Could a menopause drug change how the brain responds to sex?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion criteria: * Women 40 year old or older who have been diagnosed with menopause (either chemical, surgical or natural menopause) * No menstruation for at least a year. * Moderate or severe VVA diagnosis (defined by the presence of ≤ 5% of superficial cells and vaginal pH \> 5). * For homogenisation of brain patterns, women had to be right-handed. * Women should be strictly heterosexual, in a stable relationship of at least 1 year duration (with expectations of remaining with the same relationship), and have had experience viewing sexually explicit images * For the FSIAD groups, women will be included if they are diagnosed with FSIAD, defined according to the criteria of DSM-V and confirmed by a structured clinical interview and by means of the scores of the SFQ and the FSDS-R (with a score of ≤20 for FSFI and ≥15 for the FSDS-R, respectively). These criteria will be an exclusion criterion for women without FSIAD. * Informed written consent of the patient. Exclusion criteria * Women with known history of mental illness, history of drug or alcohol abuse. * Women with VVA treatment (oestrogens or ospemifene) at any time during the last 6 months, and/or laser treatment at any time during the last year. * Use of medication or herbal preparations at any time during the last 3 months for the purpose of improving sexual performance. * Women who have received any medication previous to the study inclusion, that may alter or interfere with brain activation patterns (psychoactive drugs). * Women with history of sexual offenses. * Women with abnormal vision that would impair the visualisation of the images and the olfactory stimuli. * Women with claustrophobia or implants that would preclude fMRI procedures. * Women with diagnosis of depression assessed by PHQ self-administered questionnaire. * Patients who had undergone vaginal surgery in the last 12 months. * Women who did not sign the written informed consent. * Hypersensitivity to the active substance or to any of the excipients included in Senshio. * Past or active history of venous thromboembolic events (VTE), including deep vein thrombosis, pulmonary embolism and retinal vein thrombosis. * Unexplained vaginal bleeding. * Patients with suspected breast cancer or who are receiving active treatment (including adjuvant treatment) for breast cancer. * Suspicion of neoplasia or active neoplasia dependent on sex hormones (eg endometrial cancer). * Patients with signs or symptoms of endometrial hyperplasia; In this group of patients, safety has not been studied.