American Journal of Obstetrics & Gynecology
Volume 198, Issue 3 , Pages 265.e1-265.e7 , March 2008

The effect of ultralow-dose transdermal estradiol on sexual function in postmenopausal women

  • Alison Huang, MD

      Affiliations

    • Department of Medicine, University of California San Francisco School of Medicine, San Francisco, CA
    • Corresponding Author InformationReprints: Alison J. Huang, MD, MPhil, 1635 Divisadero St, Suite 600, San Francisco, CA 94115.
    • ,
  • Kristine Yaffe, MD

      Affiliations

    • Neurology and Psychiatry, University of California San Francisco School of Medicine, San Francisco, CA
    • ,
  • Eric Vittinghoff, PhD

      Affiliations

    • Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, CA
    • ,
  • Miriam Kuppermann, PhD

      Affiliations

    • Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA
    • ,
  • Ilana Addis, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Arizona Health Sciences Center, Tucson, AZ
    • ,
  • Vladimir Hanes, MD

      Affiliations

    • Berlex Laboratories, Incorporated, Wayne, NJ.
    • ,
  • Judy Quan, PhD

      Affiliations

    • Department of Medicine, University of California San Francisco School of Medicine, San Francisco, CA
    • ,
  • Deborah Grady, MD

      Affiliations

    • Department of Medicine, University of California San Francisco School of Medicine, San Francisco, CA
    • Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, CA

Received 26 February 2007 ,Revised 11 June 2007 ,Accepted 19 September 2007.

References 

  1. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281:537–544
  2. Berman JR, Goldstein I. Female sexual dysfunction. Urol Clin North Am. 2001;28:405–416
  3. Addis IB, Van Den Eeden SK, Wassel-Fyr CL, Vittinghoff E, Brown JS, Thom DH. Sexual activity and function in middle-aged and older women. Obstet Gynecol. 2006;107:755–764
  4. Modugno F, Ness RB, Ewing S, Cauley JA. Effect of raloxifene on sexual function in older postmenopausal women with osteoporosis. Obstet Gynecol. 2003;101:353–361
  5. Nathorst-Boos J, Wiklund I, Mattsson LA, Sandin K, von Schoultz B. Is sexual life influenced by transdermal estrogen therapy? (a double blind placebo controlled study in postmenopausal women). Acta Obstet Gynecol Scand. 1993;72:656–660
  6. Wiklund I, Karlberg J, Mattsson LA. Quality of life of postmenopausal women on a regimen of transdermal estradiol therapy: a double-blind placebo-controlled study. Am J Obstet Gynecol. 1993;168(Pt 1):824–830
  7. Hays J, Ockene JK, Brunner RL, et al. Effects of estrogen plus progestin on health-related quality of life. N Engl J Med. 2003;348:1839–1854
  8. Sherwin BB. The impact of different doses of estrogen and progestin on mood and sexual behavior in postmenopausal women. J Clin Endocrinol Metab. 1991;72:336–343
  9. Shulman LP, Yankov V, Uhl K. Safety and efficacy of a continuous once-a-week 17beta-estradiol/levonorgestrel transdermal system and its effects on vasomotor symptoms and endometrial safety in postmenopausal women: the results of two multicenter, double-blind, randomized, controlled trials. Menopause. 2002;9:195–207
  10. Gelfand MM, Moreau M, Ayotte NJ, Hilditch JR, Wong BA, Lau CY. Clinical assessment and quality of life of postmenopausal women treated with a new intermittent progestogen combination hormone replacement therapy: a placebo-controlled study. Menopause. 2003;10:29–36
  11. Yang TS, Wang HL, Chen YJ, Chang SP, Yuan CC. Effect of continuous administration of conjugated estrogen plus medroxyprogesterone acetate (Premelle) in postmenopausal women in Taiwan. J Chin Med Assoc. 2004;67:336–343
  12. Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288:321–333
  13. Anderson GL, Limacher M, Assaf AR, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA. 2004;291:1701–1712
  14. Rossouw JE, Prentice RL, Manson JE, et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA. 2007;297:1465–1477
  15. Hendrix SL, Cochrane BB, Nygaard IE, et al. Effects of estrogen with and without progestin on urinary incontinence. JAMA. 2005;293:935–948
  16. Barber MD, Visco AG, Wyman JF, Fantl JA, Bump RC. Sexual function in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol. 2002;99:281–289
  17. Walters MD, Taylor S, Schoenfeld LS. Psychosexual study of women with detrusor instability. Obstet Gynecol. 1990;75:22–26
  18. Casson PR, Elkind-Hirsch KE, Buster JE, Hornsby PJ, Carson SA, Snabes MC. Effect of postmenopausal estrogen replacement on circulating androgens. Obstet Gynecol. 1997;90:995–998
  19. Serin IS, Ozcelik B, Basbug M, Aygen E, Kula M, Erez R. Long-term effects of continuous oral and transdermal estrogen replacement therapy on sex hormone binding globulin and free testosterone levels. Eur J Obstet Gynecol Reprod Biol. 2001;99:222–225
  20. Marx P, Schade G, Wilbourn S, Blank S, Moyer DL, Nett R. Low-dose (0.3 mg) synthetic conjugated estrogens A is effective for managing atrophic vaginitis. Maturitas. 2004;47:47–54
  21. Cardozo L, Bachmann G, McClish D, Fonda D, Birgerson L. Meta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: second report of the Hormones and Urogenital Therapy Committee. Obstet Gynecol. 1998;92(Pt 2):722–727
  22. Ettinger B, Ensrud KE, Wallace R, et al. Effects of ultralow-dose transdermal estradiol on bone mineral density: a randomized clinical trial. Obstet Gynecol. 2004;104:443–451
  23. Sherbourne CD. Social functioning: sexual problems measure. In:  Stewart AL,  Ware JE editor. Measuring functioning and well-being: The Medical Outcomes Study approach. Durham (NC): Duke University Press; 1992;p. 194–204
  24. Kuppermann M, Summitt RL, Varner RE, et al. Sexual functioning after total compared with supracervical hysterectomy: a randomized trial. Obstet Gynecol. 2005;105:1309–1318
  25. Kuppermann M, Varner RE, Summitt RL, et al. Effect of hysterectomy vs medical treatment on health-related quality of life and sexual functioning: the medicine or surgery (Ms) randomized trial. JAMA. 2004;291:1447–1455
  26. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10:77–84
  27. McHorney CA, Ware JE, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III, tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32:40–66
  28. Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959;22:719–748
  29. McCulloch C, Searle SR. Generalized, linear, and mixed models. New York: John Wiley; 2001;
  30. Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986;42:121–130
  31. Modelska K, Cummings S. Female sexual dysfunction in postmenopausal women: systematic review of placebo-controlled trials. Am J Obstet Gynecol. 2003;188:286–293
  32. Modelska K, Litwack S, Ewing SK, Yaffe K. Endogenous estrogen levels affect sexual function in elderly post-menopausal women. Maturitas. 2004;49:124–133
  33. Anastasiadis AG, Davis AR, Salomon L, Burchardt M, Shabsigh R. Hormonal factors in female sexual dysfunction. Curr Opin Urol. 2002;12:503–507
  34. Dennerstein L, Lehert P, Burger H. The relative effects of hormones and relationship factors on sexual function of women through the natural menopausal transition. Fertil Steril. 2005;84:174–180
  35. Johnson SR, Ettinger B, Macer JL, Ensrud KE, Quan J, Grady D. Uterine and vaginal effects of unopposed ultralow-dose transdermal estradiol. Obstet Gynecol. 2005;105:779–787
  36. Diem S, Grady D, Quan J, et al. Effects of ultralow-dose transdermal estradiol on postmenopausal symptoms in women aged 60 to 80 years. Menopause. 2006;13:130–138
  37. Sarrel PM. Ovarian hormones and vaginal blood flow: using laser Doppler velocimetry to measure effects in a clinical trial of post-menopausal women. Int J Impot Res. 1998;10(Suppl 2):S91–S93discussion S98-101
  38. Archer JS, Love-Geffen TE, Herbst-Damm KL, Swinney DA, Chang JR. Effect of estradiol versus estradiol and testosterone on brain-activation patterns in postmenopausal women. Menopause. 2006;13:528–537

 This research was supported in part by a grant from Berlex Laboratories, Inc and by Grant KLZRR024130 from the National Center for Research Resource, a component of the NIH.

 Cite this article as: Huang AJ, Yaffe K, Vittinghoff E, et al. The effect of ultralow-dose transdermal estradiol on sexual function in postmenopausal women. Am J Obstet Gynecol 2008;198:265.e1-265.e7.

PII: S0002-9378(07)01183-0

doi: 10.1016/j.ajog.2007.09.039

American Journal of Obstetrics & Gynecology
Volume 198, Issue 3 , Pages 265.e1-265.e7 , March 2008

Article Tools

* Image Usage & Resolution