The use of vaginal estriol and its effects on sexual intercourse and serum estriol levels in postmenopausal women
Bibliographic record
Abstract
OBJECTIVES: Vaginal estrogenization plays a crucial role in alleviating pain during sexual activity while low-dose vaginal estrogen therapy provides benefit often with no increase in systemic estrogen levels after use. This study aimed to compare the effects of estriol applied to the distal or proximal thirds of the vagina on dyspareunia in postmenopausal women, evaluate serum estriol levels, and assess sexual function. METHODS: This prospective, randomized clinical trial included a total of 116 sexually active postmenopausal women with dyspareunia who were randomized to receive vaginal estriol (1.0 mg/application, every other day) for 12 weeks in the proximal estriol group (PEG) or distal estriol group (DEG), or a vaginal lubricant gel (VLG) before intercourse. Plasma estriol levels, coital pain (McGill Pain Questionnaire), sexual function (FSFI), and emotional status (HADS) were assessed at baseline and after 12 weeks. Statistical analyses included the Shapiro-Wilk test for normality, one-way ANOVA with Tukey's post-hoc test, χ 2 test, and Pearson correlation as appropriate. RESULTS: No significant changes in serum estriol levels were observed in any group after the intervention. PEG and DEG showed significant increases in FSFI total scores and all domains. The VLG group showed improvements in FSFI total scores and the domains of desire, arousal, lubrication, satisfaction, and pain. Intergroup analysis revealed that the PEG group showed significantly greater improvement in the lubrication domain compared with DEG (mean difference=0.70; 95% CI: 0.05-1.37; P =0.04) and VLG (mean difference=1.22; 95% CI: 0.58-1.86; P <0.01). All other domains showed no statistically significant differences between groups. CONCLUSIONS: Vaginal estriol, applied distally or proximally, improved dyspareunia and sexual function without increasing systemic estriol levels. Lubricant use also enhanced sexual function (except orgasm) and reduced pain comparably to estriol.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".