Efficacy of pharmacological and non-pharmacological interventions on low sexual interest/arousal of peri- and post-menopausal women: a meta-analysis

The aim of our study was to investigate the therapeutic efficacy of pharmacological and non-pharmacological interventions on low sexual interest/arousal of peri- and post-menopausal women. In this systematic review and meta-analysis, randomized clinical trials (RCTs) that published up to 22 June 2016 were retrieved from several online electronic databases, including Cochrane Library, PubMed, Ovid, Scopus, Medline, CINHAL, and EBSCO. Fifty-seven studies were included in the meta-analysis. The results showed that both pharmacological interventions (mean difference (MD) = -0.86, 95% confidence interval (CI) = -1.49 to -0.90, p = 0.0001) and non-pharmacological interventions (MD = -0.92, 95% CI = -1.35 to -0.49, p = 0.0001) had statistically significant effects on improving sexual interest/arousal. Among pharmacological interventions, hormone therapy with dehydroepiandrosterone, testosterone, tibolone and estrogen in combination with progesterone, estrogen in combination with testosterone as well as estrogen in combination with progesterone and testosterone were found to be effective. Non-hormonal medications including flibanserin and sildenafil as well as herbal medicines were also shown to be effective. However, due to high heterogeneity of the findings and scarcity of the studies in certain domains, there is uncertainty of their true effect. So, further well-designed RCTs with larger samples are required to ascertain the long-term effects of studies.