous hormone replacement therapy on the vaginal maturation index and value in menopausal women. Koomesh J 2012;13:397‑404.

Panjari M, Davis SR. Vaginal DHEA to treat menopause related atrophy: A review of the evidence. Maturitas 2011;70:22‑5.

Marx P, Schade G, Wilbourn S, Blank S, Moyer DL, Nett R. Low‑dose (0.3 mg) synthetic conjugated estrogens A is effective for managing atrophic vaginitis. Maturitas 2004;47:47‑54.

Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility, 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 552‑99.

Gharekhani P, Sadatiyan A. Women’s diseases CMMD, 5th ed. Tehran: Noordanesh publication; 2000. p. 309‑24.

Palacios S. Managing urogenital atrophy. Maturitas 2009;63:315‑8.

Tadayon M, Rad P, Abbaspour MR, Latifi SM, Rashidi I, Barati M, Delaaviz H. The effect of vitamin D suppository on atrophic vaginal mucosa in menopausal women. Armaghane‑danesh 2012;17:187‑195.

Labrie F, Archer D, Bouchard C, Fortier M, Cusan L, Gomez G, et al. Intravaginaldehydroepiandrosterone (Prasterone), a physiological and highly efficient treatment of vaginal atrophy. Menopause 2009;16:907‑22.

Rajaeefard A, Mohammad‑Beigi A, Mohammad‑Salehi N. Estimation of natural age of menopause in Iranian women: A meta‑analysis study. Koomesh J 2011;13:1‑7.

Shohani M, Rasouli F, Haji AP, Hasanpoor DA, Mahmoudi M. Evaluation of the urogenital problems of menopausal woman referred to the health care centers of Ilam, Iran. HMJ 2009; 13:189‑96.

Greendale G, Zibecchi L, Petersen L, Ouslandert G, kahn B, Ganz P. Development and validation of aphysical examination scale vaginal atrophy and inflammation to assess vaginal atrophy and inflammation. Climacteric Journal 1999;2:197‑204.

Rayan KJ, Berkowitz RS. Kisner’s Gynecology & women’s Health, 7th ed. Boston: Mosby; 1999. p. 634‑46.

Castelo‑Branco C, Cancelo M, Villero G, Nohales F, Juli M. Management of post‑menopausal vaginal atrophy and atrophic vaginitis. Maturitas 2005;52:46‑52.

Raymundo N, Yu‑cheng B, Zi‑yan H, Lai CH, Leung K, Subramaniam R, et al. Treatment of atrophic vaginitis with topical conjugated equine estrogens in postmenopausal Asian women. Climacteric 2004;7:312‑8.

Gass M, Taylor M. Alternatives for women through menopause. AJOG 2001;185:47‑56.

Xu LW, Jia M, Salchow R, Kentsch M, Cui X, Deng HY, et al. Efficacy and side effects of Chinese herbal medicine for menopausal symptoms: A critical review. Evid Based Complement Alternat Med 2012;2012:568106.

Ziagham S, Abbaspoor Z, Safyari S, Rad P. Effect of vitamin E vaginal suppository on atrophic vaginitis among postmenopausal women. Jundishapur Journal of Chronic Disease Care 2013;2:11‑19.

Vitamin E (tocopherol). Org [Internet]. Available from http:// www.vitamins‑supplements.org. [Last accessed on 2013 Jan 21].

Ziagham Z, Abbaspoor Z, Abbaspour MR. The comparison between the effects of hyaluronic acid vaginal suppository and vitamin E on the treatment of atrophic vaginitis in menopausal. AMUJ 2012;15:57‑64.

Ziaei S, Kazemnejad A, Zareai M. The effect of vitamin E on hot flashes in menopausal women. Gynecol Obstet Invest 2007;64:204‑7.

Costantino D, Guaraldi C. Effectiveness and safety of vaginal suppositories for the treatment of the vaginal atrophy in postmenopausal women: An open, non‑controlled clinical trial. Eur Rev Med Pharmacol Sci 2008;12:411‑6.

Vitamin E. 2013. Available from: https://fa.wikipedia.org/wiki. [Last accessed on 2013 Jan 21].

Mohamadi NI. Vitamin in health and disease, 1st ed. Tehran: Boshrapublisher; 2007. p. 135‑50.

Das P, Chowdhury M. Vitamin E‑deficiency induced changes in ovary and Uterus. Molecular and Cellular Biochemistry Journal 1999;198:151–156.

Kohi D, Ghaderpanahi M. Nutrition and sexual orientation. Available from: http://www.civilica.com/Paper‑NCFSP02‑ NCFSP02_004.htm2005. [Last accessed on 2005 Nov 22].

Feinstein A. Treatment with vitamins, 1st ed. Translation: Haghir H. Tehran: Afarinegan Publisher; 2000. p. 413‑591.

Valenta C. The use of mucoadhesive polymers in vaginal delivery. Adv Drug Deliv Rev 2005;57:1692‑712.

Shahraz S, Ghaziani T. Comprehensive text book of drug information, 4th ed. Tehran: Teimourzadeh publisher; 2007. p. 281.


  • There are currently no refbacks.