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Hormone patch improves sexual function in postmenopausal women

Sexual function was modestly, but significantly, improved by treatment with transdermal estrogen therapy in early postmenopausal women with low sexual function compared with placebo, according to research published in JAMA Internal Medicine.

“Sexual dysfunction, an important determinant of women’s health and quality of life, is commonly associated with declining estrogen levels around the menopausal transition,” Hugh S. Taylor, MD, from the department of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, and colleagues wrote.

Taylor and colleagues performed an additional analysis of the Kronos Early Estrogen Prevention Study (KEEPS) to determine how oral and transdermal estrogen therapy affected sexual function in recently postmenopausal women (within 36 months from their last menstrual period) aged 42 to 58 years compared with placebo. Of the original 727 KEEPS enrollees, 670 agreed to participate in the new study. Participants were randomly assigned to receive either 0.45 mg of oral conjugated equine estrogens per day, 50 g of transdermal 17 beta-estradiol per day or placebo. Participants randomized to receive oral conjugated equine estrogens or transdermal 17 beta-estradiol also received 200 mg of oral micronized progesterone for 12 days per month, and those in the placebo group received an additional placebo for the same duration. Researchers used the female sexual function inventory (FSFI; range, 0-36 points) to assess factors of sexual function and experience, such as desire, arousal, lubrication, orgasm, satisfaction and pain. An overall FSFI score of less than 26.55 indicated low sexual function.

Across all time points, transdermal 17 beta-estradiol significantly, although moderately improved the FSFI overall compared with placebo (average efficacy, 2.6; 95% CI, 1.11-4.10). The FSFI overall score did not significantly differ between patients treated with oral conjugated equine estrogens and those treated with placebo (mean efficacy, 1.4; 95% CI, 0.1 to 2.8). On average, the FSFI overall score did not differ between patients treated with transdermal 17 beta-estradiol or oral conjugated equine estrogens (adjusted P = .22). Compared with placebo, transdermal 17 beta-estradiol was significantly associated with an increase in mean lubrication (0.61; 95% CI, 0.25-0.97) and decreased pain (0.67; 95% CI, 0.25-1.09). After treatment with transdermal 17 beta-estradiol, the number of women with low sexual function was significantly reduced compared with placebo (67%; 95% CI, 55%-77% vs. 76%; 95% CI, 67%-83%). Treatment with oral conjugated equine estrogens did not significantly reduce the likelihood of low sexual function.

“[In] early postmenopausal women, treatment with [transdermal 17 beta-estradiol] t-E₂ provided modest benefits for sexual function,” Taylor and colleagues concluded. “The efficacy of [oral conjugated equine estrogens] o-CEE treatment seemed to be less than that of t-E₂, especially in the subgroup of women with [low sexual function] LSF, although there was no statistically significant difference between the hormone groups on overall sexual function.” – by Alaina Tedesco

Disclosures: Taylor reports receiving consultation fees from Pfizer and grant support from Pfizer through Yale University. Please see full study for all other authors’ relevant financial disclosures.