title: Effect of tibolone on sexual function in late postmenopausal women.
abstract: BACKGROUND
  Sexual dysfunction may significantly affect quality of life and marital relations in the postmenopausal period. The aim of the study was to assess the effect of tibolone on climacteric symptoms and sexuality in late postmenopausal but still symptomatic women.
  
  
  METHODS
  A six-month prospective study was conducted of two groups of clinically healthy postmenopausal women: a control group (n = 18; mean age 57.8 +/- 4.1 yrs; menopause at 49.7 +/- 2.5; years of amenorrhea 8.1 +/- 4.0 yrs) and a tibolone group (n = 22; mean age 57 +/- 4.5 yrs; menopause at 47.7 +/- 3.9; years of amenorrhea 9.2 +/- 4.6 yrs), who received 2.5 mg tibolone daily for six months. The Kupperman menopausal index (KI) was calculated for both groups at baseline and at six months. Sexual function was assessed by the Female Sexual Function Index (FSFI) questionnaire at the beginning and at the end of the study. The FSFI comprised five main domains: desire, arousal, lubrication, orgasm and pain. Satisfaction and a total score were also recorded.
  
  
  RESULTS
  The results showed that during the observation period KI decreased significantly in the tibolone group (15.7 +/- 9.2 vs 11.3 +/- 6.8, p < 0.001), while in the control group no difference was observed. There was a significant improvement of sexual function in the tibolone group in all domains: desire -- from 2.6 +/- 1.0 to 3.1 +/- 1.0 (p < 0.001); arousal -- from 2.3 +/- 1.8 to 3.4 +/- 1.1 (p < 0.001); lubrication - 2.6 +/- 2.1 and 3.5 +/- 1.4 (p < 0.05). The ability to reach orgasm increased (p < 0.001) and pain and discomfort during and after sexual intercourse significantly decreased (p < 0.01). The overall satisfaction and the total score in the treated group changed favourably in a statistically significant manner, while these parameters did not change in the control group.
  
  
  CONCLUSIONS
  Treatment with tibolone had a beneficial effect on the climacteric symptoms and sexual function of late postmenopausal women. Moreover, tibolone seems to have an advantage over conventional hormone replacement therapy (HRT) in improving desire and arousal.
authors.affiliation: Clinic of Endocrinology, Alexandrov's Hospital, Department of Pathophysiology, Medical University, Sofia, Bulgaria.
authors.forename: Zdravko A
authors.initials: ZA
authors.lastname: Kamenov
authors.forename: Maria K
authors.initials: MK
authors.lastname: Todorova
authors.forename: Vladimir G
authors.initials: VG
authors.lastname: Christov
mesh_terms: D020847:Estrogen Receptor Modulators / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009652:Norpregnenes / Q000627:therapeutic use*; D017698:Postmenopause / Q000523:psychology; D011446:Prospective Studies; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy* / Q000209:etiology; D011795:Surveys and Questionnaires
chemical_list: D020847:Estrogen Receptor Modulators; D009652:Norpregnenes; C027385:tibolone