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Interferential current viable alternative to vaginal estriol cream for painful sex symptoms

Women with premature ovarian insufficiency prescribed oral hormone therapy were more likely to report increased in sexual satisfaction and fewer painful intercourse symptoms when assigned to 4 weeks of interferential current therapy vs. similar women assigned to vaginal estriol cream, according to findings from a randomized clinical trial presented at the North American Menopause Society annual meeting.

Helena Giraldo

“Premature ovarian insufficiency strikes young women who have great loss when in menopause, especially concerning their sexual function,” Helena Giraldo, MD, of the University of Campinas, Brazil, told Endocrine Today. “However, it is clear to us that these women do not need to suffer. There are ways to improve the quality of their sexual lives.”

Giraldo and colleagues analyzed data from 40 sexually active women diagnosed with premature ovarian insufficiency and prescribed HT who completed the Female Sexual Function Index questionnaire (FSFI) and provided data on time of diagnosis, length of HT use and frequency of sexual intercourse. Researchers randomly assigned women to electrical stimulation of the pelvic floor with interferential current for eight 20-minute sessions over 4 weeks (electrodes were placed over the vulvar lips on both sides) or to a control group prescribed vaginal estriol cream applied daily for 4 weeks (0.5 mg per day). Researchers evaluated FSFI total and domain scores (desire, excitement, lubrication, orgasm, satisfaction and pain) at baseline and after treatment.

Mean age was 39 years for the interferential current group and 36 years for the control group; mean length of HT use for both groups was 8.3 and 8.1 years, respectively.

The researchers found that women in both groups experienced improvements in FSFI scores during the study, although differences were greater for women assigned to interferential current. Mean differences between baseline and 4 weeks were 4.37 for the interferential current group (P = .004) and 2.78 for the control group (P = .001).

The researchers noted that the differences between the domains showed an improvement in lubrication and pain symptoms in both groups, but the improvement in orgasm and satisfaction domains improved only for the interferential current group. After 4 weeks, mean orgasm and sexual satisfaction domains scores improved by 0.9 (P = .01) and 0.7 (P = .021), respectively. Sexual activity frequency decreased during the study for the control group but rose for women in the interferential current group, according to researchers.

“The use of physiotherapy, especially with interferential current associated to oral hormone therapy, can greatly improve vaginal sexual complaints in women in menopause, due to the impact on deeper tissues, vs. conventional physiotherapy,” Giraldo said. – by Regina Schaffer

Reference:

Giraldo HP, et al. Abstract S-17. Presented at: North American Menopause Society Annual Meeting; Oct. 3-6, 2018; San Diego.

Disclosure: The Sao Paulo Research Foundation supported this study.

Women with premature ovarian insufficiency prescribed oral hormone therapy were more likely to report increased in sexual satisfaction and fewer painful intercourse symptoms when assigned to 4 weeks of interferential current therapy vs. similar women assigned to vaginal estriol cream, according to findings from a randomized clinical trial presented at the North American Menopause Society annual meeting.

Helena Giraldo

“Premature ovarian insufficiency strikes young women who have great loss when in menopause, especially concerning their sexual function,” Helena Giraldo, MD, of the University of Campinas, Brazil, told Endocrine Today. “However, it is clear to us that these women do not need to suffer. There are ways to improve the quality of their sexual lives.”

Giraldo and colleagues analyzed data from 40 sexually active women diagnosed with premature ovarian insufficiency and prescribed HT who completed the Female Sexual Function Index questionnaire (FSFI) and provided data on time of diagnosis, length of HT use and frequency of sexual intercourse. Researchers randomly assigned women to electrical stimulation of the pelvic floor with interferential current for eight 20-minute sessions over 4 weeks (electrodes were placed over the vulvar lips on both sides) or to a control group prescribed vaginal estriol cream applied daily for 4 weeks (0.5 mg per day). Researchers evaluated FSFI total and domain scores (desire, excitement, lubrication, orgasm, satisfaction and pain) at baseline and after treatment.

Mean age was 39 years for the interferential current group and 36 years for the control group; mean length of HT use for both groups was 8.3 and 8.1 years, respectively.

The researchers found that women in both groups experienced improvements in FSFI scores during the study, although differences were greater for women assigned to interferential current. Mean differences between baseline and 4 weeks were 4.37 for the interferential current group (P = .004) and 2.78 for the control group (P = .001).

The researchers noted that the differences between the domains showed an improvement in lubrication and pain symptoms in both groups, but the improvement in orgasm and satisfaction domains improved only for the interferential current group. After 4 weeks, mean orgasm and sexual satisfaction domains scores improved by 0.9 (P = .01) and 0.7 (P = .021), respectively. Sexual activity frequency decreased during the study for the control group but rose for women in the interferential current group, according to researchers.

“The use of physiotherapy, especially with interferential current associated to oral hormone therapy, can greatly improve vaginal sexual complaints in women in menopause, due to the impact on deeper tissues, vs. conventional physiotherapy,” Giraldo said. – by Regina Schaffer

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Reference:

Giraldo HP, et al. Abstract S-17. Presented at: North American Menopause Society Annual Meeting; Oct. 3-6, 2018; San Diego.

Disclosure: The Sao Paulo Research Foundation supported this study.

    Perspective

    Mary Jane Minkin

    Giraldo and colleagues have conducted a good, preliminary study on the use of interferential current therapy for women with premature ovarian insufficiency to improve their sexual function. Women with premature ovarian insufficiency are a group very vulnerable to sexual issues, and even when appropriately receiving systemic hormone therapy (as they all should be for medical reasons), many will still have sexual complaints. The electrical stimulation, which delivers high-frequency current, penetrates the skin and goes to the deeper underlying muscles. In this study, the treatment seems to have improved lubrication and dyspareunia, measured by the Female Sexual Function Index, comparably to vaginal estrogen cream. However, according to their results, orgasmic function showed greater improvement with the electrical stimulation.

    As the authors note, this is a small study, but given the favorable results, it merits further investigation.

    Of note to non-gynecologists, it is common that women on systemic estrogen therapy do require a vaginal “booster” for urogenital issues. Standard therapy for years has been vaginal estrogens or vaginal DHEA. Many gynecologists have been looking to alternative therapies, such as laser treatments, but as of the moment, there are no prospective, randomized, double-blind, controlled trials with the various lasers, and there has been considerable discussion on mechanism of action for vaginal improvement. This interferential current therapy offers another option to treat women with sexual dysfunction. The authors themselves point out that further investigation is warranted, and given favorable results with minimal complications noted, sounds like a good suggestion.

    • Mary Jane Minkin, MD, FACOG
    • Clinical professor, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale Medical School

    Disclosures: Minkin reports consulting for Nature's Way, Novo Nordisk, Pfizer and Shionogi.

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