Brazilian researchers have analyzed three different topical treatments for vaginal atrophy in postmenopausal women. They found that certain preparations containing estrogen, testosterone, or polyacrylic acid improved sexual function when compared to a placebo lubricant.
For many women, the decline in estrogen that occurs with menopause causes vaginal atrophy. This condition is characterized by vaginal dryness, itching, burning, and pain during intercourse.
Past studies have found that treatments containing estrogen, testosterone, or polyacrylic acid can be effective, but each has its advantages and disadvantages. For example, estrogen applied to the vagina my help improve sexual satisfaction, but the risks of estrogen therapy make some women reluctant or unable to use it.
In this study, the researchers sought to compare these three treatments with a placebo lubricant, noting that the results could help in the development of other treatments for vaginal atrophy.
Eighty postmenopausal women between the ages of 40 and 70 participated in the study. All of the women had symptoms of vaginal atrophy. The women were randomly assigned to try one of four treatments:
• Vaginal cream with polyacrylic acid
• Vaginal cream with testosterone propionate
• Vaginal cream with conjugated estrogens
• Lubricant with glycerin gel (placebo)
The women were instructed to use their designated treatment three times a week for twelve weeks.
At baseline and again at six- and 12-week time points, the researchers assessed the women’s sexual functioning using interviews and the Female Sexual Function Index (FSFI) questionnaire. The FSFI is designed to evaluate six domains of female sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain/discomfort.
The researchers found that when compared to the placebo group:
• Women using polyacrylic acid and testosterone had better FSFI results in the domains of desire, lubrication, satisfaction, and pain. Their overall scores were higher than those of the placebo group.
• Women using estrogen had improved desire scores.
• No group had improved scores on the arousal and orgasm domains.
• Total intragroup FSFI scores for the 12 weeks showed improvements for women taking estrogen, testosterone, and polyacrylic acid.
Women in the testosterone group tended to see the quickest improvements. The authors explained that testosterone might have a more direct effect on the vagina. However, they also stressed that treating low sexual desire with testosterone still needs further study.
Women using polyacrylic acid saw improvements within the first six weeks of treatment. For women taking estrogen, improvements generally began after six weeks.
The authors acknowledged that their study groups were small. And at this point, they could not recommend estrogen, testosterone, or polyacrylic acid for the treatment of vaginal atrophy because further study is needed to learn more about adverse effects over the long term. However, they felt that these encouraging results provided a solid basis for future research.
The study was first published online in February 2014 in the Journal of Sexual Medicine.
The Journal of Sexual Medicine
Fernandes, Tatiane, MD, et al.
“Efficacy of Vaginally Applied Estrogen, Testosterone, or Polyacrylic Acid on Sexual Function in Postmenopausal Women: A Randomized Controlled Trial”
(Full-text. First published online: February 25, 2014)