Update on Women’s Health
Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women. (Sep 2009)
Objective: To provide evidence that dehydroepiandrosterone (DHEA) applied vaginally has positive effects on sexual function in postmenopausal women.
Design: A randomized, double-blind, placebo-controlled trial to assess the effects of DHEA on desire/interest, arousal, orgasm, and pain at sexual activity measured with the Menopause Specific Quality of Life (MENQOL) and Abbreviated Sex Function (ASF) questionnaires. 216 postmenopausal women with moderate-to-severe vaginal atrophy were enrolled in the study, and were randomized into three treatment groups and one placebo group.
Treatment: Patients applied one ovule containing 3.25, 6.5, or 13 mg of DHEA intravaginally daily at bedtime for 12 weeks.
Results: Compared to placebo, DHEA 13 mg increased desire/interest by 49% (p=0.0061) and 23% (p=0.0257) according to MENQOL and ASF respectively. Per ASF, DHEA also increased arousal/sensitivity (68%; p=0.006), arousal/lubrication (39%; p=0.0014), orgasm (75%; p=0.047), and dryness during intercourse (57%; p=0.0001).
Conclusion: DHEA applied locally to the vagina results in increased libido and sexual function without increasing serum steroid hormone levels.
Role of topical oxytocin in improving vaginal atrophy in postmenopausal women: a randomized, controlled trial. (Apr 2018)
Objective: To test the effectiveness of topical oxytocin gel in treating vaginal atrophy in postmenopausal women.
Design: Prospective, randomized trial including 140 postmenopausal women.
Treatment: Subjects inserted 1 mg (600 IU) of oxytocin or matching placebo intravaginally for 30 days.
Results: 67% of women in the oxytocin group improved after 30 days, compared to none in the placebo group (p=0.001). Oxytocin also improved pain during sex and soreness (p=0.001 for each).
Conclusion: Intravaginal oxytocin gel is useful for the treatment of vaginal atrophy associated with menopause.
Safety and Efficacy of a Testosterone Metered-Dose Transdermal Spray for Treating Decreased Sexual Satisfaction in Premenopausal Women
Objective: To evaluate the effects of topical testosterone treatment in premenopausal women with decreased libido.
Design: A randomized, double-blind, placebo-controlled study. 261 women aged 35-46 were enrolled in the study if they had free testosterone below 3.8 pmol/L, and were randomized into one of three treatment groups or a placebo group. Patients measured the number of self-reported satisfactory sexual events (SSEs) every 4 weeks throughout the study duration.
Treatment: Patients applied 56μg, 90μg, or 180μg of testosterone spray or placebo once daily for 16 weeks.
Results: Mean SSE increased for all four experimental groups. The 90μg treatment group was the only testosterone group that had a statistically greater SSE increase compared to placebo (p=0.04). The most common adverse event reported was dose-related hypertrichosis at the application site.
Conclusion: Daily 90μg transdermal testosterone increases the sexual satisfaction experienced by premenopausal women with low free testosterone.