The effects of oestrogen on urogenital health.

The decline in sex hormone levels that accompanies the menopause has substantial effects on the tissues of the urogenital system, leading to atrophic changes. These changes can have negative effects on sexual and urinary function, leading to dyspareunia and incontinence. Treatment of urogenital atrophy with systemic or local oestrogens can improve the adverse effects of loss of oestrogen on both sexual and urinary functions. In some cases, treatment with oestrogen alone may not be sufficient to address sexual problems in menopausal women and androgen addition is required. Because of the complexity of sexual problems in menopausal women, assessment and therapy should address both the physical and other factors that play a role in the condition.