Vaginal atrophy and sexual dysfunction in current users of systemic postmenopausal hormone therapy.
OBJECTIVE
To determine the prevalence of vaginal atrophy and sexual dysfunction in current users of systemic postmenopausal hormone therapy (pHT).


METHODS
A cross-sectional study was conducted in 97 current users of pHT at Siriraj Menopause Clinic from 2005 to 2007. Subjective symptoms of vaginal atrophy and sexual dysfunction were assessed by interviewing. Objective signs of vaginal atrophy were assessed using pelvic examination, vaginal pH, and maturation value (MV).


RESULTS
The prevalence of vaginal atrophy in current users of systemic pHT determining from patient's symptoms, pelvic examination, vaginal pH, and MV were 44.3%, 15.5%, 21.6% and 8.8%, respectively. The prevalence of sexual dysfunction varied from 48.7% to 71.6% depending on types of dysfunction. There was poor association between the subjective symptoms and signs, and the objective indicators of vaginal atrophy. Among various regimens of pHT, tibolone had the lowest prevalence of subjective atrophic symptoms; estrogen-only pHT had the lowest prevalence of objective atrophic signs; and raloxifene had the highest prevalence of atrophic symptoms and signs, and sexual dysfunction. There was statistically significant association between regimens of pHT and objective indicators for vaginal atrophy (p = 0.004 for pH, and 0.000 for MV).


CONCLUSIONS
Current users of systemic pHT still have vaginal atrophy and sexual dysfunction which relates to regimens of pHT. The prevalence of vaginal atrophy varies depending on the assessment methods. The subjective method gives higher prevalence than the objective one does. Since the subjective symptoms of vaginal atrophy would have more adverse effect on quality of life than the objective signs do, the authors suggest that patients' complaints be used to assess factors affecting vaginal atrophy in further research.
Indhavivadhana
Suchada
S
Gynecologic Endocrinology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Leerasiri
Pichai
P
Rattanachaiyanont
Manee
M
Laiwejpithaya
Somsak
S
Tanmahasamut
Prasong
P
Techatraisak
Kitirat
K
Angsuwathana
Surasak
S
D000282:Administration, Intravaginal; D000328:Adult; D000368:Aged; D044466:Asian People; D001284:Atrophy; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects* / Q000502:physiology / Q000523:psychology; D015995:Prevalence; D012735:Sexual Dysfunction, Physiological / Q000473:pathology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014621:Vagina / Q000187:drug effects / Q000473:pathology*; D014623:Vaginal Diseases / Q000473:pathology*