Effects of hormone treatment on sexual functioning in postmenopausal women: pharmacological intervention and female sexuality

Effects of hormone treatment on sexual functioning in postmenopausal women. Pharmacological intervention and female sexuality: a complex, controversial clinical and social issue. The studies presented in this thesis have been conducted to investigate the effects of hormone therapy (HT) and tibolone on sexual function in postmenopausal women. Sufficient evidence for the effects of tibolone on sexual function and dysfunction in postmenopausal women was, until now not available. As tibolone does have some androgenic properties, the theory that it may therefore work as a weak androgen justifies, apparently, pharmacological intervention in daily clinical practice. Several considerations were explored before identifying the approach to conduct this project as the female sexual response cycle is vulnerable and reflects an entity which is highly complex and dependent of many factors, hormones most likely being only a small part of the puzzle. Results: European middle aged women experience menopause as a process that brings sexual changes with impact on their relationship and their quality of life. One third of these women would be open for pharmacotherapy to help solving sexual problems if it was available. However, counselling remains one of the crucial elements in a multi-dimensional approach for sexual problems. If pharmacotherapy is indicated, tibolone should be considered as a first line treatment option for postmenopausal women with sexual dysfunction as its efficacy and medium to long term tolerability & safety is now sufficiently established.