Management of vulvovaginal atrophy-related sexual dysfunction in postmenopausal women: An up-to-date review

Orkun Tan, Karen Bradshaw, Bruce R. Carr

Research output: Contribution to journalReview articlepeer-review

107 Scopus citations


OBJECTIVE: Menopause and its transition represent significant risk factors for the development of vulvovaginal atrophy-related sexual dysfunction. The objective of this study was to review the hormonal and nonhormonal therapies available for postmenopausal women with vulvovaginal atrophy-related sexual dysfunction, focusing on practical recommendations through a literature review of the most relevant publications in this field. METHODS: This study is a literature review. RESULTS: Available vaginal estrogen preparations are conjugated equine estrogens, estradiol vaginal cream, a sustained-release intravaginal estradiol ring, or a low-dose estradiol tablet. Vaginal estrogen preparations with the lowest systemic absorption rate may be preferred in women with history of breast cancer and severe vaginal atrophy. Vaginal lubricants and moisturizers applied on a regular basis have an efficacy comparable with that of local estrogen therapy and should be offered to women wishing to avoid the use of vaginal estrogens. CONCLUSIONS: Oral, transdermal, or vaginal estrogen preparations are the most effective treatment options for vulvovaginal atrophy-related sexual dysfunction. Selective estrogen receptor modulators such as lasofoxifene and ospemifene showed a positive impact on vaginal tissue in postmenopausal women. Vaginal dehydroepiandrostenedione, vaginal testosterone, and tissue selective estrogen complexes are also emerging as promising new therapies; however, further studies are warranted to confirm their efficacy and safety.

Original languageEnglish (US)
Pages (from-to)109-117
Number of pages9
Issue number1
StatePublished - Jan 1 2012


  • Dehydroepiandrosterone
  • Estrogens
  • Menopause
  • Selective estrogen receptor modulators
  • Sexual dysfunction
  • Vulvovaginal atrophy

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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