-EE 0.625 mg plus Level of orgasm (SMD mT 1.25/day 0.28, 95% CI 0.19 to -EE 1.25 mg plus 0.37) mT 2.5 mg/day) Arousal (SMD 0.36, 95% CI 0.27 to 0.45) Pleasure or enjoyment of sex (SMD 0.33, 95% CI 0.22 to 0.43) Sexual concerns (SMD0.32, 95% CI 0.22 to 0.41) Responsiveness (SMD 0.32, 95% CI 0.23 to 0.40) Sexual self-image (SMD 0.26, 95% CI 0.16 to 0.35) Composite sexual function score (SMD 0.41, 95% CI 0.19 to 0.63) Authors’ conclusion: is good evidence that adding testosterone to HT has a beneficial effect on sexual function in post-menopausal “There women. However, the combined therapy is associated with a higher incidence of hair growth and acne and a reduction in HDL cholesterol. These adverse events may differ by the different doses and route of testosterone administration. There is insufficient evidence to determine the effect of testosterone in long term use.” Rahn et al (2014)27, vaginal oestrogen 44 RCTs and Women identified Vaginal oestrogen 1. Placebo; 14 Genitourinary Compared with (1)Yes. Searched prospective as having the (various studies syndrome placebo, vaginal Medline and comparative genitourinary concentrations of (N=4232) (vaginal estrogens improved Cochrane Library. studies syndrome of oestradiol 2. Other dryness, itching dryness, dyspareunia, (2)Yes. Quality menopause. administered vaginal or burning, urinary urgency, assessment using Women with through vaginal oestrogens; 18 and frequency, SUI and UUI. GRADE. breast cancer tablet, cream, dyspareunia, Endometrial pathology
-EE 0.625 mg plus mT 1.25/day -EE 1.25 mg plus mT 2.5 mg/day) Level of orgasm (SMD 0.28, 95% CI 0.19 to 0.37) Arousal (SMD 0.36, 95% CI 0.27 to 0.45) Pleasure or enjoyment of sex (SMD 0.33, 95% CI 0.22 to 0.43) Sexual concerns (SMD0.32, 95% CI 0.22 to 0.41) Responsiveness (SMD 0.32, 95% CI 0.23 to 0.40) Sexual self-image (SMD 0.26, 95% CI 0.16 to 0.35) Composite sexual function score (SMD 0.41, 95% CI 0.19 to 0.63) Authors’ conclusion: “There is good evidence that adding testosterone to HT has a beneficial effect on sexual function in post-menopausal women. However, the combined therapy is associated with a higher incidence of hair growth and acne and a reduction in HDL cholesterol. These adverse events may differ by the different doses and route of testosterone administration. There is insufficient evidence to determine the effect of testosterone in long term use.” Rahn et al (2014)27, vaginal oestrogen 44 RCTs and prospective comparative studies Women identified as having the genitourinary syndrome of menopause. Women with breast cancer Vaginal oestrogen (various concentrations of oestradiol administered through vaginal tablet, cream, 1. Placebo; 14 studies (N=4232) 2. Other vaginal oestrogens; 18 Genitourinary syndrome (vaginal dryness, itching or burning, and dyspareunia, Compared with placebo, vaginal estrogens improved dryness, dyspareunia, urinary urgency, frequency, SUI and UUI. Endometrial pathology (1)Yes. Searched Medline and Cochrane Library. (2)Yes. Quality assessment using GRADE.