Reviewer ’s rep ort 
 
Title: Investigating the effect of vitamin D vaginal suppo sitory on sexual function among 
postmenopausal women: Study Protocol for a Randomized Controlled Trial  
 
Version: 0 Date: 24 Aug 2019  
 
Reviewer: Salvatore Caruso  
 
Reviewer's report:  
I was pleased to review the Manuscript "Investigating the effect of vitamin D vaginal 
suppository on sexual function among postmenopausal women: Study Protocol for a 
Randomized Control led Trial" (BMWH -D-18-00606). In my opinion, this is a well -written 
protocol. I appreciated the methodology described by the Authors but the paper should be further 
improved.  
 
In general, I have only a few comments and suggestions to the authors:  
 
* I sugg est a further linguistic revision by a native English speaker in order to correct 
several typos.  
* In this paper, the Authors investigated the effectiveness of vitamin D vaginal suppository 
in improving sexual function of postmenopausal women. I think it would be interesting to further 
discuss the relationship between vitamin D and postmenopausal symptoms, mentioning these 
studies about the topic: Prz Menopauzalny. 2018;17(1):1 -7. doi: 10.5114/pm.2018.73791; 
Maturitas. 2014 Sep;79(1):3 -7. doi: 10.1016/j.ma turitas.2014.06.003.  
* The Authors correctly discussed the use of systemic estrogen therapy for the treatment of 
vulvovaginal atrophy symptoms in postmenopausal women. In this regard, I think it is important 
to also discuss the use of topical estrogen ther apy with particular reference to ultralow -
concentration estriol vaginal gel. I suggest referring to the following studies about this topic: 
Menopause. 2017 Aug;24(8):900 -907. doi: 10.1097/GME.0000000000000851; Menopause. 
2012 Oct;19(10):1130 -9. doi: 10.109 7/gme.0b013e3182518e9a.  
* References should be formatted according to the Journal's guidelines. Please follow this 
example: Rohrmann S, Overvad K, Bueno -de-Mesquita HB, Jakobsen MU, Egeberg R, 
Tjønneland A, et al. Meat consumption and mortality - results f rom the European Prospective 
Investigation into Cancer and Nutrition. BMC Medicine. 2013;11:63.  
 
Are the methods  appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional s tatistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary fro m an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of  this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has appl ied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be includ ed 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal