BackgroundThe perimenopausal and postmenopausal periods are associated with many symptoms, including sexual complaints. ObjectivesTo assess the effect of hormone therapy (HT) on sexual function in perimenopausal and postmenopausal women. Search methodsWe searched for articles in the Cochrane Menstrual Disorders and Subfertility Group (MDSG) Specialised Register, CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, ClinicalTrials.gov, Current Controlled Trials, WHO International Clinical Trials Registry Platform, ISI Web of Knowledge and OpenGrey. The last search was performed in December 2012. Selection criteriaWe included randomised controlled trials comparing HT to either placebo or no intervention (control). We considered as HT estrogens alone; estrogens in combination with progestogens; synthetic steroids (for example tibolone); or selective estrogen receptor modulators (SERMs) (for example raloxifene, bazedoxifene). Studies of other drugs possibly used in the relief of menopausal symptoms were excluded. We included studies that evaluated sexual function using any validated assessment tool. The primary outcome was a composite score for sexual function and the scores for individual domains (arousal and sexual interest, orgasm, and pain) were secondary outcomes. Studies were selected by two authors independently. Hormone therapy for sexual function in perimenopausal and postmenopausal women (Review)
Introduction There is a need for specific measures to address overall care in women with polycystic ovary syndrome (PCOS). Physical resistance training (PRT) has been shown to improve certain body parameters. However, the effect of PRT on the sexual function of PCOS women has not been evaluated. Aim The study aimed to assess sexual function and emotional status of PCOS women after 16 weeks of PRT. Methods This case-control study involved 43 women with PCOS and 51 control ovulatory women, aged 18–37 years. All women were subjected to a supervised PRT protocol for 16 weeks and evaluated at the end of the program. Sexual function was assessed at baseline and after PRT protocol. Main Outcome Measures The main outcome measure used was the Female Sexual Function Index (FSFI). Results Of the 43 women with PCOS, 30 (69.70%) had a basal total FSFI score ≤ 26.55 and 24 of them (58.54%) had a score ≤ 26.55 after PRT (P = 0.08). Of the 51 control women, 32 (62.7%) and 27 (52.9%) had FSFI scores < 26.55 at baseline and after PRT, respectively (P = 0.06). Control women experienced a significant improvement in pain domain score after PRT (P < 0.03). PCOS women experienced significant increases in total score and in the desire, excitement and lubrication domains after PRT (P < 0.01 each). After PRT, there was a significant difference between the PCOS and control groups in the sexual desire domain (4.09 ± 1.29 vs. 3.75 ± 1.42, P = 0.04). Significantly fewer women in the PCOS group were at risk of depression (P < 0.01) and anxiety (P < 0.02) after than before PRT, whereas the differences in the control group were not significant. Mean depression and anxiety scores were reduced significantly in both the PCOS (P < 0.01 each) and control (P < 0.01) groups. Conclusions PRT significantly enhanced total score and the desire, excitement, and lubrication domains of the FSFI in PCOS women. PRT reduced pain, and total depression and anxiety scores in both groups.
Sexual dysfunction prevalence is high among women. However, doctors rarely ask about their patients' sexual life, because they feel uncomfortable or because their knowledge about investigation techniques is insufficient. The PLISSIT model, a useful tool to access human sexual function, is composed by four elements: permission, limited information, specific suggestions, and intensive therapy, that favor dialogue between the doctor and the patient allowing the access to the sexual complaints. The therapeutics consists of counseling measures, drug prescription, basic orientations about sexual function and interventions on anatomic and functional aspects of the sexual apparatus with positive impact in the woman's sexual life. The present review shows how to use it. In addition, many aspects of female sexual dysfunction are discussed, such as prevalence, diagnostic and treatment options for female sexual dysfunction.
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