Clinicians strive to individualize menopausal therapies. Commonly, shared decision-making takes into account a woman's concerns for quality-of-life outcomes such as sexual function when choosing treatment. Libido, lubrication, orgasm, and penetration pain may be adversely altered during menopause1–5 and medications to treat other menopausal symptoms can potentially worsen or improve sexual function.
Although postmenopausal estrogen therapy is approved by the U.S. Food and Drug Administration for treatment of moderate to severe hot flushes and genital atrophy, only ospemifene is U.S. Food and Drug Administration-approved for improving menopausal dyspareunia. Relatively few postmenopausal hormone therapy trials have examined sexual function6; the majority evaluated trans dermal estrogen.7–10 Oral estrogen can increase sex hormone-binding globulin and decrease circulating free testosterone,11 theoretically diminishing desire and arousal. Women continue to choose oral hormone formulations to manage menopausal symptoms12; further study of sexual function is warranted.
Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynaecology/
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