Continuing Medical Education: The Use of Estrogen Therapy in Women's Sexual Functioning (CME)

Authors

  • Rossella E. Nappi MD, PhD,

    1. University of Pavia—Research Center for Reproductive Medicine, Department of Morphological, Eidological and Clinical Sciences, Pavia, Italy;
    2. University of Pavia—Unit of Gynecological Endocrinology and Menopause, Department of Internal Medicine and Endocrinology, IRCCS “S Maugeri Foundation”, Pavia, Italy
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  • Franco Polatti MD

    1. University of Pavia—Research Center for Reproductive Medicine, Department of Morphological, Eidological and Clinical Sciences, Pavia, Italy;
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Rossella E. Nappi, MD, PhD, Research Center for Reproductive Medicine, Department of Morphological, Eidological and Clinical Sciences, & Gynecological Endocrinology Unit— Department of Internal Medicine & Endocrinology, IRCCS S. Maugeri Foundation, University of Pavia, Via Ferrata 8—27100 Pavia, Italy. Tel: +39 0382 592201; Fax: +39 0382 520070; E-mail: renappi@tin.it

ABSTRACT

Introduction.  Estrogen is relevant to women's well-being including sexual functioning.

Aim.  The goal of this Continuing Medical Education article was to provide a comprehensive review of the effect of exogenous estrogen use on women's sexual function.

Main Outcome Measures.  We present a literature review.

Methods.  The medical literature was accurately searched (1990–2008) with regard to estrogen therapy in menopausal women by using several terms related to and including the terms “estrogen” and “sexual function.”

Results.  A review of the studies most useful to guide menopausal practice.

Conclusions.  Estrogen decline is one of the key factors contributing to sexual functioning during menopausal transition and beyond. Systemic estrogen treatments are associated with significant benefits in some domains of menopausal sexual function, especially when estradiol is delivered transdermally, whereas local estrogens are effective in preventing urogenital aging. Even tibolone, a selective tissue estrogenic activity regulator, displays positive effects in postmenopausal women with sexual complaints. However, a tailored approach to the individual woman is always needed. Nappi RE, and Polatti F. The use of estrogen therapy in women's sexual functioning. J Sex Med 2009;6:603–616.

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