title: Sexual function in women on estradiol or venlafaxine for hot flushes: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate sexual function in midlife women taking low-dose oral estradiol or venlafaxine for hot flushes.
  
  
  METHODS
  In an 8-week randomized controlled trial among women aged 40-62 years, sexual function was compared between 0.5 mg oral estradiol per day or 75 mg venlafaxine per day (both compared with a placebo). Measures included composite and six domain scores from the Female Sexual Function Index and sexually related personal distress.
  
  
  RESULTS
  Participants were aged 54.6 years (standard deviation [SD] 3.8) years, 59% white, with 8.1 (SD 5.3) daily hot flushes. Median composite baseline Female Sexual Function Index score was 16.3 (SD 11.9, n=256) for all women and 21.7 (SD 9.3, n=198) among sexually active women. Composite mean Female Sexual Function Index change from baseline to week 8 was 1.4 (95% confidence interval [CI] -0.4 to 3.2) for estradiol, 1.1 (95% CI -0.5 to 2.7) for venlafaxine, and -0.3 (95% CI -1.6 to 1.0) for placebo. Composite Female Sexual Function Index and sexually related distress change from baseline did not differ between estradiol and placebo (P=.38, P=.30) or venlafaxine and placebo (P=.79, P=.48). Among sexually active women, Female Sexual Function Index domain score change from baseline differences (active compared with placebo) in desire was 0.3 (95% CI 0.0-0.6) for estradiol, -0.6 (95% CI -1.2 to 0.0) in orgasm for venlafaxine, and 0.9 (95% CI 0.2-1.6) in penetration pain for venlafaxine. No women reported adverse events related to sexual dysfunction.
  
  
  CONCLUSIONS
  Overall sexual function among nondepressed midlife women experiencing hot flushes did not change over 8 weeks with low-dose oral estradiol or venlafaxine (compared with placebo), although a subtle increase in desire (estradiol) and decreases in orgasm and pain (venlafaxine) may exist.
  
  
  BACKGROUND
  ClinicalTrials.gov, www.clinicaltrials.gov, NCT01418209.
  
  
  METHODS
  I.
authors.affiliation: Departments of Obstetrics and Gynecology and Epidemiology, University of Washington School of Medicine, the Group Health Research Institute, and the Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, Washington; the Departments of Psychiatry and Medicine, Brigham and Women's Hospital, the Departments of Psychiatry and Obstetrics and Gynecology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts; and the Departments of Obstetrics and Gynecology and Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Reed
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Mitchell
authors.forename: Hadine
authors.initials: H
authors.lastname: Joffe
authors.forename: Lee
authors.initials: L
authors.lastname: Cohen
authors.forename: Jan L
authors.initials: JL
authors.lastname: Shifren
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Newton
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Larson
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Guthrie
mesh_terms: D000328:Adult; D003511:Cyclohexanols / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D004414:Dyspareunia / Q000503:physiopathology; D004958:Estradiol / Q000494:pharmacology* / Q000627:therapeutic use; D004967:Estrogens / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D009948:Orgasm / Q000187:drug effects; D047648:Perimenopause / Q000502:physiology; D017698:Postmenopause / Q000502:physiology; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D012725:Sexual Behavior / Q000187:drug effects* / Q000502:physiology; D014621:Vagina / Q000187:drug effects; D000069470:Venlafaxine Hydrochloride
chemical_list: D003511:Cyclohexanols; D004958:Estradiol; D004967:Estrogens; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride