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Published on: August 13, 2019
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Hormone therapy for sexual function in perimenopausal and postmenopausal women
Lucia A Lara1, Denisse Cartagena-Ramos2, Jaqueline Bp Figueiredo1,3
1Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.
The Cochrane Database of Systematic Reviews
|August 24, 2023
Summary
Hormone therapy with estrogen alone likely improves sexual function in postmenopausal women, particularly in lubrication and satisfaction. Evidence for other hormone therapies remains uncertain due to low-quality studies.
Area of Science:
- Reproductive Medicine
- Women's Health
- Pharmacology
Background:
- Menopause, including perimenopausal and postmenopausal stages, is often accompanied by various symptoms, notably sexual complaints.
- This review serves as an updated analysis of a previous 2013 publication on the topic.
Purpose of the Study:
- To evaluate the impact of hormone therapy (HT) on the sexual function of women experiencing perimenopause and postmenopause.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
- Searches were performed across multiple databases up to December 2022, including reference checking and expert consultation.
- Included RCTs compared various forms of HT (estrogen alone, estrogen with progestogens, tibolone, SERMs) against placebo or no intervention, assessing sexual function using validated tools.
Main Results:
- Thirty-six studies involving 23,299 women were included; 35 focused on postmenopausal women.
- Estrogen alone likely offers a slight improvement in the sexual function composite score for symptomatic/early postmenopausal women (moderate-quality evidence) and unselected postmenopausal women (moderate-quality evidence).
- Evidence for the efficacy of estrogen combined with progestogens, synthetic steroids, and selective estrogen receptor modulators (SERMs) on sexual function is of very low to low quality, leading to uncertainty about their effects.
Conclusions:
- Estrogen-alone hormone therapy appears to offer modest benefits for sexual function in postmenopausal women, particularly concerning lubrication, pain, and satisfaction.
- The effects of combined hormone therapies, synthetic steroids, and SERMs on sexual function remain largely uncertain due to insufficient high-quality evidence.
- Further high-quality research is needed to clarify the efficacy of various hormone therapies for improving sexual function in perimenopausal and postmenopausal women.
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