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 .
Transdermal estradiol gel for the treatment of symptomatic postmenopausal women
Objective The aim of this study was to determine the efficacy , safety , and lowest practical dose of a transdermal estradiol gel in the treatment of symptomatic postmenopausal women . Methods Healthy postmenopausal women with seven or more moderate to severe hot flushes per day or 50 to 60 or more per week were r and omized to transdermal gel containing 1.5 mg ( n = 73 ) or 0.75 mg ( n = 75 ) estradiol ( EstroGel 0.06 % ) or placebo ( n = 73 ) in a phase 3 study , or to 0.375 mg ( n = 119 ) or 0.27 mg ( n = 118 ) estradiol ( 0.03 % gel ) or placebo ( n = 114 ) in a phase 4 study . Results The frequency of moderate to severe hot flushes and severity of all hot flushes significantly decreased versus placebo at weeks 4 and 12 with 1.5 , 0.75 , and 0.375 mg estradiol . Overall participant responder rates were generally lower in the phase 4 study than those in the phase 3 study with the approved 0.75-mg estradiol dose . Vaginal maturation index ( VMI ) shifts from baseline to week 12 were significant ( P < 0.001 ) with 0.75 and 1.5 mg estradiol versus placebo ;  VMI improved ( P < 0.001 ) , superficial cells increased ( P = 0.005 ) , and parabasal cells decreased ( P = 0.002 ) with 0.375 mg estradiol vs placebo but not with 0.27 mg estradiol . The most frequently reported treatment-emergent adverse events , although not necessarily treatment related , were headache , infection , breast pain , and nausea ( phase 3 study ) and insomnia and headache ( phase 4 study ) . No serious adverse events were related to treatment ; no deaths occurred . Conclusion A transdermal gel with 0.75 mg estradiol was the lowest practical dose that effectively reduced the frequency and severity of moderate to severe hot flushes , improved VMI , and was well tolerated
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 .