Sexual function in pre- and post-menopausal women with obstructive sleep apnea syndrome

Abstract

The objective of this study was to evaluate the female sexual function in relation to hormonal status in pre-and postmenopausal women with obstructive sleep apnea (OSA). A total of 43 premenopausal (mean age 42.1±4.9) and 58 postmenopausal (mean age 59.9±4.8) women were included in the study. All women filled out the Epworth sleepiness scale (ESS), the Beck Depression Inventory (BDI) and the Female Sexual Function Index (FSFI). Testosterone, estradiol and progesterone were measured. After polysomnography, women were allocated to a not-severe OSA group (Apnea--Hypopnea Index (AHI) 10--30) and a severe OSA group (AHI 430). Healthy subjects comprised the control group. Severe OSA women in both pre-and post-menopausal group were found to have significantly lower mean FSFI score (16.5 ± 4.0 and 16.9 ± 4.7, respectively) compared with not-severe OSA (23.4 ± 5.5, Po0.01 and 21.8 ± 7.5, Po0.05) and control subjects (27.0 ± 5.5, Po0.01 and 24.0±6.7, Po0.01). Progesterone, which was significantly lower in severe OSA premenopausal women (0.26±0.2) compared with not-severe OSA (0.55 ± 0.14, Po0.01) and control group (0.62 ± 0.16, Po0.01), correlated significantly with FSFI (r ¼ 0.39, Po0.01). Our study demonstrated that OSA is associated with sexual dysfunction in both premenopausal and postmenopausal women in a dose-related fashion. Regarding premenopausal women, our results indicated that progesterone may play a role in the association between OSA and female sexual dysfunction.

Association of sleep disturbance and sexual function in postmenopausal women

“…5,6,7 It is believed that obesity, menopausal symptoms, including vasomotor symptoms, as well as decreasing hormone levels are associated with decreased sexual function and OSA. 5-10 Moreover, many factors can impact both sleep and sexual function such as general health, age, emotional and psychological issues, life events/changes contributing to stress, social support or lack thereof, recent abuse, medications and chronic disease. 11-19 For example, data from the Study of Women's Health Across the Nation (SWAN) demonstrated a co-occurrence of a triad of menopausal symptoms including sleep disturbance, depressed mood and sexual problems.…”

Contraceptive Method Mix Utilization and its Associated Factors among Married Women in Gedeo Zone, Southern Nations, Nationality and People Region-Ethiopia: A Community based Cross Sectional Study

“…Estrogen decline causes a decrease in the production of vaginal lubrication, loss of vaginal elasticity and thickness of vaginal epithelium (vaginal atrophy), and development of uretheral caruncles [29]. This association of vaginal dryness with sexual dysfunction could be an important psychological factor in depression that eventually leads to sleep disturbance in menopausal and post-menopausal women [30]. Estrogen replacement therapy in menopausal and postmenopausal women has been shown to improve sleep by decreasing night time awakenings.…”

“…In the pre-menopausal women, time spent below the oxygen saturation of 90% has been found to be associated with sexual dysfunction [98]. Sexual dysfunction has been found to be related to the severity of OSA in both pre-menopausal as well as post-menopausal women [30]. This data suggests that post-menopausal women with OSA should be routinely screened for sexual dysfunction as it may contribute to other sleep problems including insomnia (Table 2).…”

Obstructive sleep apnea in women

“…Az OSA-ban szenvedő nőknek 2-szer nagyobb esélyük van a krónikus obstruktív légúti betegségekre (OR: 2,63; 95% CI: 1,85-3,72) és a depresszióra (OR: 2,24; 95% CI: 1,45-3,44) a férfi akhoz képest [20]. A szexuális diszfunkció sokkal gyakoribb azoknál a nőknél, akik OSA-ban szenvednek a nem apnoés betegekhez ké-pest, ezért rá kell kérdezni a problémára az ő esetükben is ugyanúgy, mint a férfi aknál [21].…”