Longitudinal changes in sexual functioning as women transition through menopause

Abstract

Objective-Sexual functioning is an important component of women's lives. The extent to which the menopause transition is associated with decreased sexual functioning remains inconclusive. This study seeks to determine if advancing through the menopause transition is associated with changes in sexual functioning.Design-A prospective, longitudinal cohort study of women aged 42-52 at baseline recruited at 7 US sites (N=3302) in the Study of Women's Health Across the Nation (SWAN). Cohort eligible women had an intact uterus, at least one ovary, were not currently using exogenous hormones, were either pre-or early perimenopausal, and self-identified as one of the study's designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. Outcomes are self-reported ratings of importance of sex; frequency of sexual desire, arousal, masturbation, sexual intercourse, and pain during intercourse; degree of emotional satisfaction and physical pleasure. Address correspondence to: Nancy E. Avis, Ph.D., Wake Forest University School of Medicine, Division of Public Health Sciences, Department of Social Sciences and Health Policy, Piedmont Plaza II 2 nd floor, Winston-Salem, NC 27157-1063. Telephone: 336-716-6974, Facsimile: 336-716-7554, navis@wfubmc.edu. SWAN Clinical Centers: University of Michigan, Ann Arbor -MaryFran Sowers, PI; Massachusetts General Hospital, Boston, MARobert Neer, PI 1994-1999 Joel Finkelstein, PI 1999-present; Rush University, Rush University Medical Center, Chicago, ILLynda Powell, PI; University of California, Davis/Kaiser -Ellen Gold, PI; University of California, Los Angeles -Gail Greendale, PI; University of Medicine and Dentistry -New Jersey Medical School, Newark Gerson Weiss, PI 1994 -2004; Nanette Santoro, PI 2004 -present; and the University of Pittsburgh, Pittsburgh, PA -Karen Matthews, PI. Results-Adjusting for baseline age, chronological aging, and relevant social, health, and psychological parameters, the odds of reporting vaginal or pelvic pain increased and desire decreased by late perimenopause. Masturbation increased at early perimenopause, but declined during postmenopause. Menopausal transition was unrelated to other outcomes. Health, psychological functioning, and importance of sex were related to all sexual function outcomes. Age, race/ethnicity, marital status, change in relationship, and vaginal dryness were also associated with sexual functioning. NIH ProgramConclusions-Pain during sexual intercourse increases and sexual desire decreases over the menopausal transition. Masturbation increases during the early transition, but then declines in postmenopause. Adjusting for other factors, the menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with partner, or physical pleasure.Keywords sexual functioning; menopause; aging; diverse populations Sexual functioning is an important component of women's lives and has incr...

Evaluation of Factors Affecting Sexual Desire During Menopausal Transition and Post Menopause

“…In our study one of the effective factors impacting sexual desire is sexual satisfaction. Sexual desire was 88% higher in women who had sexual satisfaction than in other women, a condition confirmed by other studies (5,20). Because menopause and its symptoms depend on steroids, which in turn is dependent on FSH.…”

“…Subjects with higher scores in mood changes had the worst sexual functioning (16). Other studies also showed a negative relationship between psychological complaints and sexual interest (3,5,7).…”

“…So, sexual desire may spontaneously occur without sexual stimulation or may follow arousal (1)(2)(3). In one of the biggest studies on women's sexual activity, decrease in sexual desire has been introduced as the main problem in women aged between 18 to 81 years where women aged 45 to 64 years had higher sexual distress compared to younger or older women (4,5). In some studies it has been asserted that sexual dysfunction, especially decrease in sexual desire, enhances with increasing age.…”

Symptoms of Depressed Mood, Disturbed Sleep, and Sexual Problems in Midlife Women: Cross-Sectional Data from the Study of Women's Health Across the Nation

“…Studies have shown repeatedly that relationship factors (availability of sexual partner and quality of relationship) and psychological factors including mood, anxiety, and depression outweigh hormonal contribution to overall sexual function in menopausal-aged women. [16][17][18][19] During the MT, the symptom triad of disturbed sleep, depressed mood, and sexual problems may be more likely to co-occur in women with psychosocial risk factors. In our clinical population of midlife women aged 40-60 years seeking care from menopause specialists, 20% of women surveyed complained of the symptom triad of disturbed sleep, depressed mood, and sexual problems.…”

El cáncer colorrectal en la mujer

“…Aunque aproximadamente un tercio de las mujeres entre 50 y 70 años refieren ausencia de deseo sexual en condiciones normales, se estima que más de la mitad de las mujeres casadas mayores de 70 años continúan siendo sexualmente activas y más del 75% de ellas considera el sexo un aspecto importante de su vida personal (Avis et al, 2009;Beckman et al, 2008;Tan et al, 2009). La función sexual en las mujeres que han sido tratadas de un cáncer de recto puede verse afectada por múltiples causas, incluidas la pobre imagen corporal, la depresión, la pérdida de independencia, el daño de los nervios pélvicos del sistema autónomo por la cirugía o por la radioterapia, o el fallo hormonal ovárico inducido por la quimioterapia o la radioterapia (Bachmann y Leiblum, 2004;Donovan, Thompson y Hoffe, 2010;Grigsby et al, 1995;Havenga et al, 2000;Lange et al, 2009;Maas et al, 1998;Maurer et al, 2001;Ogilvy-Stuart y Shalet, 1993).…”