Dataset Information

Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review.

ABSTRACT:

Objective

To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women.

Data sources

We conducted a search on the PubMed, Embase, Scopus, Web of Science, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, as well as on clinical trial databases. We analyzed studies published between 1996 and May 30, 2020. No language restrictions were applied.

Selection of studies

We selected randomized clinical trials that evaluated the treatment of sexual dysfunction in postmenopausal women.

Data collection

Three authors (ACAS, APFC, and JL) reviewed each article based on its title and abstract. Relevant data were subsequently taken from the full-text article. Any discrepancies during the review were resolved by consensus between all the listed authors.

Data synthesis

A total of 55 studies were included in the systematic review. The approaches tested to treat sexual dysfunction were as follows: lubricants and moisturizers (18 studies); phytoestrogens (14 studies); dehydroepiandrosterone (DHEA; 8 studies); ospemifene (5 studies); vaginal testosterone (4 studies); pelvic ﬂoor muscle exercises (2 studies); oxytocin (2 studies); vaginal CO₂ laser (2 studies); lidocaine (1 study); and vitamin E vaginal suppository (1 study).

Conclusion

We identified literature that lacks coherence in terms of the proposed treatments and selected outcome measures. Despite the great diversity in treatment modalities and outcome measures, the present systematic review can shed light on potential targets for the treatment, which is deemed necessary for sexual dysfunction, assuming that most randomized trials were evaluated with a low risk of bias according to the Cochrane Collaboration risk of bias tool. The present review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).

SUBMITTER: Sarmento ACA

PROVIDER: S-EPMC9708399 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review.

Sarmento Ayane Cristine Alves ACA Costa Ana Paula Ferreira APF Lírio Juliana J Eleutério José J Baptista Pedro Vieira PV Gonçalves Ana Katherine AK

Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia 20221001 10

<h4>Objective</h4> To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women.<h4>Data sources</h4> We conducted a search on the PubMed, Embase, Scopus, Web of Science, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, as well as on clinical trial databases. We analyzed studies published between 1996 and May 30 ...[more]

PMID: 36446564

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Project description:BackgroundGenitourinary syndrome of menopause (GSM) is a common and disturbing issue in the postmenopausal period. Unlike vasomotor symptoms, it has a progressive trend. Our study aims to evaluate the efficacy and safety of oxytocin gel versus placebo gel in postmenopausal women with GSM.MethodsA systematic review and meta-analysis synthesizing randomized controlled trials (RCTs) from Web of Science, SCOPUS, PubMed, and Cochrane Central Register of Controlled Trials databases on January 18, 2023. Keywords such as "oxytocin," "intravaginal," "vaginal," "atrophic," and "atrophy" were used. We used Review Manager (RevMan) version 5.4 in our analysis. We used the risk ratio (RR) for dichotomous outcomes and the mean difference (MD) for continuous outcomes; both were presented with the corresponding 95% confidence interval (CI) and were calculated with the Mantel-Haenszel or inverse variance statistical method. Cochrane's Q test and the I2 statistic were used as measures of statistical inconsistency and heterogeneity. The Cochrane Risk of Bias Tool for RCTs was used for the quality assessment of the included studies.ResultsSeven studies with 631 patients were included. Regarding the maturation index, there was a statistically insignificant increase in the oxytocin arm (MD = 12.34, 95% CI (-12.52-37.19), P = 0.33). Clinically assessed vaginal atrophy showed a statistically significant reduction in the oxytocin group (RR = 0.32, 95% CI (0.23 - 0.10), P < 0.00001). For dyspareunia, vaginal pH, and histological evaluation of vaginal atrophy, there was a statistically insignificant difference between the two groups (RR = 1.02, 95% CI (0.82-1.27), P = 0.84), (MD = -0.74, 95% CI (-1.58-0.10), P = 0.08), and (MD = -0.38, 95% CI (-0.82-0.06), P = 0.09), respectively. There was no significant difference in the safety profile between the two groups as measured by endometrial thickness (MD = 0.00, 95% CI (-0.23-0.23), P = 0.99).ConclusionsAlthough oxytocin has been proposed as a viable alternative to estrogen in the treatment of GSM, our findings show the opposite. Larger, high-quality RCTs are needed to confirm or refute our results.Trial registrationPROSPERO registration number CRD42022334357.

Project description:BackgroundThe physical and mental changes created during menopause cause sexual dysfunction, which affects the quality of life, self-esteem, and emotional relationships. Wormwood cream contains tannins, terpenoids, flavonoids, phytosterols, and alkaloids. The purpose of this study is to evaluate the safety and effectiveness of wormwood vaginal cream on the sexual satisfaction and quality of sexual life of postmenopausal women.MethodThis study was a randomized, triple-blind, placebo-controlled clinical trial conducted on 112 postmenopausal women (45-65 years old) in 2021. The studied women were randomly assigned to two wormwood cream or placebo groups. Wormwood cream or placebo was used for 4 weeks and 3 times a week. The main data collection tools included the Larson Sexual Satisfaction Questionnaire (LSSQ) and the Sexual Quality of Life Questionnaire (SQOL-F). SPSS software version 26 and independent t, Mann-Whitney, paired t and Wilcoxon tests were used for statistical analysis. P < 0.05 was considered significant.ResultsBefore the intervention, the mean and standard deviation of sexual satisfaction was 73.57 ± 3.84 in the intervention group and 73.16 ± 4.52 in the placebo group. After the intervention, the mean and standard deviation of sexual satisfaction in the intervention group was 75.34 ± 3.85 and in the placebo group was 72.82 ± 4.32. The quality of women's sexual life before of the intervention in the intervention and placebo groups was 59.16 ± 14.10 and 57.18 ± 12.38, and after the intervention, it was 83.00 ± 11.51and 69.64 ± 12.97, respectively. At the end of 4 weeks, participants in the wormwood cream group showed a significant improvement in sexual satisfaction and the quality of women's sexual life (P < 0.001). It was meaningful.ConclusionBased on the findings of this trial, wormwood vaginal cream can be used as an uncomplicated topical supplement to improve sexual satisfaction and quality of sexual life in postmenopausal women with low sexual satisfaction and quality of sexual life.

Project description:Abstract Background Menopause with anatomical, physiological, and psychological changes can affect sexual satisfaction and consequently the quality of life. Aims The study sought to evaluate the effects of mindfulness-based counseling on sexual self-efficacy and sexual satisfaction among Iranian postmenopausal women. Methods This quasi-experimental study was conducted on 110 women who were assigned to an intervention group (n = 55) and a control group (n = 55). The intervention group received 8 sessions of mindfulness-based training and daily mindfulness exercises. Data collection tools included questionnaires of demographics and midwifery, sexual self-efficacy, and sexual satisfaction. They were completed before and 8 weeks after the intervention. The collected data were analyzed through a t test, a chi-square test, and repeated-measures analysis of variance. Outcomes Changes in sexual self-efficacy and sexual satisfaction scores were evaluated. Results The mindfulness-based intervention significantly improved sexual self-efficacy (F = 146.98, P = .000, ƞ2 = 0.576) and sexual satisfaction (F = 129.47, P = .000, ƞ2 = 0.545) over time. The mean scores of sexual self-efficacy (17.03 ± 2.08) and sexual satisfaction (87.94 ± 8.26) in the intervention group increased after the intervention as opposed to the mean scores of sexual self-efficacy (12.65 ± 1.70) and sexual satisfaction (76.61 ± 6.45) in the control group. Clinical Implications Mindfulness training can improve sexual self-efficacy and sexual satisfaction in postmenopausal women. Strengths and Limitations The intervention was implemented on a population of menopausal women in a culture in which the expression of sexual issues is taboo and has not been noticed in the past. The main limitation of this study was self-reporting, which may have affected the responses. The next limitation was the nonrandomized controlled design. Finally, the research sample included menopausal women who were heterosexual and married. Hence, the findings may not be generalizable to more diverse samples. In this study, psychological maladjustment or psychological distress was not analyzed. They should also be considered in future research. Conclusion According to the results, it is advisable to employ mindfulness-based intervention in routine care, because it can improve different aspects of menopausal women’s life.

Dataset Information

Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review.

Objective

Data sources

Selection of studies

Data collection

Data synthesis

Conclusion

Publications

Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review.

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