271 Vulvoscopic Findings, Patient Reported Outcome (Pro) Measures, and Hormonal Blood Test Values in Menopausal Women With Female Sexual Dysfunction Pre- and Post-Hormonal Treatment: A Retrospective Single Center Study

Abstract

Menopausal women frequently experience symptoms and signs associated with reduced sex steroid hormones. Estradiol deficiency related symptoms of Genitourinary Syndrome of Menopause (GSM) include dryness, burning, thinning, itching, urinary frequency and dyspareunia. Testosterone deficiency related symptoms include diminished sense of well-being, reduced muscle and bone mass, provoked vestibulodynia, and decreased sexual desire, arousability, and orgasmic pleasure. The hypothesisis is that with both high patient adherence and close health care provider monitoring, hormonal management will lead to subjective and objective improvements in signs and symptoms. The aim of this study was to evaluate clinical benefit of hormonal replacement strategies for management of sexual dysfunction and GSM utilizing pre- and post-treatment: blood test monitoring; Female Sexual Function Index (FSFI) scores; and vulvoscopy findings. Charts from August 1, 2007 through December 1, 2015 were reviewed. Five bioidentical hormonal replacement efforts are designed to keep serum estradiol levels 35-50 pg/ml, serum progesterone levels at 1.0 ng/ml and calculated free testosterone levels at 0.8 ng/dl including daily topical vestibular and vaginal estradiol and testosterone applications. Subjects included were peri-menopausal or post-menopausal at their initial visit, naturally or surgically, and have both an initial and at least one follow-up vulvoscopy. Exclusions included cosmetic vulvar or vestibular surgery.