An article in JAMA Internal Medicine reports that sexual function in early postmenopausal women showed some improvement with use of transdermal estrogen therapy. Noting that declining estrogen levels can cause sexual dysfunction and adversely affect quality of life, Yale School of Medicine researchers investigated whether estrogen delivered through the skin could help.
To do that, the study team analyzed an ancillary study of a clinical trial focusing on changes in sexual function in recently postmenopausal women. Included were 670 women who were given either oral conjugated equine estrogens (o-CEE), transdermal 17?-estradiol (t-E2), or placebo. All participants were within 3 years of their last menstrual period and ranged in age from 42 to 58 years.
Aspects of sexual function and experience—desire, arousal, lubrication, orgasm, satisfaction, and pain—were assessed using a questionnaire. Because distress linked to sexual symptoms was not evaluated, scores below a certain threshold were characterized as low sexual function as opposed to sexual dysfunction, researchers point out.
Results indicate that transdermal treatment was associated with moderate improvement in the overall sexual-function score across all time points, compared with placebo. No significant difference in overall sexual function score was detected with oral estrogen treatment compared with placebo, however.
In addition, no variation was documented in overall sexual function score between the oral and transdermal estrogen therapies, on average, over 4 years of analysis. For some specific areas of sexual function, the transdermal treatment was linked to an increase in average lubrication and decreased pain compared with placebo, the study notes.
In general, according to the article, the proportion of women with low sexual function declined after transdermal treatment compared with placebo, but there was no significant reduction in the odds of low sexual function with oral estrogen therapy.
Clinical-trial participants were predominantly white women with a higher educational background than the general population, so researchers caution about the generalizability of their results.
“In summary, in a randomized clinical trial of hormone therapy in early postmenopausal women, treatment with t-E2 provided modest benefits for sexual function,” the study authors write. “The efficacy of o-CEE treatment seemed to be less than that of t-E2, especially in the subgroup of women with LSF (low sexual function), although there was no statistically significant difference between the hormone groups in overall sexual function.”
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