(029) DOWNSTREAM IMPROVEMENT IN SEXUAL COMPLAINTS IN INDIVIDUALS WHO USED HORMONE THERAPY (HT) TO ALLEVIATE HOT FLASHES
Authors: Javaid S , Nezolosky M , Krychman M 
Published: December 2024

Abstract

Introduction
It is estimated that while up to 75% of individuals aged between 45- and 55-years’ experience vasomotor symptoms (mainly, hot flashes and night sweats), only 20-30% of individuals seek treatment for these concerns. When left untreated, hot flashes cause many downstream effects, including: sexual complaints, fatigue, memory issues, and possibly an increased risk of cardiovascular disease. Specialized clinical centers that focus on delivering optimal menopause care offer their providers clinical education and sensitivity training, along with dose optimization and close patient surveillance. Coupled together, these tenets are essential to maintain patient compliance and establish superior outcomes.

Objective
The purpose of this study was to demonstrate that menopausal hot flashes correlate with many downstream clinical symptoms, including distressing sexual problems. Treatment of bothersome hot flashes with the gold standard of hormone therapy (HT) can result in resolution of sexual problems for menopausal women. We hypothesize that adherence and compliance with the HT treatment paradigm requires provider education and training, close surveillance, and direct patient contact, all of which are offered at specialty centers.

Methods
A retrospective chart review of a random convenience sample from two specialty centers during the study period from January 1 – April 19, 2023 was conducted to assess the clinical experience of patients who experienced hot flashes. All data were stored in a HIPAA-protected database.

Results
A random sample (n = 56; mean age 51.3 years (range 30-73)) from two specialty centers was assessed for individuals who experienced hot flashes. Associated menopausal symptoms included: brain fog/memory issues (66%), sleep disturbances (59%), decreased libido (49%), weight management (38%), vaginal dryness (31%), and dyspareunia (14%). Treatment modalities included: behavioral intervention counseling (100%), systemic hormonal therapy (96.5%), and over-the-counter supplements (3.5%). Overall, 96% of patients responded to their intervention with self-reported improvement in hot flashes at scheduled follow-up visits. Patients underwent multiple in-office and telehealth visits to ensure HT dose optimization, efficacy of symptom resolution, and ensure no emergent adverse effects from therapy. 5% of patients (n = 3) reported adverse effects (minimal vaginal spotting). No patients discontinued treatment. All patients reported resolution of their sexual complaints.

Conclusions
In this small retrospective study, the treatment of hot flashes effectively relieved downstream sexual complaints in patients seen at specialty clinical centers. Here, all providers receive menopausal education which includes standardized clinical algorithms, research article database, one-on-one didactic supervision, and preceptorships. This education, coupled with extended, 40-minute visits, allow for close clinical surveillance and outcome optimization.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: EXELTIS, RICKETT BENCKISER.