title: Quality of life and sexual function of naturally postmenopausal women on an ultralow-concentration estriol vaginal gel.
abstract: OBJECTIVE
  This study aims to evaluate the sexual function and quality of life (QoL) of naturally postmenopausal women affected by genitourinary syndrome of menopause who were treated with an ultralow-concentration estriol vaginal gel (0.005%).
  
  
  METHODS
  Postmenopausal women with vulvovaginal atrophy symptoms and sexual disorders were enrolled in a case-control study. Women were treated with vaginal gel (containing 50 μg of estriol) daily for 3 weeks and then twice weekly up to 12 weeks. Determination of vaginal maturation index, evaluation of vaginal pH, and assessment of vaginal atrophy symptoms were carried out. QoL, sexual function, and distress were investigated using the Short Form 36, Female Sexual Function Index, and Female Sexual Distress Scale questionnaires. Changes between baseline and week 12 were assessed.
  
  
  RESULTS
  Sixty-eight women were included in the study group, and 42 women were included in the control group. Women on estriol vaginal gel had a significant increase in vaginal maturation index and improvement of vaginal pH compared with baseline (P < 0.05). Mean total Female Sexual Function Index score improved, and Female Sexual Distress Scale score decreased from baseline to follow-up. Results from the Short Form 36 questionnaire showed a significant improvement in the overall index of somatic aspects (P < 0.05). The control group showed no changes from baseline evaluation (P = NS).
  
  
  CONCLUSIONS
  Estriol vaginal gel (0.005%) therapy significantly improves the trophism of the vaginal mucosa and the sexual health and QoL of naturally postmenopausal women. These results confirm that low doses of vaginal estrogen must be considered as the first choice for the initial treatment of postmenopausal genitourinary symptoms.
authors.affiliation: 1Gynecological Clinic and Research Group for Sexology, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy 2Cytological Laboratory of the Institute of Pathological Anatomy, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Caruso
authors.forename: Stefano
authors.initials: S
authors.lastname: Cianci
authors.forename: Francesca F
authors.initials: FF
authors.lastname: Amore
authors.forename: Betty
authors.initials: B
authors.lastname: Ventura
authors.forename: Elisa
authors.initials: E
authors.lastname: Bambili
authors.forename: Saveria
authors.initials: S
authors.lastname: Spadola
authors.forename: Antonio
authors.initials: A
authors.lastname: Cianci
mesh_terms: D000282:Administration, Intravaginal; D001284:Atrophy; D016022:Case-Control Studies; D004964:Estriol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000523:psychology*; D011788:Quality of Life; D012725:Sexual Behavior / Q000187:drug effects / Q000523:psychology; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014621:Vagina / Q000473:pathology; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage; D014623:Vaginal Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D014844:Vulva / Q000473:pathology
chemical_list: D014622:Vaginal Creams, Foams, and Jellies; D004964:Estriol