Effects of hormone replacement therapy on sexuality in postmenopausal women in a mideast country.
OBJECTIVE
During the postmenopausal period, sexual interest and activity seem to decline, as part of the menopausal effect of oestrogen deficiency. The aim of this study was to evaluate other factors that could contribute to sexual dysfunction and the effect of hormone replacement therapy among postmenopausal women in Kuwait.


METHODS
Between June 1992, and June 1994, details of sexual history were compiled from 261 postmenopausal women that attended the Menopause Clinic at the Maternity Hospital, Kuwait. The effect of hormone replacement was analysed from the sexual history and the bacteriology of the lower genital tract.


RESULTS
About 71% of the 261 postmenopausal women were still sexually active. Among those not sexually active, 38% had loss of interest, 22% because of divorce or death of husband, 20% from loss of interest by husband, and in 13% because the husbands had impotence from medical problems. Of the sexually active women, 41.1% had reduced libido. Contributing factors included vaginal symptoms like dyspareunia and vaginal dryness, vaginal infection, disturbances in the premenopausal menstrual pattern and disharmony with husbands. About 23 to 45% of the postmenopausal women with oestrogen replacement therapy, had significant relief of their symptoms of sexual dysfunction. Vasomotor symptoms had better response compared to sexual dysfunction (p < 0.01). Natural oestrogen gave slightly better relief of symptoms of sexual dysfunction than other forms of oestrogen therapy. Livial gave complete relief of dyspareunia and vaginal dryness in 9.1% and 3.9% respectively, but none of those with libido and vaginal discharge had any relief.


CONCLUSIONS
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.
Omu
A E
AE
Department of Obstetrics and Gynaecology, Maternity Hospital, Kuwait.
al-Qattan
N
N
D000328:Adult; D004414:Dyspareunia / Q000188:drug therapy / Q000209:etiology; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007730:Kuwait; D007989:Libido; D008875:Middle Aged; D017698:Postmenopause; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D019529:Sexuality; D014623:Vaginal Diseases / Q000188:drug therapy / Q000209:etiology