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    A randomized study of low-dose conjugated estrogens on sexual function and quality of life in postmenopausal women
    (Lippincott Williams & Wilkins, 2009-03-01) Gast, Michael J.; Freedman, Murray A.; Vieweg, Alberta J.; De Melo, Nilson R.; Girao, Manoel J. B. C. [UNIFESP]; Zinaman, Michael J.; Dyspareunia Study Grp; Wyeth Pharmaceut; Med Coll Georgia; Inst Saude & Ben Estar da Mulher; Universidade Federal de São Paulo (UNIFESP); Loyola Univ Chicago
    Objective: To evaluate the effects of combined vaginal and oral low-dose estrogen plus progestogen therapy (EPT) on the frequency and severity of dyspareunia, sexual function, and quality of life in recently postmenopausal women.Methods: This outpatient, double-blind, randomized, placebo-controlled trial enrolled 285 healthy, sexually active postmenopausal women aged 45 to 65 years. Women received either one daily oral low-dose conjugated estrogens (0.45 mg)/medroxyprogesterone (1.5 mg) tablet for six 28-day cycles along with I g conjugated estrogens vaginal cream (0.625 mg), intravaginally for the first 6 weeks of the trial or a placebo cream and placebo tablet. Efficacy was evaluated using the McCoy Female Sexuality Questionnaire, self-reported daily diary cards, the Brief Index of Sexual Functioning-Women (BISF-W), and the Women's Health Questionnaire.Results: the EPT group had a significant decrease in the frequency of dyspareunia compared with baseline and placebo in an analysis of responses to the McCoy Female Sexuality Questionnaire. Also, EPT was associated with a significant improvement in a woman's level of sexual interest, frequency of orgasm, and pleasure of orgasm. There was no effect of EPT use on coital frequency. the EPT group had significant improvement in receptivity/initiation and relationship satisfaction, although not in other BISF-W domains, versus placebo (BISF-W analysis) and significant improvement versus placebo on most Women's Health Questionnaire responses.Conclusions: EPT provided a statistically significant improvement compared with placebo in dyspareunia, sexual experience, and quality of life as measured in this study. in general, EPT also improved self-reported sexual perception and enjoyment significantly compared with placebo.