Effects of vaginal administration of conjugated estrogens tablet on sexual function in postmenopausal women with sexual dysfunction: a double-blind, randomized, placebo-controlled trial

Abstract

Background: Female sexual dysfunction (FSD) is prevalent in women with genitourinary syndrome of menopause (GSM). Vaginal estrogen is effective GSM treatment. This study was primarily aimed to evaluate the effects of vaginal administration of conjugated estrogens tablet on postmenopausal FSD using the Female Sexual Function Index (FSFI). Secondary aims were to evaluate vaginal pH, Vaginal Maturation Value (VMV), Normal Flora Index (NFI) and Most Bothersome Symptoms (MBS) changes. Methods: A double-blind trial was conducted in postmenopausal women with FSD (FSFI ≤26.55). Sixty-seven participants were randomized into two arms; vaginally administered conjugated estrogens tablet (0.625 mg, daily for 3 weeks then twice weekly for 9 weeks, n = 33), or placebo (n = 34). Results: There was no significant improvement of FSFI observed in estrogens arm compared to placebo in each domain and overall index (p = 0.182). The estrogens significantly improved vaginal pH and VMV, toward more acidity (p = < 0.001), higher VMV (p = < 0.001) and more superficial cells (p = < 0.001). We observed no significant difference in NFI and MBS between arms (p = 0.282, 0.182). Conclusion: We found no significant changes in FSFI, NFI, and MBS, but significant improvement in vaginal pH and VMV in postmenopausal women with FSD treated with vaginally administered conjugated estrogens tablet. Few side-effects were reported.

Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review

“…90 In healthy postmenopausal women with sexual dysfunction, a conjugated estrogen tablet improved vaginal pH and vaginal maturation values but not sexual function. 91 It should be noted that in women with breast cancer estrogens are contraindicated. With inconclusive findings across different studies, further research is needed.…”

Hormone therapy for sexual function in perimenopausal and postmenopausal women: a systematic review and meta-analysis update

“…This result, however, is limited because of the small number of participants included in the analysis (Supplemental Digital Content, Appendix B, http://links.lww.com/MENO/B126). 32 Low Low Some concerns Low Some concerns Some concerns Caruso et al 34 Some concerns Some concerns High Some concerns Some concerns High Cruz et al 36 Low Low High Low Some concerns High Ferrante et al 38 Low Low High High Some concerns High Hirschberg et al 39 Low Low High Low Some concerns High Lillemon et al 41 Some concerns Some concerns Some concerns Low Some concerns High Mac Bride 42 Some concerns Low Some concerns Low High High MsFLASH VHT Diem et al, 45 Mitchell et al, 46 Jensen, 47…”

The Current Strategy in Hormonal and Non-Hormonal Therapies in Menopause—A Comprehensive Review

“…The study showed no significant changes in the Female Sexual Function Index. However, a significant improvement in the vaginal pH and Vaginal Maturation Value was observed [ 21 ].…”

“…Thus, there are several therapeutic schemes to improve genitourinary symptoms. Current treatment is based on topical estrogen alone [ 21 , 22 , 23 , 24 , 25 , 26 ] or combined with testosterone [ 27 , 28 ] which has shown improvements over time in the fields of vaginal trophicity, arousal, orgasm, and satisfaction ( Table 1 ). For moderate/severe dyspareunia the treatment uses daily intravaginal 0.50% DHEA ovules (suppositories—Prasterone) for 12 weeks [ 29 , 30 ].…”