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Grand Rounds

How Large is the Placebo Effect in Sexual Dysfunction Treatment Studies?

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BACKGROUND AND PURPOSE:

  • Weinberger et al. (Obstetrics & Gynecology 2018) sought to quantify the placebo effect in the treatment of female sexual dysfunction

METHODS:

  • Systematic review and meta-analysis
  • Participants: Women with sexual dysfunction not receiving any concurrent treatment
  • Study selection
    • RCT with blinded placebo arm
  • Outcome measure: Female Sexual Function Index
    • Validated 19-item instrument
    • Evaluates six domains of sexual functioning
    • The International Consultation on Sexual Medicine considers this the gold standard
  • Treatments included
    • Flibanserin | Bupropion | Onabotulinum toxin A | Intravaginal prasterone | Intranasal oxytocin | Ospemifene | Bremelanotide

RESULTS:

  • A total of 8 RCTs were included
    • 1,723 women received placebo
    • 2,163 women received treatment
  • The weighted effect for women receiving placebo was a 3.62 (95% CI 3.29–3.94) improvement on the Female Sexual Function Index vs an increase of 5.35 (95% CI 4.13–6.57) in the treatment group

CONCLUSION:

  • 67.7% of the treatment effect for female sexual dysfunction is accounted for by placebo
  • There is a positive therapeutic effect with current medications, but it is suboptimal
  • There is an ongoing need for more efficacious treatment for female sexual dysfunction
  • The authors state “One key limitation is that the percent of improvement accounted for by placebo varied across studies. This suggests that the placebo effect may not account for 67.7% of the treatment effect for all medications. However, the placebo effect accounted for greater than 50% of the treatment effect in seven of eight component trials.”

Learn More – Primary Sources:

Female Sexual Dysfunction and the Placebo Effect: A Meta-analysis

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Related ObG Topics:

Treatment Options for the Patient with Low Sexual Desire
A Patient Complains of Low Sexual Desire – Making an Accurate Diagnosis
Treatment Options for the Patient with Sexual Arousal Concerns

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