Osmanağaoğlu 2006.

Methods	Randomised controlled trial
Participants	165 naturally postmenopausal women; absence of menstruation > 1 year; FSH ≥ 30 IU/L; not undergone any gynaecological operation; no absolute contraindication for HT. Mean age 50 years
Interventions	Tibolone 2.5 mg/d Oestradiol valerate 2 mg plus dienogest 2 mg/d Administered for 6 months
Outcomes	Lubrication and pain during sexual intercourse as score at baseline and at post treatment
Notes	Only 107 women were considered in the analyses (excluding women assigned to "no treatment") Even if not specified in the protocol, lubrication has been evaluated as a measure of vaginal dryness Timing: unclear Location: Turkey? Multi‐centre: not specified
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not specified
Allocation concealment (selection bias)	Unclear risk	Not specified
Blinding of participants and personnel (performance bias) All outcomes	High risk	Study authors declare that the study is single‐blind (participant), but in some cases, women were given doctor samples from drug companies
Blinding of outcome assessment (detection bias) All outcomes	High risk	Outcomes were evaluated through a self‐administered questionnaire, but it is unclear whether participating women were blind
Incomplete outcome data (attrition bias) All outcomes	Low risk	7/165 participants without follow‐up data
Selective reporting (reporting bias)	Unclear risk	Study protocol not available
Conflict of interest	Low risk	Study authors declare that they did not receive external funding and that they do not have conflicts of interest