Topical may be more effective than oral estrogen at relieving certain sexually related symptoms in hysterectomized women, but neither form seems to significantly affect sexual desire or activity despite increasing vaginal blood flow, according to a randomized, comparative study conducted in China. 

Cheng-Yu Long, MD, and colleagues randomized 57 women to receive oral or topical estrogen once daily. More women in the topical group than in the oral group experienced statistically significant reductions in vaginal dryness and dyspareunia, but neither formulation seemed to be more effective in affecting low libido and coital frequency.  

Women should be counseled about the benefits and risks of ET alone, including its effect on the risks for stroke, coronary heart disease, and breast cancer. Further research is needed to determine the lowest possible beneficial dose in order to minimize the risk of other problems.  

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Topical may be more effective than oral estrogen at relieving certain sexually related symptoms in hysterectomized women, but neither form seems to significantly affect sexual desire or activity despite increasing vaginal blood flow, according to a randomized, comparative study conducted in China.