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Minerva Obstetrics and Gynecology 2021 Sep 09

DOI: 10.23736/S2724-606X.21.04862-4


lingua: Inglese

Sexual function analysis and clitoral vascularization in postmenopausal women with genitourinary syndrome treated with Ospemifene

Michele C. SCHIAVI 1, Pietro CIGNINI 1, Marzio A. ZULLO 2, Paolo LUFFARELLI 2, Claudia MORGANI 1, 3, Veronica YACOUB 1, 3 , Valerio CARLETTI 1, 3, Francesco BISOGNI 1, Francesco GALANTI 1, 4, Anna DI PINTO 5, Donatella MIRIELLO 4, Rocco RAGO 4, Herbert C. VALENSISE 3, 6, Pier Luigi PALAZZETTI 1

1 Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy; 2 Department of Surgery-Week Surgery, Campus Biomedico University, Rome, Italy; 3 Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy; 4 Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy; 5 Department of Obstetrics and Gynecology, Santa Maria Goretti Hospital, Latina, Italy; 6 Department of Obstetrics and Gynecology, Casilino Hospital, Rome, Italy


AIMS: To evaluate the efficacy of Ospemifene in the vaginal health index (VHI), in the vulvovaginal vascular perfusion and to assess its impact on quality of life and sexual function.
METHODS: Among 52 eligible patients, 43 consecutive postmenopausal patients affected by vulvo-vaginal atrophy (VVA) or Genitourinary Syndrome (GSM) were evaluated. VVA evaluation and ultrasound of the vulvo-vaginal vascularization by sampling the pulsatility index (PI) of clitoris dorsal artery were performed before and after 3 months-treatment with Ospemifene. The 36-Item Short Form Survey (SF-36) for the quality-of-life assessment before and after 3 months were available for all women; instead Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) questionnaires for the sexual function evaluation were performed for sexually active women in the study. The Patient Impression of Global Improvement (PGI-I) after 3 months of treatment was also calculated.
RESULTS: The number of sexually active women significantly increased after 3 months [26 (60.46%) vs 35 (81.39%); p=0.01]. The mean number of intercourses during the treatment increased (12.87 ± 3.43 vs 15.79 ± 3.12, p=0.03). The PI of clitoris dorsal artery has significantly changed before and after treatment respectively [PI (1.69 ± 0.42 vs 1.28 ± 0.45, p=0.001) RI (0.74 ± 0.11 vs 0.54 ± 0.15, p=0.001)]. The FSFI, FSDS and SF-36 questionnaires scores showed a significant improvement after 3 months. VHI and PI were the independent factors of a lower FSFI after 3 months of treatment at multivariate analysis.
CONCLUSIONS: Ospemifene improve the VHI and vulvovaginal vascular perfusion demonstrating a positive impact on sexual function and quality of life.

KEY WORDS: Genitourinary syndrome; Menopause; Ospemifene; Sexual function; Vulvovaginal atrophy

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