Female sexual dysfunction in postmenopausal women: Systematic review of placebo-controlled trials

Abstract Objective: This systematic review includes all randomized and placebo-controlled trials (RCTs) of treatment for female sexual dysfunction (FSD) in postmenopausal women published since 1990. Study Design: Electronic database and manual bibliography searches were conducted to identify all relevant publications. Results: Only six RCTs have been done to assess the effects of different therapies on sexual function in postmenopausal women: one with sildenafil citrate (Viagra), three with hormone replacement therapy, and two with tibolone. Conclusions: In women with FSD, many treatments that are used in practice are not supported by adequate evidence. Although an improvement of sexual function was reported with tibolone and the combination of estrogen-androgen therapy, it still remains unclear which groups of postmenopausal women with FSD would benefit most from these therapies. The adverse effects of testosterone replacement therapy should be assessed against the effects of placebo in RCTs with larger sample sizes and longer duration. (Am J Obstet Gynecol 2003;188:286-93.)