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Quality of life and sexual function of naturally postmenopausal women on an ultralow-concentration estriol vaginal gel

Caruso, Salvatore MD1; Cianci, Stefano MD1; Amore, Francesca F. MD2; Ventura, Betty MD1; Bambili, Elisa MD1; Spadola, Saveria MD2; Cianci, Antonio MD1

doi: 10.1097/GME.0000000000000485
Original Articles

Objective: This study aims to evaluate the sexual function and quality of life (QoL) of naturally postmenopausal women affected by genitourinary syndrome of menopause who were treated with an ultralow-concentration estriol vaginal gel (0.005%).

Methods: Postmenopausal women with vulvovaginal atrophy symptoms and sexual disorders were enrolled in a case-control study. Women were treated with vaginal gel (containing 50 μg of estriol) daily for 3 weeks and then twice weekly up to 12 weeks. Determination of vaginal maturation index, evaluation of vaginal pH, and assessment of vaginal atrophy symptoms were carried out. QoL, sexual function, and distress were investigated using the Short Form 36, Female Sexual Function Index, and Female Sexual Distress Scale questionnaires. Changes between baseline and week 12 were assessed.

Results: Sixty-eight women were included in the study group, and 42 women were included in the control group. Women on estriol vaginal gel had a significant increase in vaginal maturation index and improvement of vaginal pH compared with baseline (P < 0.05). Mean total Female Sexual Function Index score improved, and Female Sexual Distress Scale score decreased from baseline to follow-up. Results from the Short Form 36 questionnaire showed a significant improvement in the overall index of somatic aspects (P < 0.05). The control group showed no changes from baseline evaluation (P = NS).

Conclusions: Estriol vaginal gel (0.005%) therapy significantly improves the trophism of the vaginal mucosa and the sexual health and QoL of naturally postmenopausal women. These results confirm that low doses of vaginal estrogen must be considered as the first choice for the initial treatment of postmenopausal genitourinary symptoms.

1Gynecological Clinic and Research Group for Sexology, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy

2Cytological Laboratory of the Institute of Pathological Anatomy, Department GF Ingrassia, University of Catania, Catania, Italy.

Address correspondence to: Salvatore Caruso, MD, Gynecological Clinic of the Policlinico Universitario, Via S. Sofia 78, Catania 95124, Italy. E-mail:

Received 21 February, 2015

Revised 2 April, 2015

Accepted 2 April, 2015

Funding/support: None.

Financial disclosure/conflicts of interest: None reported.

© 2016 by The North American Menopause Society.