Eficácia das abordagens hormonais e não hormonais para atrofia vaginal e disfunções sexuais em mulheres na pós-menopausa: Uma revisão sistemática

Sarmento, Ayane Cristine Alves; Costa, Ana Paula Ferreira; Lírio, Juliana; Eleutério Jr, José; Baptista, Pedro Vieira; Gonçalves, Ana Katherine

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Brasil

Revista Brasileira de Ginecologia e Obstetrícia

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Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review Article • Rev Bras Ginecol Obstet 44 (10) • 2022 • https://doi.org/10.1055/s-0042-1756148 copiar

Eficácia das abordagens hormonais e não hormonais para atrofia vaginal e disfunções sexuais em mulheres na pós-menopausa: Uma revisão sistemática

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

Objetivo

Avaliar a eficácia das abordagens hormonais e não hormonais para os sintomas de disfunção sexual e atrofia vaginal em mulheres na pós-menopausa.

Fontes de Dados

Pesquisamos as bases de dados PubMed, Embase, Scopus, Web of Science, SciELO, Cochrane Central Register of Controlled Trials (CENTRAL), e Cumulative Index to Nursing and Allied Health Literature (CINAHL), assim como bancos de dados de ensaios clínicos. Foram analisados estudos publicados entre 1996 e 30 de maio de 2020. Nenhuma restrição de idioma foi aplicada.

Seleção dos Estudos

Foram selecionados ensaios clínicos randomizados que avaliavam o tratamento das disfunções sexuais em mulheres na pós-menopausa.

Coleta de Dados

Três autores (ACAS, APFC e JL), revisaram cada artigo com base em seu título e resumo. Os dados relevantes foram posteriormente retirados do texto completo do artigo. Quaisquer discrepâncias durante a revisão foram resolvidas por consenso entre todos os autores listados.

Síntese dos Dados

Ao todo, 55 estudos foram incluídos na revisão sistemática. As abordagens testadas para tratar a disfunção sexual foram: lubrificantes e hidratantes (18 estudos); fitoestrogênios (14 estudos); deidroepiandrosterona (DHEA; 8 estudos); ospemifeno (5 estudos); testosterona vaginal (4 estudos); exercícios para os músculos do assoalho pélvico (2 estudos); oxitocina (2 estudos);laser de CO₂ vaginal (2 estudos); lidocaína (1 estudo), e vitamina E vaginal (1 estudo).

Conclusão

Identificou-se falta de coerência na literatura quanto aos tratamentos propostos e medidas de resultados selecionadas. Apesar da grande diversidade de modalidades de tratamento e medidas de resultados, esta revisão sistemática pode lançar luz sobre alvos potenciais para o tratamento, que é considerado necessário para a disfunção sexual, assumindo que a maioria dos estudos randomizados foi avaliada com baixo risco de viés de acordo com a ferramenta de avaliação de risco de viés de Cochrane Collaboration. Esta revisão tem cadastro no International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).

Palavras-chave
menopausa; dispareunia; orgasmo; terapêutica; estrogênios

Number	Search items
1	Menopause
2	Postmenopause
3	Genitourinary syndrome of menopause
4	Dyspareunia
5	Orgasm
6	Vaginal atrophy
7	Female sexual dysfunction
8	Sexual function
9	Or/1-8
10	Therapeutics
11	Vaginal estrogen
12	Estrogens
13	Vaginal therapy
14	Non-hormonal treatments
15	Dehydroepiandrosterone
16	Testosterone
17	Oxytocin
18	Phytoestrogens
19	Local lidocaine
20	Hyaluronic acid
21	Lubricants
22	Moisturizers
23	Laser therapy
24	Radio waves
25	Microablative fractional radiofrequency
26	Physical therapy modalities
27	Or/10-26
28	Randomized clinical trial
29	Clinical trial
30	Or/28-29
31	9 and 27 and 30

Study	Random sequence generation	Allocation concealment	Blinding of participants and personnel	Blinding of outcome assessment	Incomplete outcome data	Selective reporting	Other bias
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[1] Address for correspondence Ana Katherine Gonçalves, Professor rua Major Laurentino de Morais, 1.218/1.301, Natal, RN, 59020-390, Brazil (e-mail: anakatherine_ufrnet@yahoo.com.br).