There is a decline in sexual response and activity in postmenopausal women in Kuwait. This is however, multifactorial in origin. Although oestrogen replacement therapy gives significant relief in symptoms of sexual dysfunction, other contributory factors should always be evaluated.

There was no demonstrably clear effect of the estrogen-progestin combination on lipoprotein levels, probably because of other compounding variables such as obesity, lack of exercise and the type of progestin used.

The objective of this study was to evaluate the effect of hormone replacement therapy in 261 postmenopausal women in Kuwait 1 year after starting treatment. The investigations were carried out from June 1992 to June 1994. Combined estrogen and progesterone were used by 50.6% of the women while estrogen implants were used by 18%, transdermal therapeutic system (TTS) patches by 10.3%, natural estrogen by 10.0%, Livial by 6.1%, and estrogen cream by 5.0%. The side effects of HRT were few and mild. Nine of the 27 patients on TTS patch had allergic skin reactions. Significant reduction in the vasomotor symptoms of hot flushes, night sweats and palpitations was achieved in 80-90% of the patients; 31-37% experiencing total elimination of symptoms. Although there was appreciable reduction in the musculoskeletal, psychological and sexual dysfunction symptoms, relief was significantly better for the vasomotor symptoms (p < 0.01). There was a significant reduction in the levels of FSH and LH, and an increase in estrogen levels (p < 0.001), but no significant change was recorded in the lipoprotein profile (p > 0.05). In conclusion, hormone replacement therapy has a significant place in the alleviation of climacteric symptoms in this community.