A comparison in vitamin D receptor expression during oral menopausal hormone therapy and vaginal estrogen therapy

Abstract

Objective: The aim of this study was to examine vitamin D receptor (VDR) expression in vaginal cell and vaginal maturation index (MI) of menopausal women after hormone replacement therapy (HRT). Materials and Methods: The authors enrolled 60 healthy postmenopausal women at one year after diagnosis of menopause who had no history of HRT. The subjects were randomized into two groups in an open label fashion. The oral HRT group was treated with one tablet (two mg drospirenone, one mg estradiol hemihydrate per tablet) per day for four weeks, and the vaginal estrogen therapy (ET) group used one vaginal suppository (500 mu g estriol per tablet) every day over four weeks. The authors evaluated clinical characteristics, Kupperman index, and vaginal pH before and after treatment. Vaginal epithelial cells were obtained by vaginal swab and prepared to determine the vaginal MI or VDR expression using immunocytochemistry (ICC) and immunofluorescence, followed by confocal microscopy before and after treatment. Results: The authors confirmed cytoplasmic expression of VDR in vaginal epithelial cells and that VDR expression was increased in the vaginal epithelium after both oral HRT and vaginal ET, although VDR expression after oral HRT was more effective in increasing VDR than vaginal ET. Conclusion: VDR expression in the vagina is affected by different types of HRT.