[Clinical effects of hormone replacement therapy with estradiol valerate and cyproterone acetate in perimenopausal women]. Hormone therapy in menopausal women with cognitive complaints Effect of different preparations of hormone therapy on sexual dysfunction in naturally postmenopausal women The effects of postmenopausal hormone therapy on social activity, partner relationship, and sexual life – experience from the EPHT trial [Influence of hormone replacement therapy on the quality of life in postmenopausal women with hypertension]. The effect of hormone therapy on women's quality of life in the first year of the Estonian Postmenopausal Hormone Therapy trial The effects of compounded bioidentical transdermal hormone therapy on hemostatic, inflammatory, immune factors; cardiovascular biomarkers; quality-of-life measures; and health outcomes in perimenopausal and postmenopausal women. Effect of 1-year, low-dose DHEA therapy on climacteric symptoms and female sexuality Hormone replacement therapy use and menopausal symptoms among women participating in a behavioral lifestyle intervention. Effect of Gua sha therapy on perimenopausal syndrome: a randomized controlled trial Change in health-related quality of life over the menopausal transition in a multiethnic cohort of middle-aged women: Study of Women's Health Across the Nation The effects of hormone therapy on pulmonary function tests in postmenopausal women. Histories of abuse predict stronger within-person covariation of ovarian steroids and mood symptoms in women with menstrually related mood disorder PERCEIVED EFFECTS OF TESTOSTERONE REPLACEMENT THERAPY IN PERIMENOPAUSAL AND POSTMENOPAUSAL WOMEN: AN INTERNET PILOT STUDY The benefits of androgens combined with hormone replacement therapy regarding to patients with postmenopausal sexual symptoms. Efficacy and tolerability of continuous combined hormone replacement therapy in early postmenopausal women Cognitive-behavioral intervention among women with slight menopausal symptoms: a pilot study.
BACKGROUND In perimenopause many women complain of psychogenic and organic disorders often connected with initial and increasing levels of hypoestrogenism . In this study we evaluated the effects of hormone replacement therapy ( HRT ) in symptomatic women in perimenopause . METHODS We enrolled 100 healthy and symptomatic women who were r and omly distributed to two groups for a 12-month study . Group A : 50 patients received HRT with estradiol valerate and cyproterone acetate ( Pausene(R ) ) ; Group B : 50 patients were used as a control group ( treated with Cacit Vitamin D30(R ) ) . A number of clinical and instrumental tests were performed at 0 , 6 and 12 months to evaluate any changes in vasomotor and urogenital symptoms , bone and serum homeostasis and possible sexual disorders . The statistical analysis was performed using the c2 test . RESULTS The group of women receiving HRT showed a significant reduction in vasomotor clinical symptoms ( p<0.001 ) and sexual disorders ( p<0.002 ) ; this was not reflected in the control group where libido decreased steadily with apparent slight improvements only at the end of the study . The urogenital disorders disappeared almost completely in Group A , whereas they diminished in Group B. HRT patients also showed a slight increase ( p<0.001 ) in the initial value of BMD ( bone mineral density ) , a reduction in the marker for bone turnover and an improved lipid profile ( p<0.05 ) . These changes were unfortunately not noted in Group B. CONCLUSIONS On the basis of these results we conclude that HRT appeared to have a beneficial effect on perimenopausal clinical symptoms over the 12-month period , leading to marked improvements in the psychophysical wellbeing of symptomatic women in perimenopause Objective : To evaluate the effects of hormone therapy ( HT ) on cognition and subjective quality of life ( QoL ) in recently postmenopausal women with cognitive complaints . Methods : Cognitive Complaints in Early Menopause Trial ( COGENT ) was a r and omized , double-blind , placebo-controlled , multicenter , pilot study of 180 healthy postmenopausal women aged 45 to 55 years , r and omly assigned to receive either placebo or conjugated equine estrogen 0.625 mg/medroxyprogesterone acetate 2.5 mg for 4 months . Outcome measures included memory , subjective cognition , QoL , sexuality , and sleep , which were assessed at baseline and month 4 . Results : The study was terminated before the expected final sample size of 275 due to a decrease in enrollment coinciding with the publication of findings from the Women ’s Health Initiative . There were no differences between groups on any cognitive or QoL measures , except for an increase in sexual interest and thoughts with HT . Modest negative effects on short- and long-term verbal memory approached significance ( p < 0.10 ) . Women with baseline vasomotor symptoms ( VMS ) showed a decrease in VMS and an improvement in general QoL , but no cognitive benefit vs placebo . Conclusions : With the power to detect an effect size of ≥0.45 , this study suggests potential modest negative effects on verbal memory that are consistent with previous hormone therapy trials in older women . GLOSSARY : BTA = Brief Test of Attention ; BVRT = Benton Visual Retention Test ; COGENT = Cognitive Complaints in Early Menopause Trial ; CRT = Educational Testing Service Card Rotation Test ; CVLT = California Verbal Learning ; FAS = Letter Fluency Test ; HERS = Heart and Estrogen/progestin Replacement Study ; HT = hormone therapy ; MFSQ = McCoy Female Sexuality Scale Question naire ; MFQ = The Memory Functioning Question naire ; PANAS = Positive and Negative Affect Scale ; PSQI = The Pittsburgh Sleep Quality Index ; QoL = subjective quality of life ; SWAN = Study of Women ’s Health Across the Nation ; UQoL = Utian Quality of Life ; VMS = vasomotor symptoms Test ; WHI = Women ’s Health Initiative ; WHISCA = WHI Study of Cognitive Aging ; WMS-R/DGT-F , MS-R/DGT-B = Digit Span Forward and Backward Subtests of the Wechsler Memory Scale – Revised Objective To compare the effect of different formulations of continuous combined hormone therapy on sexual performance in naturally postmenopausal women . Material and methods A total of 158 postmenopausal women were enrolled and prospect ively r and omized to the single-blind study . Fifty-four women received tibolone 2.5 mg , 53 received 2 mg estradiol and 2 mg dienogest ( E2/dienogest ) , and 51 did not receive any menopausal therapy . The patients were monitored after 6 months . Attitudes of sexuality were evaluated by using the Rosen 's female sexual function index . Results Compared with E2/dienogest and the control group , tibolone treatment was associated with more improvement of sexual performance , including sexual desire , sexual arousal and satisfaction . Both of the hormone therapies decreased frequencies of vaginal dryness and painful intercourse . Conclusions Tibolone has more positive effects on the sexual dysfunction of postmenopausal women and may be an alternative to the E2/dienogest preparation in postmenopausal women with sexual dysfunction Background With the exception of sexual functioning and weight , social and behavioural effects of postmenopausal hormone therapy ( HT ) have not been reported from trials . This paper reports such results from the EPHT-trial in Estonia . Methods A r and omized trial , with a blind and non-blind sub-trial in Estonia . From 1999–2001 , 1778 women were recruited . The mean follow-up was 3.6 years . Women 's experiences were asked in the first and final study year by mailed question naires ( 74 and 81 % response rates ) . Comparisons of the groups were made by cross-tabulation and logistic regression , adjusting for age . Results There were no differences between the HT and non-HT groups in regard to being employed , the extent of social involvement or marital status or opinions on aging . There was no difference in the frequency of free-time exercise , or overweight . Some of the indicators suggested less sexual inactivity , but the differences were small . Conclusion In a trial setting , postmenopausal hormone therapy did not influence work or social involvement or health behaviour . Trial registration IS RCT AIM The effect of hormone replacement therapy ( HRT ) on the quality of life in women with hypertension is still not clear . Thus , the aim of the study was to assess the effect of hormone replacement therapy on quality of life in postmenopausal women with essential hypertension by using a battery of st and ardized question naires . MATERIAL AND METHODS The study population consisted of 53 women ( mean age 50.9 + /- 6.3 years ) with mild and moderate essential hypertension ( mean duration 6.4 + /- 6.4 years ) . The postmenopausal status was defined as the absence of menstrual blood loss during > 6 months and blood estradiol concentration < 50 pg/ml , accompanied by follicle-stimulating hormone ( FSH ) levels > 21 U/I. Twenty seven women were blindly r and omised to transdermal hormone replacement therapy ( HRT ) and received 17-beta-estradiol and noretisterone acetate , TTS .  Twenty six women were r and omly selected as controls . The subjects were evaluated at baseline ( after 2 weeks ' wash-out from hypotensive drug period ) and after three months of HRT using self-administered st and ardized quality of life question naires : the Psychological General Well-being Index ( PGWB ) and the Subjective Symptoms Assessment Profile ( SSA-P ) . RESULTS No differences were found in blood pressure values , heart rate , body mass index and distribution of body fat tissue between women receiving HRT and controls at baseline and after 3 months of follow-up . There were no significant differences in the baseline total PGWB score as well as in its subscale between two groups . Similarly , the frequency and intensity of subjective symptoms assessed by SSA-profile were the same in both groups at baseline . After 3 months , a significant improvement in PGWB total score was observed in women receiving HRT . This effect was due to improvement in anxiety , positive well-being and vitality . Moreover , emotional distress , symptoms of flushing , sweating and trembling h and s also diminished and sexual capacity improved in women treated with HRT . CONCLUSION A three-month hormone replacement therapy in hypertensive postmenopausal women slightly improves the general well-being , seems to decrease emotional tension , increase sexual capacity and markedly relieves some vasomotor symptoms Background For postmenopausal women , the main reason to start hormone therapy ( HT ) is to reduce menopausal symptoms and to improve quality of life ( QOL ) . The aim of this study was to analyse the impact of HT on different aspects of symptom experience and QOL during a r and omised trial . A total of 1823 postmenopausal women were recruited into the Estonian Postmenopausal Hormone Therapy ( EPHT ) trial in 1999–2001 . Women were r and omised to blind HT , open-label HT , placebo or non-treatment arm . After one year in the trial , a question naire was mailed and 1359 women ( 75 % ) responded , 686 in the HT arms and 673 in the non-HT arms . Mean age at filling in the question naire was 59.8years . The question naire included Women 's Health Question naire ( WHQ ) to assess menopause specific QOL of middle-aged women together with a 17-item question naire on symptoms related to menopause , a question about painful intercourse , and a question about women 's self-rated health . Results After one year in the trial , fewer women in the HT arms reported hot flashes , trouble sleeping , and sweating on the symptom question naire . According to WHQ , women in the HT arms had fewer vasomotor symptoms , sleep problems , and problems with sexual behaviour , but more menstrual symptoms ;  HT had no effect on depression , somatic symptoms , memory , attractiveness , or anxiety . A smaller proportion of women reported painful intercourse in the HT arms . There were no significant differences between the trial arms in women ’s self-rated subjective health . Conclusions The results from the EPHT trial confirm that HT is not justified for treating symptoms , other than vasomotor symptoms , among postmenopausal women . WHQ proved to be a useful and sensitive tool to assess QOL in this age group of women Menopause impacts 25 million women world wide each year , and the World Health Organization estimates 1.2 billion women will be postmenopausal by 2030 . Menopause has been associated with symptoms of hot flashes , night sweats , dysphoric mood , sleep disturbance , and conditions of cardiovascular disease , depression , osteoporosis , osteoarthritis , depression , dementia , and frailty . Conventional hormone replacement therapy results in increased thrombotic events , and an increased risk of breast cancer and dementia as evidence d in large prospect i ve clinical trials including Heart and Estrogen/Progestin Replacement Study I and the Women 's Health Initiative . A possible mechanism for these adverse events is the unfavorable net effects of conjugated equine estrogens and medroxyprogesterone acetate on the hemostatic balance and inflammatory and immune factors . Physiologic sex steroid therapy with transdermal delivery for peri/postmenopausal women may offer a different risk/benefit profile , yet long-term studies of this treatment model are lacking . The objective of this study was to examine the long-term effects of compounded bioidentical transdermal sex steroid therapy including estriol , estradiol , progesterone , DHEA , and testosterone on cardiovascular biomarkers , hemostatic , inflammatory , immune signaling factors ; quality -of-life measures ; and health outcomes in peri/postmenopausal women within the context of a hormone restoration model of care . A prospect i ve , cohort , closed-label study received approval from the Human Subjects Committee . Recruitment from outpatient clinics at an academic medical center and the community at large result ed in three hundred women giving signed consent . Seventy-five women who met strict inclusion /exclusion criteria were enrolled .  Baseline hormone evaluation was performed along with baseline experimental measures . Following this , women received compounded transdermal bioidentical hormone therapy of BiEst ( 80%Estriol/20%Estradiol ) , and /or Progesterone for eight weeks to meet established physiologic reference ranges for the luteal phase in premenopausal women . The luteal phase hormone ratios were selected based on animal and epidemiologic studies demonstrating favorable outcomes related to traumatic , ischemic , or neuronal injury . Follow-up testing was performed at eight weeks and adjustment to hormone regimens were made including addition of and rogens of DHEA and Testosterone if indicated . Experimental subjects were monitored for 36 months . Baseline , 2-month , and annual values were obtained for : blood pressure , body mass index , fasting glucose , Homeostasis Metabolic Assessment of Insulin Resistance ( HOMA-IR ) , fasting triglycerides , total Factor VII , Factor VIII , fibrinogen , Antithrombin III , Plasminogen Activator Inhibitor1(PAL-1 ) , C-reactive protein ( CRP ) , Interleukin-6 ( IL-6 ) , Matrix Metalloproteinase-9 ( MMP-9 ) , Tumor Necrosis Factor-alpha ( TNF ) , Insulin-like Growth Factor ( IGF-1 ) , and sex steroid levels . Psychosocial measures included : Greene Climacteric Scale , Visual Analog Pain Scale , Hamilton Anxiety Scale , Hamilton Depression Scale , Holmes Rahe Stress Scale , Job Strain , and Home Strain . Health outcome measures included the number of prescribed medications used , number of co-morbidities , and endometrial thickness in postmenopausal women with intact uteri . Subjects receiving  compounded transdermal bioidentical hormone therapy showed significant favorable changes in : Greene Climacteric Scale scores , Hamilton Anxiety Scale , Hamilton Depression Scale , Visual Analog Pain Scale , fasting glucose , fasting triglycerides , MMP-9 , C-reactive Protein , fibrinogen , Factor VII , Factor VIII , Insulin-Like Growth Factor 1 , and health outcomes of co-morbidities and a number of prescribed medications . Antithrombin III levels were significantly decreased at 36 months . All other measures did not exhibit significant effects . Administration of compounded transdermal bioidentical hormone therapy in doses targeted to physiologic reference ranges administered in a daily dose significantly relieved menopausal symptoms in peri/postmenopausal women . Cardiovascular biomarkers , inflammatory factors , immune signaling factors , and health outcomes were favorably impacted , despite very high life stress , and home and work strain in study subjects . The therapy did not adversely alter the net prothrombotic potential , and there were no associated adverse events . This model of care warrants consideration as an effective and safe clinical therapy for peri/postmenopausal women especially in population s with high perceived stress and a history of stressful life events prior to , or during the menopausal transition ABSTRACT Background Sexual desire is affected by endocrine and psychosocial factors . Menopausal hormonal changes are relevant to the causes of sexual dysfunction during reproductive aging . Aim To evaluate the effects of different types of hormonal replacement therapy ( HRT ) on sexual function , frequency of sexual intercourse , and quality of relationship in early postmenopausal women . We recruited 48 healthy postmenopausal women aged 50–60 years ( mean age 54.5 ± 3.3 years ) . Women with climacteric symptoms were uniformly r and omized into three groups receiving either dehydroepi and rosterone ( DHEA 10 mg ) daily , or daily oral estradiol ( 1 mg ) plus dihydrogesterone ( 5 mg ) , or daily oral tibolone ( 2.5 mg ) for 12 months . Women who refused hormonal therapy were treated with oral vitamin D ( 400 IU ) . Efficacy was evaluated using the McCoy Female Sexuality Question naire before treatment and after 12 months . We evaluated the hormonal profile before treatment and after 3 , 6 and 12 months . Results The groups receiving DHEA or HRT reported a significant improvement in sexual function compared to baseline ( p < 0.001 and p < 0.01 , respectively ) using the McCoy total score . The quality of relationship was similar at baseline and after 3 , 6 and 12 months of treatment . There were significant increases in the numbers of episodes of sexual intercourse in the previous 4 weeks in women treated with DHEA , HRT and tibolone in comparison with the baseline value ( p < 0.01 , p < 0.05 , p < 0.01 , respectively ) . No changes in the McCoy score occurred in women receiving vitamin D. Conclusions Daily oral DHEA therapy at the dose of 10 mg , HRT and tibolone all provided a significant improvement in comparison with vitamin D  in sexual function and in frequency of sexual intercourse in early postmenopausal women BACKGROUND The decision to take hormone replacement therapy ( HRT ) is a choice many women encounter when entering menopause . The purpose of this study was to examine the choice to take HRT while participating in a lifestyle intervention to reduce cardiovascular risk through the menopause . METHODS The Women 's Healthy Lifestyle Project is a r and omized clinical trial design ed to examine whether a behavioral lifestyle intervention can decrease the expected rise in cardiovascular risk through the menopause . Participants ( N = 535 ) completed question naires and were interviewed regarding menopausal symptoms , menopausal status , hot flashes , and  HRT  use at baseline and 54 months . RESULTS The intervention was successful in preventing risk elevation through the 54-month visit . At the final visit , there was no difference between the intervention and control groups in the percentage who had become postmenopausal ( 32.9 % vs 35.0 % , respectively ) , there was no difference between control and intervention with  HRT  use , with 31.2 % reporting use of HRT , and there was no difference between groups with menopausal symptoms . The women started HRT an average of 6 months after they missed a period . Baseline risk factors did not predict HRT use at the 54-month visit . CONCLUSIONS A sizable number of women reported HRT use . The decision to use HRT was not influenced by the lifestyle intervention or their baseline cardiovascular risk , and these women started HRT very early in the peri- to postmenopause . Further , weight loss in the perimenopause did not affect menopausal symptoms Objective : This study aims to evaluate the effectiveness and safety of Gua sha therapy on perimenopausal symptoms , quality of life , and serum female hormones in participants with perimenopausal syndrome . Methods : A prospect i ve , r and omized , controlled clinical trial was conducted at the First Affiliated Hospital of Nanjing University of Chinese Medicine in China . Eighty women with perimenopausal syndrome were recruited and r and omized into an intervention group or a control group . Participants in the intervention group received 15-minute Gua sha treatment sessions once a week plus conventional treatment for 8 weeks , whereas participants in the control group received conventional treatment alone . The primary outcome was the change in perimenopausal symptoms and quality of life as obtained through the modified Kupperman Index ( KI ) and the Menopause-Specific Quality of Life . The secondary outcome was the change of serum female hormones including estrogen , follicle-stimulating hormone , and luteinizing hormone . Results : Seventy-five out of 80 participants ( 93.8 % ) completed the study —38 in the intervention group and 37 in the control group . The baseline levels of demographic and outcome measurements were comparable between the two groups . After eight sessions of intervention , the reduction in the total modified KI score was , however , 16.32 ± 4.38 in the intervention group and 11.46 ± 5.96 in the control group , with a difference of 4.86 ± 6.15 ( P < 0.01 ) between the two groups . Also the reductions of hot flash/sweating , paresthesia , insomnia , nervousness , melancholia , fatigue , and headache were greater in the intervention group than in the control group ( P < 0.05 ) . The reduction in the total Menopause-Specific Quality of Life score was 17.87 ± 3.84 in the intervention group and 13.62 ± 7.40 in the control group , with a difference of 4.46 ± 7.52 ( P < 0.01 ) between the two groups . And the scores for vasomotor , psychosocial , and physical domains in the intervention group were significantly lower than those in the control group ( P < 0.05 ) . There were no significant differences in serum estrogen , follicle-stimulating hormone , and luteinizing hormone between the two groups . Conclusions : The results of this study suggest that Gua sha therapy was effective and safe in relieving perimenopausal symptoms and improving the quality of life in participants with perimenopausal syndrome . The therapy may serve as a promising , effective , nondrug treatment for perimenopausal syndrome in clinical work . Additional research is needed to better underst and its effectiveness and examine its mechanism for treating perimenopausal syndrome Objective : The aim of this study was to examine changes in health-related quality of life ( HRQL ) during the menopausal transition , controlling for chronological aging , symptoms , and other covariates . Methods : This was a prospect i ve , longitudinal study of women aged 42 to 52 years at baseline recruited at seven US sites ( N = 3,302 ) in the multiethnic Study of Women 's Health Across the Nation . Women eligible for the cohort had an intact uterus , had at least one ovary , were not currently using exogenous hormones , were either premenopausal or early perimenopausal , and were self-identified as one of the study 's design ated racial/ethnic groups . Data from the baseline interview and six annual follow-up visits are reported . HRQL was assessed with five subscales from the Medical Outcomes Study Short-Form Health Survey , with reduced functioning defined as being in the lowest 25 % on a subscale . Covariates included symptoms , medical conditions , sociodemographics variables , physical activity , and psychological factors . Results : With adjustment for baseline age , chronological aging , and relevant covariates , the odds of reduced role-physical functioning were significantly greater at late perimenopause ( odds ratio , 1.46 ; 95 % CI , 1.08 - 1.99 ) and postmenopause ( odds ratio , 1.49 ; 95 % CI , 1.09 - 2.04 ) compared with premenopause . Menopause status was unrelated to bodily pain , vitality , role-emotional , or social functioning .  Hormone therapy users were more likely to report reduced functioning . Other variables significantly related to HRQL across all domains included vasomotor symptoms , urine leakage , poor sleep , arthritis , depressed mood , perceived stress , and stressful life events . Conclusions : The menopausal transition showed little impact on HRQL when adjusted for symptoms , medical conditions , and stress OBJECTIVE To investigate the effects of hormone therapy ( HT ) administered to postmenopausal women on pulmonary function tests ( PFT ) . METHODS Eighty-two postmenopausal women who were having natural or surgically initiated menopause and had no risk factor that could affect the respiratory system were included into this prospect i ve , r and omized study . Twenty-five women who refused to use HT were assessed as the control group ( Group I ) . Nineteen women who accepted using HT and who were having surgically initiated menopause were given continuous estrogen ( Group II ) , 23 were given continuous estrogen and progesterone in combination ( Group III ) and 15 were given cyclic estrogen and progesterone combination ( Group IV ) . Forced expiratory volume ( FEV1 ) , forced vital capacity ( FVC ) , FEV1/FVC , forced expiratory flow rate over 25 - 75 % of the forced vital capacity volume and peak expiratory flow rate were assessed at the beginning of the treatment and in the third month in order to evaluate the effects of HT regimens on the women 's PFT . RESULTS A statistically significant increase was observed only in the FEV1 and FVC parameters of Group III after three months of therapy ( P<0.05 ) . The comparison between pre- and posttherapy FEV1 and FVC values showed an increase in the Group IV , but the difference was not statistically significant , while there was no difference between basal and third month FEV1 and FVC values of the group receiving estrogen only . CONCLUSIONS It was seen that particularly continuous combined HT regimen positively affected the FEV1 and FVC parameters of the postmenopausal women OBJECTIVE Individual differences in sensitivity to cyclical changes in ovarian steroids estradiol ( E2 ) and progesterone ( P4 ) have been implicated in the pathophysiology of menstrually related mood disorder ( MRMD ) . However , no prospect i ve studies have investigated psychosocial risk factors for sensitivity to hormone effects on mood in MRMD . Using a repeated measures approach and multilevel models , we tested the hypothesis that a history of abuse provides a context in which within-person elevations of E2 and P4 prospect ively predict daily symptoms . METHOD 66 women with prospect ively-confirmed MRMD recruited for a trial of oral contraceptives provided  1 month of baseline hormone and mood data prior to r and omization . Lifetime physical and sexual abuse experiences were assessed . Across one cycle , women completed daily measures of symptoms and provided blood sample s on 5 days across the menstrual cycle . Current E2 and P4 were centered within person ( CWP ) such that higher values represented cyclical elevations in hormones . RESULTS Rates of physical ( 27 % ) and sexual ( 29 % ) abuse were high , consistent with previous work documenting a link between trauma and MRMD . In women with a history of physical abuse , cyclical increases in P4 predicted greater mood and interpersonal symptoms on the three days following that sample . In women with a history of sexual abuse , cyclical increases in E2 predicted greater anxiety symptoms on the three days following that sample . CONCLUSIONS Results inform further inquiry into the role of severe life stressors and stress response systems in MRMD . We discuss areas for future research on the psychosocial and physiological pathways through which abuse may influence the link between hormones and symptoms Women experience somatic , mood , energy , and libido changes during menopause .  Testosterone replacement therapy is being prescribed in conjunction with estrogen replacement therapy ( ERT ) for these symptoms . Little is known about women ’s perceptions of the benefits and risks of testosterone , so an Internet survey was conducted to elicit women ’s perceptions of the effects on mood , energy , sexuality , and somatic symptoms .  A sample of 61 women primarily from the United States and Canada participated in the survey ; one woman from Germany and one from Sweden also took part in the survey . Participants reported significantly improved sexuality and improved mood and vigor , with a decline in fatigue . Of the 7 somatic complaints assessed , improvements were noted in 5 ( sleep disturbances , hot flashes , night sweats , vaginal dryness , and appetite ) . A prospect i ve clinical trial is needed to confirm these results OBJECTIVE To evaluate the benefits and risks of hormone replacement therapy ( HRT ) combined with methyltestosterone ( MT ) in postmenopausal women with sexual dysfunction .  DESIGN This study was a r and omized , double-blind , placebo-controlled and crossover trial . Eighty-five women using HRT  were divided into four treatment groups : GI-HRT plus placebo for 4 months ; GII-HRT plus MT 2.5mg/day for 4 months ; GIII-HRT plus placebo for 2 months and then replaced with HRT plus MT 2.5mg/day for 2 months ; GIV-HRT plus MT 2.5mg/day and then replaced with HRT plus placebo for 2 months . Blood was collected at baseline , after 2 months ( T1 ) and 4 months ( T2 ) of treatment for hormone determinations of estradiol , FSH , total and free testosterone , GOT , GPT , glucose , total and fractions of cholesterol and triglycerides . All participants answered clinical questions and a vali date d question naire of modified McCoy 's sex scale . RESULTS The association of HRT with MT 2.5mg/day did not significantly change liver enzymes or increase cardiovascular risk factors . The patients of GII , GIIII and GIV when using MT presented amelioration of sex symptoms , mainly satisfaction and desire ( p<0.01 ) ; however , GIII at T1 ( 1.3+/-0.3 ) presented similar problem score results as compared to GIII at T2 ( 1.5+/-0.6 ) . CONCLUSION All data suggest that combined HRT- and rogen therapy may be beneficial for postmenopausal women receiving HRT who continue to complain of sexual difficulties or for postmenopausal women with sexual complaints who are not undergoing estrogen therapy Objective . Continuous combined hormone replacement therapy ( ccHRT ) based on estradiol valerate ( E2V ) and medroxyprogesterone acetate ( MPA ) is effective for relief of menopausal symptoms three years or more after the menopause . This study was undertaken to examine the efficacy and tolerability of ccHRT in early postmenopausal women ( last menstrual period 1.3 years before study entry ) . Study design . This was a 52-week , r and omized , double-blind , multinational study of ccHRT comprising three different dose combinations of E2V/MPA in 459 early postmenopausal non-hysterectomized women experiencing 30 or more moderate to severe hot flushes a week and /or vasomotor symptoms requiring treatment . Main outcomes measures . The primary endpoint was change in frequency and severity of moderate to severe hot flushes at 12 weeks . Secondary outcome measures included number of bleeding days and evaluation of tolerability . Results . The frequency of hot flushes was reduced by ≥70 % after one month ( P<0.001 for all doses at week 2 onwards ) , with little evidence of statistically different dose effects . Severity of flushing was also attenuated by  ccHRT . Mean number of bleeding days fell to < 1 per 28-day cycle at 52 weeks . Rates of amenorrhoea approached 80–90 % at the end of the study , but were significantly lower at several time points with the highest-dose regimen ( 2 mg E2V + 5 mg MPA ) than with the lower-dose options ( 1 mg E2V + 2.5 mg MPA and 1 mg E2V + 5 mg MPA ; P<0.05 ) . Adverse events declined in frequency over time with all regimens but throughout the study were more numerous with the highest-dose regimen than with lower doses ( P= 0.0002 ) . Conclusions . Continuous combined HRT was effective for the relief of climacteric symptoms in early postmenopausal women and was well tolerated Menopause is associated with a considerable variety of physical , psychological and social symptoms that can be treated using cognitive-behavioral techniques . In the present study , 21 women took part in an eight-week group intervention consisting of weekly two-hour sessions to address their slight symptoms related to the climacteric stage of life . The intervention included : psycho education on menopause , relaxation techniques , nutrition and fitness exercises , Kegel exercises , and problem-solving techniques . A control group was included that did not receive treatment and consisted of 28 women . The results revealed a significant reduction in most symptoms ( including depression and anxiety ) after intervention as compared to the baseline period . No changes appeared in the control group . The relevance of this work lies in the potential element of prevention this therapeutic package could offer to relieve various symptoms , slight and incipient , during the perimenopausal stage
HT treatment with estrogens alone or in combination with progestogens was associated with a small to moderate improvement in sexual function , particularly in pain , when used in women with menopausal symptoms or in early postmenopause ( within five years of amenorrhoea ) , but not in unselected postmenopausal women .
The current evidence does not suggest an important effect of tibolone or of SERMs alone or combined with estrogens on sexual function .
BACKGROUND The perimenopausal and postmenopausal periods are associated with many symptoms , including sexual complaints .
OBJECTIVES To assess the effect of hormone therapy ( HT ) on  sexual function in perimenopausal and postmenopausal women .