Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy.
Department of Surgery-Week Surgery, Campus Bio-Medico University, Rome, Italy.
Minerva Obstet Gynecol. 2023 Apr;75(2):138-144. doi: 10.23736/S2724-606X.21.04862-4. Epub 2021 Sep 9.
The aim of this study was 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.
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.
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.
Ospemifene improve the VHI and vulvovaginal vascular perfusion demonstrating a positive impact on sexual function and quality of life.
本研究旨在评估奥昔布宁在阴道健康指数（VHI）、外阴阴道血管灌注方面的疗效，并评估其对生活质量和性功能的影响。
在 52 名符合条件的患者中，连续评估了 43 名患有外阴阴道萎缩（VVA）或泌尿生殖系统综合征（GSM）的绝经后患者。在接受奥昔布宁治疗 3 个月前后，对 VVA 进行评估，并通过取样阴蒂背动脉搏动指数（PI）对外阴阴道血管化进行超声检查。所有女性均在治疗前后 3 个月进行了 36 项简明健康状况调查问卷（SF-36）进行生活质量评估；而对于有性生活的女性，则进行了女性性功能指数（FSFI）和女性性功能障碍困扰量表（FSDS）问卷评估。在治疗 3 个月后，还计算了患者总体改善印象（PGI-I）。
在治疗 3 个月后，有性生活的女性人数显著增加（26 [60.46%] vs. 35 [81.39%]；P=0.01）。治疗期间的平均性交次数也增加（12.87±3.43 次 vs. 15.79±3.12 次，P=0.03）。治疗前后阴蒂背动脉 PI 均有显著变化（PI [1.69±0.42 比 1.28±0.45，P=0.001] RI [0.74±0.11 比 0.54±0.15，P=0.001]）。FSFI、FSDS 和 SF-36 问卷评分在治疗 3 个月后均有显著改善。多元分析显示，VHI 和 PI 是治疗 3 个月后 FSFI 较低的独立因素。
奥昔布宁改善了 VHI 和外阴阴道血管灌注，对性功能和生活质量产生了积极影响。
