Female sexual dissatisfaction: hormone therapy inappropriate.

(1) The causes of sexual dissatisfaction are as complex as sexuality itself. Relationships, cultural, psychological, medical and other factors can all have an influence. This review examines whether hormone therapy is appropriate for postmenopausal women seeking help with sexual dissatisfaction. We conducted a review of the literature based on standardised Prescrire methodology. (2) There are no sexual norms. Treatments proposed for female sexual dissatisfaction have only been assessed according to a mechanical, standardised approach, with little relevance to women's expressed needs. Relationship problems and personal inhibitions are the principal factors contributing to sexual dissatisfaction in surveys of women's sexuality. (3) The decline in testosterone production linked to the menopause does not correlate with sexual dissatisfaction. (4) Hormone therapy has not proven to be effective for female sexual dissatisfaction. Oestrogen improves vaginal dryness, but lubricant gels are just as effective. It is better to help women understand the reasons for their dissatisfaction than to expose them to the adverse effects of hormone therapy.