Sexual function in women on estradiol or venlafaxine for hot flushes: a
randomized controlled trial.
Author(s): Reed SD(1), Mitchell CM, Joffe H, Cohen L, Shifren JL, Newton KM, Freeman EW,
Larson JC, Manson JE, LaCroix AZ, Guthrie KA.
Affiliation(s): Author information:
(1)Departments of Obstetrics and Gynecology and Epidemiology, University of
Washington School of Medicine, the Group Health Research Institute, and the Data
Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, Washington;
the Departments of Psychiatry and Medicine, Brigham and Women's Hospital, the
Departments of Psychiatry and Obstetrics and Gynecology, Massachusetts General
Hospital, and Harvard Medical School, Boston, Massachusetts; and the Departments
of Obstetrics and Gynecology and Psychiatry, University of Pennsylvania Perelman
School of Medicine, Philadelphia, Pennsylvania.
Publication date & source: 2014, Obstet Gynecol. , 124(2 Pt 1):233-41
OBJECTIVE: To evaluate sexual function in midlife women taking low-dose oral
estradiol or venlafaxine for hot flushes.
METHODS: In an 8-week randomized controlled trial among women aged 40-62 years,
sexual function was compared between 0.5 mg oral estradiol per day or 75 mg
venlafaxine per day (both compared with a placebo). Measures included composite
and six domain scores from the Female Sexual Function Index and sexually related
personal distress.
RESULTS: Participants were aged 54.6 years (standard deviation [SD] 3.8) years,
59% white, with 8.1 (SD 5.3) daily hot flushes. Median composite baseline Female
Sexual Function Index score was 16.3 (SD 11.9, n=256) for all women and 21.7 (SD
9.3, n=198) among sexually active women. Composite mean Female Sexual Function
Index change from baseline to week 8 was 1.4 (95% confidence interval [CI] -0.4
to 3.2) for estradiol, 1.1 (95% CI -0.5 to 2.7) for venlafaxine, and -0.3 (95% CI
-1.6 to 1.0) for placebo. Composite Female Sexual Function Index and sexually
related distress change from baseline did not differ between estradiol and
placebo (P=.38, P=.30) or venlafaxine and placebo (P=.79, P=.48). Among sexually
active women, Female Sexual Function Index domain score change from baseline
differences (active compared with placebo) in desire was 0.3 (95% CI 0.0-0.6) for
estradiol, -0.6 (95% CI -1.2 to 0.0) in orgasm for venlafaxine, and 0.9 (95% CI
0.2-1.6) in penetration pain for venlafaxine. No women reported adverse events
related to sexual dysfunction.
CONCLUSION: Overall sexual function among nondepressed midlife women experiencing
hot flushes did not change over 8 weeks with low-dose oral estradiol or
venlafaxine (compared with placebo), although a subtle increase in desire
(estradiol) and decreases in orgasm and pain (venlafaxine) may exist.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov,
NCT01418209.
LEVEL OF EVIDENCE: I.
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