24774442
BACKGROUND	We have previously observed that intravaginal prasterone ( dehydroepiandrosterone , DHEA ) improved all domains of female sexual dysfunction ( FSD ) .
OBJECTIVE	Investigate the influence of moderate/severe pain at sexual activity ( dyspareunia ) ( MSD ) at baseline on FSD following prasterone administration .
METHODS	The effect of daily administration of prasterone ( 0 , 3.25 mg , 6.5 mg or 13mg ) for 12 weeks on FSD in 215 postmenopausal women with or without MSD at baseline was evaluated in a prospective , randomized , double-blind , and placebo-controlled phase III clinical trial .
METHODS	Differences were examined on desire , arousal and orgasm .
RESULTS	Comparable benefits were observed in women not having MSD ( n = 56 ) vs. those having MSD ( n = 159 ) .
RESULTS	The benefits over placebo in prasterone-treated women for desire , avoiding intimacy and vaginal dryness as well as for the total sexual domain of the MENQOL ( Menopause Specific Quality of Life ) questionnaire , ranged between 18.0 % and 38.2 % with P values of < 0.05 or < 0.01 except in one out of 12 subgroups .
RESULTS	For the arousal/sensation , arousal/lubrication and summary score of the ASF ( Abbreviated Sexual Function ) questionnaire , in the MSD + group , improvements of 64.2 % ( P = 0.01 ) , 118 % ( P = 0.001 ) and 31.1 % ( P = 0.03 ) were observed over placebo , respectively , while similar differences ( 58.0 % , 67.6 % and 32.1 % ) did not reach statistical significance in the MSD - group having up to only 44 prasterone-treated women compared with 119 in the MSD + group .
CONCLUSIONS	No MSD at baseline does not apparently affect the effects of intravaginal prasterone on sexual dysfunction .
CONCLUSIONS	Knowing the absence of significant effects of estrogens on FSD , the present data suggest that vulvovaginal atrophy ( VVA ) and vulvovaginal sexual dysfunction ( VVSD ) are two different consequences of sex steroid deficiency at menopause which can respond independently .
CONCLUSIONS	In addition , the present data seriously question the justification of pain being part of FSD as well as the separation of FSD into separate domains .

