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J Sex Med. 2008 Jan;5(1):132-8. Epub 2007 Oct 24.

Comparison of the effects of hormone therapy regimens, oral and vaginal estradiol, estradiol + drospirenone and tibolone, on sexual function in healthy postmenopausal women.

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1
Department of Obstetrics and Gynecology, University of Mersin School of Medicine, Mersin, Turkey. filizcayan@yahoo.com

Abstract

INTRODUCTION:

Sexual dysfunction is more prevalent in postmenopausal women.

AIMS:

To prospectively evaluate and compare the effects of hormone therapy (HT) regimens, oral and vaginal estradiol, estradiol + drospirenone and tibolone, on sexual function in healthy postmenopausal women.

METHODS:

The study included 169 consecutive healthy postmenopausal women, and the women were divided into two groups: 111 women received HT, and 58 women received no treatment and served as a control group. As an HT, 23 women with surgically induced menopause received oral 17-beta estradiol. The rest of the women with natural menopause were prospectively randomized: 22 received oral 17-beta estradiol + drospirenone daily, 42 received oral tibolone, and 24 received vaginal 17-beta estradiol. Sexual function was evaluated with a detailed 19-item questionnaire, the female sexual function index, including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain.

MAIN OUTCOME MEASURES:

The differences in sexual function were compared before and 6 months after the treatment in all women.

RESULTS:

Total sexual function score increased from 19.81 +/- 7.15 to 22.9 +/- 6.44 in the HT group and decreased from 21.6 +/- 8.69 to 17.6 +/- 5.7 in the control group, revealing a significant difference from baseline to post-treatment between the two groups (P = 0.000). The highest improvement in total score and arousal was achieved with the oral 17-beta estradiol (P = 0.000 and P = 0.000, respectively). The highest improvement in lubrication was achieved with the oral and vaginal 17-beta estradiol groups (P = 0.000). The highest improvement in orgasm was achieved with the tibolone group (P = 0.000). The highest improvement in pain was achieved with the oral and vaginal 17-beta estradiol groups (P = 0.000).

CONCLUSIONS:

HT provided significant improvement in sexual function compared to women receiving no treatment, and therefore, HT regimens should be suggested for improvement in sexual functioning of postmenopausal women.

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