Appendix Table 4.
Summary of Outcome Reporting for Change in MBS
| Comparison | # trials Total N | Follow-up | Measurement tool | Author, year | Intervention | Intervention Mean change |
Comparator Mean change |
Direction of effect*** | Summary COE |
|---|---|---|---|---|---|---|---|---|---|
| Vaginal estrogen vs. placebo | 4 trials N=1,003 | 12 weeks | 4-point severity† | Bachmann, 2009 (36) | CEC 0.5g 21/7 CEC 0.5g 2x/wk |
−1.3** −1.4** |
−0.08** −0.7** |
↑ | Low ⨁⨁◯◯ Improve |
| Freedman, 2009 (37) | CEC 1g 2x/wk | −1.7* | −1.1* | ↑ | |||||
| Mitchell, 2018 (30) | Estradiol 10 mcg | −1.4 (95% CI −1.6, −1.2) | −1.3 (−1.5, −1.1) | ↔ | |||||
| Tanmahasamut, 2020 (29) | CEC 0.5g daily | −2.0 (95% CI −2.9, −1.1) | −1.6 (−2.4, −0.8) | ? | |||||
| Vaginal DHEA vs. placebo | 2 trials N=659 | 12 weeks | 4-point severity† | Barton, 2018 (26) | DHEA 0.25% DHEA 0.5% |
−1.6 (95% CI −1.8, −1.4) −1.8 (−2.0, −1.5) |
−1.5 (−1.7, −1.3) | ↔ ↑ | Very low ⨁◯◯◯ Uncertain |
| Labrie, 2009 (62) | DHEA 0.25% DHEA 0.5% DHEA 1.0% |
−1.2 (95% CI −1.4, −1.0) −1.5 (−1.7, −1.3) −1.3 (−1.5, −1.1) |
−0.6 (−0.8, −0.4) | ↑ | |||||
| Vaginal moisturizer vs. placebo | 1 trial N=200 | 12 weeks | 4-point severity† | Mitchell, 2018 (30) | Polycarbophil gel | −1.2 (95% CI −1.4, −1.0) | −1.3 (−1.5, −1.1) | ↔ | Low ⨁⨁◯◯ No difference |
| Vaginal oxytocin vs. placebo | 1 trial N=157 | 12 weeks | 4-point severity† | Fianu Jonasson, 2020 (54) | Oxytocin gel 400 IU | −1.2** | −1.3** | ↔ | Moderate ⨁⨁⨁◯ No difference |
Abbreviations: CEC=conjugated estrogens cream; CI=confidence interval; COE=certainty of evidence; DHEA=Dehydroepiandrosterone; g=gram; IU=international unit; mcg=microgram; mg=milligram; SD=standard deviation; SEM=standard error of mean; wk=week
Direction of Effect Symbols: Based on statistical comparison between arms; ↑ intervention statistically significantly better than comparator; ↔ no statistically significant difference; ? no statistical comparison
Scale score interpretation:
4-point severity (0=none to 3=severe)
Mean difference calculated by review team (trial only reported baseline and follow-up means)
Trial did not provide precision statistics (e.g., SD, SEM, 95% CI)
Direction of effect is based on statistical significance.