An overview of the phytoestrogen effect on vaginal health and dyspareunia in peri- and post-menopausal women

Abstract

Objective: The aim of this overview was to evaluate the effectiveness of phytoestrogens on vaginal health and dyspareunia in peri- and post-menopausal women. Material and methods: Three databases including MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials were from inception to August 2017. Result: Two systematic reviews and 11 RCTs were included in the overview. According to the findings, isoflavones increased the maturation value and attenuated the vaginal atrophy in the post-menopausal women. Topical isoflavones had beneficial effects on the vaginal atrophy. Similar efficacy was found in Pueraria mirifica and conjugated estrogen cream on dryness (p = 0.277), soreness (p = 0.124) and irritation (p = 0.469), as well as discharge (p = 0.225) and dyspareunia (p = 0.089). However, the conjugated estrogen cream was more effective compared to Pueraria mirifica (p > 0.005) regarding maturation index improvement. Comparison of fennel 5% vaginal cream and placebo gel showed significant difference in superficial cells (p < 0.01), parabasal cells (p < 0.01) and intermediate cells (p < 0.01), whereas no difference was found between the oral fennel and placebo in terms of superficial, parabasal and intermediate cells as well as Maturation value. Administration of 80 mg red clover oil had a significant effect on superficial (p < 0.005), intermediate (p < 0.005) and parabasal and vaginal dryness (p < 0.005) compared to the placebo. Flaxseed had also a trivial effect on maturation value. Genistein had a more prominent effect on the genital score. The severity of dyspareunia decreased by 27%. Conclusion: Phytoestrogens have various effects based on administration route and type on the vaginal atrophy.