HT treatment with estrogens alone or in combination with progestogens was associated with a small to moderate improvement in sexual function , particularly in pain , when used in women with menopausal symptoms or in early postmenopause ( within five years of amenorrhoea ) , but not in unselected postmenopausal women .
The current evidence does not suggest an important effect of tibolone or of SERMs alone or combined with estrogens on sexual function .
BACKGROUND The perimenopausal and postmenopausal periods are associated with many symptoms , including sexual complaints .
OBJECTIVES To assess the effect of hormone therapy ( HT ) on  sexual function in perimenopausal and postmenopausal women .
Comparison of the effects of hormone therapy regimens, oral and vaginal estradiol, estradiol + drospirenone and tibolone, on sexual function in healthy postmenopausal women.
INTRODUCTION Sexual dysfunction is more prevalent in postmenopausal women . AIMS To prospect ively evaluate and compare the effects of hormone therapy ( HT ) regimens , oral and vaginal estradiol , estradiol + drospirenone and tibolone , on  sexual function in healthy postmenopausal women . METHODS The study included 169 consecutive healthy postmenopausal women , and the women were divided into two groups : 111 women received HT , and 58 women received no treatment and served as a control group . As an HT , 23 women with surgically induced menopause received oral 17-beta estradiol . The rest of the women with natural menopause were prospect ively r and omized : 22 received oral 17-beta estradiol + drospirenone daily , 42 received oral tibolone , and 24 received vaginal 17-beta estradiol .  Sexual function was evaluated with a detailed 19-item question naire , the female sexual function index , including sexual desire , arousal , lubrication , orgasm , satisfaction , and pain . MAIN OUTCOME MEASURES The differences in sexual function were compared before and 6 months after the treatment in all women . RESULTS Total sexual function score increased from 19.81 + /- 7.15 to 22.9 + /- 6.44 in the HT group and decreased from 21.6 + /- 8.69 to 17.6 + /- 5.7 in the control group , revealing a significant difference from baseline to post-treatment between the two groups ( P = 0.000 ) . The highest improvement in total score and arousal was achieved with the oral 17-beta estradiol ( P = 0.000 and P = 0.000 , respectively ) . The highest improvement in lubrication was achieved with the oral and vaginal 17-beta estradiol groups ( P = 0.000 ) . The highest improvement in orgasm was achieved with the tibolone group ( P = 0.000 ) . The highest improvement in pain was achieved with the oral and vaginal 17-beta estradiol groups ( P = 0.000 ) . CONCLUSIONS HT provided significant improvement in sexual function compared to women receiving no treatment , and therefore , HT regimens should be suggested for improvement in sexual functioning of postmenopausal women
HT treatment with estrogens alone or in combination with progestogens was associated with a small to moderate improvement in sexual function , particularly in pain , when used in women with menopausal symptoms or in early postmenopause ( within five years of amenorrhoea ) , but not in unselected postmenopausal women .
The current evidence does not suggest an important effect of tibolone or of SERMs alone or combined with estrogens on sexual function .
BACKGROUND The perimenopausal and postmenopausal periods are associated with many symptoms , including sexual complaints .
OBJECTIVES To assess the effect of hormone therapy ( HT ) on  sexual function in perimenopausal and postmenopausal women .