The effect of vitamin D and E vaginal suppositories on tamoxifen-induced vaginal atrophy in women with breast cancer

  • Zahra Keshavarzi
  • Roksana JanghorbanEmail author
  • Shohreh Alipour
  • Sedigheh Tahmasebi
  • Azam Jokar
Original Article



Vaginal atrophy is one of the most common side effects of using tamoxifen in women with breast cancer. Hormone therapy for vaginal atrophy is prohibited in these women. The present study was conducted to investigate the effect of vitamin D and E vaginal suppositories on vaginal atrophy in women with breast cancer receiving tamoxifen.


Women under breast cancer management receiving tamoxifen and showing symptoms of vaginal atrophy were randomized triple-blind to an 8-week trial on vaginal suppository vitamin E or vitamin D or placebo administered every night before bedtime. The genitourinary atrophy self-assessment tool was administered, and pH was measured in all three groups before the intervention and at the end of weeks 2, 4, and 8 of the intervention. The Vaginal Maturation Index (VMI) was also measured before the intervention and at the end of the eighth week. Data were analyzed with paired t tests, repeated measures analysis of variance, and chi-square test.


Thirty-two patients were randomized in each group. The results obtained showed an increase in the VMI by the end of the eighth week of the intervention in the groups receiving the vitamin D and E vaginal suppositories compared with the placebo group (P < 0.001). The vaginal pH also reduced in both groups compared with that in the placebo group (P < 0.001). The symptoms of self-reported genitourinary atrophy also improved in the two intervention groups compared with those in the placebo group by the end of the eighth week (P < 0.001).


These data support that vitamin D and E vaginal suppositories were beneficial in improving vaginal atrophy in women with breast cancer receiving tamoxifen. Given the prohibition on hormone therapy in these women, the suppositories can be used as an alternative therapy to improve these symptoms.


Breast cancer Tamoxifen Atrophic vaginitis Vitamin D Vitamin E Vaginal suppository 


Compliance with ethical standards

The research project was approved by the ethics committee of Shiraz University of Medical Sciences (IR.SUMS.REC 94-01-08-11247) and registered at the Iranian Registry of Clinical Trials (IRCT2016100229683N2).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Midwifery, School of Nursing and Midwifery, Student Research CommitteeShiraz University of Medical SciencesShirazIran
  2. 2.Department of Midwifery, School of Nursing and Midwifery, Community Based Psychiatric Care Research CenterShiraz University of Medical SciencesShirazIran
  3. 3.Department of Pharmaceutical Quality Control, School of PharmacyShiraz University of Medical SciencesShirazIran
  4. 4.Department of Surgery, School of Medicine, Breast Diseases Research CenterShiraz University of Medical SciencesShirazIran
  5. 5.Department of Midwifery, School of Nursing and MidwiferyShiraz University of Medical SciencesShirazIran

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