TY - JOUR
T1 - Sexual activity and vaginal symptoms in the postintervention phase of the Women's Health Initiative Hormone Therapy Trials
AU - Gass, Margery
AU - Larson, Joseph
AU - Cochrane, Barbara
AU - Manson, Joann E.
AU - Lane, Dorothy
AU - Barnabei, Vanessa
AU - Ockene, Judith
AU - Stefanick, Marcia L.
AU - Mouton, Charles
N1 - Funding Information:
Received July 7, 2017; revised and accepted September 5, 2017. From 1Cleveland, OH; 2Fred Hutchinson Cancer Research Center, Seattle, WA; 3University of Washington School of Nursing, Seattle, WA; 4Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA; 5Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; 6Department of Obstetrics and Gynecology, School of Medicine and Biomedical Sciences, University at Buffalo, New York, NY; 7Division of Preventive and Behavioral Medicine at the University of Massachusetts, Worcester, MA; 8Stan-Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA; and 9Office of Academic Affairs and Department of Family Medicine, University of Texas Medical Branch, Galveston, TX. Funding/support: The Women’s Health Initiative program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. Financial disclosure/conflicts of interest: None reported. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Website (www.menopause.org). Address correspondence to: Margery Gass, MD, 4 Salem Court, Cleveland, OH 44122. E-mail: margery@mgass.onmicrosoft.com
Funding Information:
The Women's Health Initiative program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C.
Publisher Copyright:
© 2017 by The North American Menopause Society.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Objective: To assess the impact of discontinuing oral hormone therapy (HT) on sexual activity, vaginal symptoms, and sexual activity components among participants in the estrogen-progestin therapy (EPT) and estrogen therapy (ET) trial of the Women's Health Initiative. Methods: Surveys were sent postintervention to those who were still taking study pills and agreed to continue in the study when the trials were stopped. Comparisons between former HT and placebo users were accomplished with chi-square tests for categorical variables and t tests for continuous variables. Results: In all, 13,902 women with mean age at survey 69.9 years (EPT trial, women with intact uterus) and 71.7 years (ET trial, women with history of hysterectomy) responded. Prevalence of sexual activity postintervention was not significantly different between former EPT and placebo users (36.0% vs 34.2%; P = 0.37). Sexual activity of former ET users was 5.6% higher than placebo users (27.6% vs 22.0%; P = 0.001). The majority of sexually active women overall maintained orgasmic capacity and sexual satisfaction. Former EPT users were 10% to 12% more likely than former placebo users to report decreased desire, arousal, intercourse, climax, and satisfaction with sexual activity, and also increased dryness and dyspareunia upon discontinuing study drugs (P < 0.001). Former ET users were more likely than placebo users to report rare to no desire or arousal postintervention (P < 0.001). Conclusions: Postintervention ET trial participants formerly assigned to ET were significantly more likely to report sexual activity than those formerly assigned to placebo. Women who discontinued EPT were significantly more likely to report negative vaginal and sex-related effects.
AB - Objective: To assess the impact of discontinuing oral hormone therapy (HT) on sexual activity, vaginal symptoms, and sexual activity components among participants in the estrogen-progestin therapy (EPT) and estrogen therapy (ET) trial of the Women's Health Initiative. Methods: Surveys were sent postintervention to those who were still taking study pills and agreed to continue in the study when the trials were stopped. Comparisons between former HT and placebo users were accomplished with chi-square tests for categorical variables and t tests for continuous variables. Results: In all, 13,902 women with mean age at survey 69.9 years (EPT trial, women with intact uterus) and 71.7 years (ET trial, women with history of hysterectomy) responded. Prevalence of sexual activity postintervention was not significantly different between former EPT and placebo users (36.0% vs 34.2%; P = 0.37). Sexual activity of former ET users was 5.6% higher than placebo users (27.6% vs 22.0%; P = 0.001). The majority of sexually active women overall maintained orgasmic capacity and sexual satisfaction. Former EPT users were 10% to 12% more likely than former placebo users to report decreased desire, arousal, intercourse, climax, and satisfaction with sexual activity, and also increased dryness and dyspareunia upon discontinuing study drugs (P < 0.001). Former ET users were more likely than placebo users to report rare to no desire or arousal postintervention (P < 0.001). Conclusions: Postintervention ET trial participants formerly assigned to ET were significantly more likely to report sexual activity than those formerly assigned to placebo. Women who discontinued EPT were significantly more likely to report negative vaginal and sex-related effects.
KW - Genitourinary syndrome of menopause
KW - Hormone therapy discontinuation
KW - Sexual function
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U2 - 10.1097/GME.0000000000000994
DO - 10.1097/GME.0000000000000994
M3 - Article
C2 - 29112594
AN - SCOPUS:85042452604
SN - 1072-3714
VL - 25
SP - 252
EP - 264
JO - Menopause
JF - Menopause
IS - 3
ER -