Comparative effects of the conventional hormone replacement therapy and tibolone on sexual performance in postmenopausal women

Sex life is one of the most important aspects of quality of life which is affected by a multitude of factors which can disrupt it. This study compares the effects of two different hormonal therapeutic regimens on sexual performance of postmenopausal women.

In this randomized clinical trial, a total of 111 healthy postmenopausal women with no absolute contraindication for hormone replacement therapy (HRT) were divided into two groups that received GI-Tibolone 2.5mg/day (N=57) and GII-continuous conjugated estrogen (CE) 0.625mg/day plus medroxyprogestrone acetate (MPA) 2.5mg/day (N=54) for six months. At baseline and after 6 months of treatment, blood samples were collected for determining sexual hormones level. Sexual function was assessed by Female Sexual Function Index (FSFI). Data were analyzed using Spss 16.

Of all the participants, 45 women in the tibolone group and 32 women in HRT completed the study. Compared with the baseline values, the tibolone group significantly improved on all the six FSFI domains; however, in the HRT group, just two of the six domains, lubrication and pain, got improved. The increase in mean total score and the score of each domain of FSFI except for satisfaction domain in the tibolone group was significantly greater than the HRT group (p<0.05). In the tibolone group, testosterone (p=0.003), FTI (p=0.002), and FEI (p=0.021) increased in comparison to the baseline, whereas SHBG decreased (p<0.001). In GII group, SHBG (p=0.001) significantly increased and tibolone was tolerated better than HRT.

In post menopausal women, tibolone is more effective than HRT in improving sexual function scores, especially the desire, arousal, and orgasm domains. Its side effects are also much more acceptable.