Vaginal dehydroepiandrosterone compared to other methods of treating
vaginal and vulvar atrophy associated with menopause

Piȩta, Wojciech; Smolarczyk, Roman

doi:10.5114/pm.2020.101943

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Hormonal topical interventions were seen to be more promising, with beneficial effects on tissue hydration. The use of DHEA intravaginal gels (large-scale RCT) resulted in significant improvements in vaginal dryness and dyspareu- nia 46,80,81 . Improvements were faster with higher-dose application of DHEA and higher frequency of application may be needed for women with severe symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…The use of DHEA intravaginal gels (large-scale RCT) resulted in significant improvements in vaginal dryness and dyspareunia. 46,80,81 Improvements were faster with higher-dose application of DHEA and higher frequency of application may be needed for women with severe symptoms. Androgen side effects (eg, voice change) may appear in some patients, possibly due to the estrogenic and androgenic activity of the hormone.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review

et al. 2022

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Importance: Cancer and its treatment negatively affect female sexual health and function. The prevalence of female sexual dysfunction after cancer is between 33% and 43%. Numerous studies have addressed treatment options for sexual dysfunction in women with cancer, but it still remains a challenge to select the most efficacious option for patients.Objective: To compile and appraise recent evidence of any interventions for managing sexual dysfunction in female cancer survivors.Evidence Review: A literature search of the electronic databases MEDLINE, EMBASE, PsycINFO, and Cochrane Central Register of Controlled Trials (January 2011 to February 2021) was conducted using general search terms of ''women'', ''cancer'', ''intervention'', ''sexual dysfunction''. We included randomized controlled trials (RCTs) and uncontrolled before-after studies that evaluated the efficacy of intervention for female sexual dysfunction in women with history of cancer. Methodological quality of studies was assessed using Risk of Bias (RoB) 2.0 for RCTs and National Institutes of Health (NIH) assessment tools for uncontrolled before-after studies.Findings: Thirty-six studies were included for qualitative synthesis (14 RCTs (n ¼ 1284), 17 uncontrolled trials (n ¼ 589), and 5 cohort studies (n ¼ 497). Only four studies were at low risk of bias. Topical interventions (vaginal gels or creams) were able to alleviate vaginal dryness and dyspareunia, with intravaginal dehydroepiandrosterone (DHEA) (6.5 mg) gel showing evidence of improved sexual function. Evidence for estriol-lactobacilli vaginal tablets was unreliable due to a small-scale study. Psychoeducational therapy (internet-based cognitive behavioral therapy [CBT]) studies typically were at high risk of bias, but all displayed significant improvements of sexual function. Both laser therapy (fractional CO 2 and erbium) and multimodal approach studies were at concerning risk of bias, although suggesting beneficial effects on sexual function.Conclusions and Relevance: The most reliable evidence for improvement was from a study of DHEA vaginal gel, but in general, gels or creams were useful in reducing dyspareunia. Pharmacological, psychoeducational, laser therapy, and multimodal approaches demonstrated potential in managing cancer-related sexual issues, but most were small in size (10-70 participants), with moderate to high risk of bias. Therefore, large-scale, double-blind, RCTs with long-period follow-up, and at low risk of bias are needed to show efficacy for these interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review

et al. 2022

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“…Vaginal and oral administration of DHEA is a valuable option for the treatment of dyspareunia in the context of GSM [64]; in fact, daily vaginal use of DHEA was approved by the FDA in 2016. The mechanism of action of DHEA on the vagina is due to the aromati-zation of androstenedione and testosterone locally to oestrone and oestradiol [65].…”

Section: Dehydroepiandrosteronementioning

confidence: 99%

Non-oestrogenic modalities to reverse urogenital aging

Garzon

Apostolopoulos

Stojanovska

et al. 2021

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Urogenital aging is a common process affecting all women in the post-menopausal period of their life, and it is substantially due to oestrogen deprivation after ovarian function cessation. These changes can lead to a progressive, chronic, and complex association of symptoms identified as the genitourinary syndrome of menopause, which has a significant impact on quality of life. Genitourinary syndrome and urogenital aging do not resolve spontaneously and usually recur when treatment is stopped. Therefore, appropriate long-term management is of paramount importance, and local oestrogen is the most effective treatment to reverse urogenital aging and to improve symptoms of genitourinary syndrome as replacement therapy. In some women, topical oestrogen may be inconvenient, it may not achieve complete response, or it may be contra-indicated. Several non-hormonal therapies have been investigated, but few treatments have been reported as potentially able to reverse the urogenital aging process similarly to exogenous oestrogens. Laser seems the most promising, although further studies to define its safety and efficacy are mandatory. Vitamin D and E, and phytotherapy have returned conflicting results and require further confirmation. Lifestyle modifications, physiotherapy, and electrical stimulation represent inexpensive and applicable treatments that might slow urogenital aging. Among the hormonal nonoestrogenic therapies, the use of vaginal oxytocin and dehydroepiandrosterone have been found to be effective compared to placebo, as well as the use of oral ospemifene, which partially relieves vulvovaginal atrophy.

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Relationship of steroid sex hormones with female sexual dysfunction in female patients having urinary incontinence

et al. 2022

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Vaginal dehydroepiandrosterone compared to other methods of treating vaginal and vulvar atrophy associated with menopause

Cited by 4 publications

References 6 publications

Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review

Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review

Non-oestrogenic modalities to reverse urogenital aging

Relationship of steroid sex hormones with female sexual dysfunction in female patients having urinary incontinence

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