title: Comparison of the effects of hormone therapy regimens, oral and vaginal estradiol, estradiol + drospirenone and tibolone, on sexual function in healthy postmenopausal women.
abstract: BACKGROUND
  Sexual dysfunction is more prevalent in postmenopausal women.
  
  
  OBJECTIVE
  To prospectively evaluate and compare the effects of hormone therapy (HT) regimens, oral and vaginal estradiol, estradiol + drospirenone and tibolone, on sexual function in healthy postmenopausal women.
  
  
  METHODS
  The study included 169 consecutive healthy postmenopausal women, and the women were divided into two groups: 111 women received HT, and 58 women received no treatment and served as a control group. As an HT, 23 women with surgically induced menopause received oral 17-beta estradiol. The rest of the women with natural menopause were prospectively randomized: 22 received oral 17-beta estradiol + drospirenone daily, 42 received oral tibolone, and 24 received vaginal 17-beta estradiol. Sexual function was evaluated with a detailed 19-item questionnaire, the female sexual function index, including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain.
  
  
  METHODS
  The differences in sexual function were compared before and 6 months after the treatment in all women.
  
  
  RESULTS
  Total sexual function score increased from 19.81 +/- 7.15 to 22.9 +/- 6.44 in the HT group and decreased from 21.6 +/- 8.69 to 17.6 +/- 5.7 in the control group, revealing a significant difference from baseline to post-treatment between the two groups (P = 0.000). The highest improvement in total score and arousal was achieved with the oral 17-beta estradiol (P = 0.000 and P = 0.000, respectively). The highest improvement in lubrication was achieved with the oral and vaginal 17-beta estradiol groups (P = 0.000). The highest improvement in orgasm was achieved with the tibolone group (P = 0.000). The highest improvement in pain was achieved with the oral and vaginal 17-beta estradiol groups (P = 0.000).
  
  
  CONCLUSIONS
  HT provided significant improvement in sexual function compared to women receiving no treatment, and therefore, HT regimens should be suggested for improvement in sexual functioning of postmenopausal women.
authors.affiliation: Department of Obstetrics and Gynecology, University of Mersin School of Medicine, Mersin, Turkey. filizcayan@yahoo.com
authors.forename: Filiz
authors.initials: F
authors.lastname: Cayan
authors.forename: Umut
authors.initials: U
authors.lastname: Dilek
authors.forename: Ozlem
authors.initials: O
authors.lastname: Pata
authors.forename: Saffet
authors.initials: S
authors.lastname: Dilek
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000736:Androstenes / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage*; D020847:Estrogen Receptor Modulators / Q000008:administration & dosage*; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007989:Libido / Q000187:drug effects; D008875:Middle Aged; D009652:Norpregnenes / Q000008:administration & dosage*; D009948:Orgasm / Q000187:drug effects; D017698:Postmenopause / Q000187:drug effects; D045167:Progesterone Congeners / Q000008:administration & dosage*; D011446:Prospective Studies; D012016:Reference Values; D012725:Sexual Behavior / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D000736:Androstenes; D020847:Estrogen Receptor Modulators; D009652:Norpregnenes; D045167:Progesterone Congeners; D004958:Estradiol; C027385:tibolone; C035144:drospirenone