Treatment of Female Sexual Dysfunction in Postmenopausal Women: What Is the Evidence?

    March 2004 in “ Reviews in Gynaecological Practice ”
    Katharina Modelska, Marı́a L. Milián
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    TLDR Hormonal changes and psychological issues can cause sexual dysfunction in postmenopausal women. Behavioral therapy is recommended first, with hormone replacement helping some symptoms but not libido. Testosterone can improve libido, but its effects on overall sexual function are unclear. Emotional and relationship issues should be addressed before using medication, and the benefits and risks of testosterone supplementation should be considered.
    In 2004, Katharina Modelska and María L. Milián conducted a study on the treatment of female sexual dysfunction in postmenopausal women. They found that hormonal changes and psychological issues were common causes of sexual dysfunction in this group. The study recommended behavioral therapy before pharmacological treatment, with hormone replacement therapy improving symptoms like vaginal dryness and dyspareunia but having little effect on libido. Testosterone replacement, however, improved libido and sexual motivation. Other treatments had inconclusive results, and the study called for more extensive trials. In a related study involving 53 women, testosterone increased sexual activity and pleasure, but its relationship with sexual function was unclear. Treatments like subcutaneous testosterone pellets and transdermal testosterone administration were found to have benefits but also potential side effects. The document concluded that emotional and relationship issues should be addressed first, with pharmacological therapies as a secondary option, and that the benefits of androgen supplementation should be weighed against possible risks.
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