Abstract
Objective: This study aimed to evaluate the effects of monophasic estrogen-progestogen therapy on the sexuality and climacteric symptoms of postmenopausal women.
Patients and methods: A prospective, randomised, double-blind, crossover, placebo-controlled, single-centre study was carried out over a total of 12 consecutive months in 40 postmenopausal women with an intact uterus who had no contraindications to hormone therapy. Patients received 17β-estradiol 2mg in combination with norethisterone acetate 1mg (Cliane®) daily for 6 months or one placebo tablet daily for 6 months. The tablets were identical in appearance. After 6 months, the groups were crossed over and the patients were followed up for another 6 months. The groups were homogenous with respect to age, height, bodyweight, body mass index and race. For the statistical analysis, the group receiving hormone therapy was referred to as group A and the placebo group was designated group B, irrespective of the placebo/hormone therapy sequence.
Results: In group A there were fewer hot flashes (F = 22.85, p < 0.01) and an improvement in sexual interest (F = 5.55, p < 0.05). The sequence in which the medication was received resulted in a statistically significant difference with respect to dyspareunia (F = 9.65, p < 0.01) and satisfaction with the duration of penetration (F = 6.58, p < 0.05). In the intrapatient analysis of variation with respect to orgasmic capability and the presence of dialogue with partner regarding the couple’s sexual life, whether the placebo was taken prior to or following hormone therapy was significant (F = 17.12, p < 0.001 and F = 7.10, p < 0.05, respectively).
Conclusions: Monophasic estrogen-progestogen therapy has a beneficial effect on sexuality and on hot flashes in postmenopausal women.
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References
Penteado SRL, Fonseca AM, Bagnoli VR, et al. Sexuality in healthy postmenopausal women. Climacteric 2003; 6: 321–9
Phanjoo AL. Sexual dysfunction in old age. Advances Psych Treatment 2000; 6: 270–7
MoreiraJr ED, Glasser D, Santos DB, et al. Prevalence of sexual problems and related help-seeking behaviors among mature adults in Brazil: data from the global study of sexual attitudes and behaviors. São Paulo Med J 2005; 123(5): 2–16
Guthrie JR, Dennerstein L, Taffe JR, et al. Hot flushes during the menopause transition: a longitudinal study in Australianborn women. Menopause 2005; 12(4): 460–7
Dennerstein L, Dudley EC, Hopper JL, et al. Sexuality, hormones and the menopausal transition. Maturitas 1997; 26: 83–93
Barrett-Connor E, Young R, Notelovitz M, et al. A two year, double blind comparison of estrogen-androgen and conjugated estrogens in surgically menopausal women. J Reprod Med 1999; 44: 1012–20
Borissova AM, Kovatcheva R, Shinkov A, et al. A study of the psychological status and sexuality in middle-aged Bulgarian women: significance of the hormone replacement therapy. Maturitas 2001; 39: 177–83
Lobo RA, Rosen CR, Yang HM, et al. Comparative effects of oral esterified estrogens with and without methyltestosterone on endocrine profiles and dimensions of sexual function in postmenopausal women with hypoactive sexual desire. Fertil Steril 2003; 79: 1341–52
Sarrel PM. Ovarian hormones and vaginal blood flow: using laser Doppler velocimetry to measure effects in a clinical trial of post-menopausal women. Int J Impot Res 1998; 10Suppl. 2: S91–3; S98-101
Semmens JP, Wagner G. Estrogen deprivation and vaginal function in postmenopausal women. JAMA 1982; 248: 445–8
Kupperman HS, Wetcheles RB; Platt MHG. Contemporary therapy of the menopausal syndrome. JAMA 1959; 171: 1603–27
Rust J, Golombok S. The GRISS: a psychometric instrument for the assessment of sexual dysfunction. Arch Sex Behav 1986; 15: 157–65
Sherwin BB. The impact of different doses of estrogen and progestin on mood and sexual behavior in post menopausal women. J Clin Endocrinol Metab 1991; 72: 336–43
Dennerstein L, Burrows GD, Hyman GJ, et al. Hormone therapy and affect. Maturitas 1979; 1: 247–59
Utian WH. The true clinical features of postmenopause and oophorectomy and their response to oestrogen therapy. S Afr Med J 1972; 46: 732–7
Coope J, Thompson JM, Poller L. Effects of ‘natural oestrogen’ replacement therapy on menopausal symptoms and blood clotting. BMJ 1975; 4: 139–40
Nathorst-Boos J, Wiklund I, Mattsson LA, et al. Is sexual life influenced by transdermal estrogen therapy? A double blind placebo controlled study in postmenopausal women. Acta Obstet Gynecol Scand 1993; 72: 656–60
Wiklund I, Karlberg J, Mattsson LA. Quality of life of postmenopausal women on regimen of transdermal estradiol therapy: a double-blind placebo controlled study. Am J Obstet Gynecol 1993; 168 (3 Pt 1): 824–30
Hays J, Ockene JK, Brunner RL, et al. Effects of estrogen plus progestin on health-related quality of life. N Engl J Med 2003; 348: 1839–54
Hammar M, Christau S, Nathorst-Boos J, et al. A double-blind, randomized trial comparing the effects of tibolone and continuous combined hormone replacement therapy in postmenopausal women with menopausal symptoms. Obstet Gynecol Surv 1999; 54(2): 116–7
Abdo CHN, Oliveira Jr WM, Moreira Jr E, et al. The impact of psychosocial factors on the risk of erectile dysfunction and inhibition of sexual desire in a sample of the Brazilian population. São Paulo Med J 2005; 123(1): 1–10
Laumann EO, Nicolosi A, Glasser DB, et al. Sexual problems among women and men aged 40 to 80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2005; 17: 39–57
Acknowledgements
Financial support for this study from Schering do Brasil Química e Farmacêutica Ltda is gratefully acknowledged.
The authors have no conflicts of interest that are directly relevant to the content of this study.
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Fonseca, A.M., Bagnoli, V.R., Penteado, S.R.L. et al. Monophasic Estrogen-Progestogen Therapy and Sexuality in Postmenopausal Women. Clin. Drug Investig. 27, 131–137 (2007). https://doi.org/10.2165/00044011-200727020-00006
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DOI: https://doi.org/10.2165/00044011-200727020-00006