Low-Dose Conjugated Oestrogen Combination Helps Improve Sexual Function in Postmenopausal Women: Presented at NAMS

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Title: Low-Dose Conjugated Oestrogen Combination Helps Improve Sexual Function in Postmenopausal Women: Presented at NAMS
URL: http://www.pslgroup.com/dg/22DF7E.htm
Doctor's Guide
October 1, 2008

By Deborah Brauser

ORLANDO, Fla -- October 1, 2008 -- Use of low-dose oral conjugated oestrogen plus progestogen combined with vaginal conjugated oestrogen therapy appears to improve symptoms of dyspareunia as well as sexual function, according to research presented here at the North American Menopause Society (NAMS) 19th Annual Meeting.

On September 26, lead investigator Michael Zinaman, MD, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, Massachusetts, reported the results of this trial, which was selected as one of the "Top 3 Rated Submitted Abstracts" by NAMS. According to his team's report, this is the first large multinational trial to evaluate changes in sexual function and women's perceptions while using low-dose oral combination therapy and vaginal conjugated oestrogen.

For their outpatient, double-blind study, Dr. Zinaman and colleagues enrolled 285 healthy, sexually active, postmenopausal women from 45 to 65 years old. These women were randomised to either 1 tablet daily containing low-dose conjugated oestrogen/medroxyprogesterone (0.45/1.5 mg) for 6 cycles of 28 days plus 1 g of conjugated oestrogen (0.625 mg) vaginal cream for the first 6 weeks of the trial, or a placebo tablet plus placebo cream.

Efficacy was evaluated using the McCoy Female Sexuality Questionnaire (MFSQ), self-reported daily diary cards, the Brief Index of Sexual Functioning-Women (BISF-W), and the Women's Health Questionnaire (WHQ).

Results showed that the combination therapy group achieved several favourable results compared with baseline and placebo. They had a significant decrease in the frequency and severity of dyspareunia as reported in the MFSQ and daily diary cards (P < .05). Statistically significant improvements were also seen at cycle 6 in scores for sexual interest (0.7 +- 0.1), frequency of orgasm (0.5 +- 0.2), and pleasure of orgasm (0.8 +- 0.2; P < .05).

Significant improvement was reported in receptivity/initiation and relationship satisfaction on BISF-W analysis and on most WHQ responses, including somatic symptoms, memory/concentration problems, and vasomotor symptoms (all outcomes P < .05).

"Of course, there are some limits to this study," said Dr. Zinaman. "The association between decreased dyspareunia and changes in quality of life measures is unclear. So changes in self-perception may be indicative of changes in pelvic physiology. However, there were about 80 questions overall and, across the board, the different questions got the same types of results for [combination therapy] -- better than placebo and better than baseline."

Funding for this trial was provided by Wyeth Research.

[Presentation tile: A Randomized Study of the Effect of Low-Dose Conjugated Estrogen on Sexual Function and Quality of Life in Postmenopausal Women. Abstract S-2]

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