Influencia de la tibolona en la función sexual y seguridad cardiovascular en la mujer posmenopáusica
Influence of tibolone on sexual function and cardiovascular safety in postmenopausal women
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Objetivo: evaluar la influencia de la tibolona en la función sexual, así como la seguridad cardiovascular en la mujer en posmenopausia.
Métodos: se hizo una revisión sistemática de la literatura en diferentes bases de datos electrónicas (CINAHL Plus, Ebsco, Embase, Medline, OVID, Pubmed, REDALYC, Scopus, entre otras), a través de términos de búsqueda libres y estandarizados; entre enero de 1995 y diciembre del 2020. Los desenlaces evaluados incluyeron eficacia de la terapia de reemplazo hormonal con tibolona, su influencia en la función sexual, seguridad cardiovascular e incidencia de efectos adversos.
Resultados: se incluyeron 76 estudios. La tibolona es efectiva para el tratamiento de los síntomas vasomotores, sequedad vaginal, alteraciones del ánimo y pérdida de la libido. Reporta efectos beneficiosos en varios aspectos de la función sexual. Su seguridad cardiovascular está avalada al tener actividad vasodilatadora e hipolipemiante con disminución del riesgo coronario durante la posmenopausia temprana, además de poseer propiedades fibrinolíticas (acciones que protegen contra la tromboembolia). Los efectos adversos con mayor incidencia destacan el sangrado vaginal, aumento de peso y sensibilidad mamaria.
Conclusión: La tibolona es tan eficaz como la terapia de reemplazo hormonal convencional para tratar los síntomas vasomotores y prevenir la pérdida ósea, pero superior para el tratamiento de las disfunciones sexuales y elevar el estado de ánimo; con demostrada seguridad cardiovascular y menor incidencia de sangrado vaginal y sensibilidad / dolor mamario. Es necesario el diseño de ensayos clínicos controlados aleatorizados, para demostrar los hallazgos de la presente revisión.
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