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Sexual dysfunction may be problematic in some women as they age

Sexual dysfunction often accompanies the menopause transition. Yet, not all women experience it the same. A new study identified the determinants that affect a woman's risk of sexual dysfunction and sought to determine the effectiveness of hormone therapy in decreasing that risk and modifying sexual behavior.

Although hot flashes easily rank as the most common symptom of menopause, the transition is often accompanied by other issues, including changes that affect a woman's libido, sexual satisfaction, and overall sexual behavior. Because hormone therapy is the most-effective treatment option to help women manage menopause symptoms, it was the focus of a new study designed to determine why some women experience greater sexual dysfunction than others.

The study involving more than 200 women aged 45 to 55 years found that women with secondary and higher education and a greater number of lifetime sexual partners were less likely to experience sexual dysfunction. In contrast, women with more anxious behaviors during sexual activity and those with more severe menopause symptoms were more at risk for sexual dysfunction.

Hormone therapy was not found to mitigate the risk for sexual dysfunction, nor did it play a major role in determining sexual behaviors. However, women using hormone therapy typically had higher body esteem during sexual activities; better sexual function in all domains, except for desire/interest; better quality of relationships; and fewer sexual complaints (other than arousal problems) than those women who do not. Of importance to helping maintain a woman's sexual function were positive sexual experiences, attitudes about sex, body image, and relationship intimacy.


Objectives: The menopausal transition is a biological adaptation to the variety of life changes (body, comorbidities, relationship), but that biology is not an "end all" in the context of sexual function and overall sexual health. The aim of this study is to evaluate determinants altering the risk of female sexual dysfunction (FSD) and other sexual problems and to establish whether menopausal hormonal therapy (MHT) decreases that risk and modifies sexual behaviors.

Methods: A cross-sectional observational study was conducted in 210 women between the ages of 45 and 55. Two groups were identified: MHT users (n = 107) and controls-MHT non-users (n = 103). Diagnostic and Statistical Manual of Mental Disorders -five criteria were used to assess sexual dysfunction. Sexual problems were evaluated by the Changes in Sexual Function Questionnaire (CSFQ), body image by Body Exposure during Sexual Activity Questionnaire, and quality of relationship by the Well-Match Relationship Questionnaire. Logistic regression was used to determine the risk factors for FSD and sexual problems.

Results: Women using MHT had higher body esteem during sexual activities, better sexual function (CSFQ) in all domains except desire/interest, better quality of relationship, and lower prevalence of FSD and sexual complaints (CSFQ) except arousal/excitement problems. However, self-rated effects of MHT on sexual behaviors showed that MHT did not play a major role. Women with secondary and higher education (OR = 0.09, CI: 0.02-0.4; P < 0.01 and OR = 0.2, CI: 0.05-1.0; P < 0.05, respectively) and with a higher number of lifetime sexual partners (OR = 0.6, CI: 0.4-0.9; P < 0.01) were less likely to have FSD. In contrast, individuals with more anxious behaviors during sexual activity (OR = 3.2, CI: 1.3-7.3; P < 0.01) and with more severe menopausal symptoms (OR = 1.1, CI: 1.0-1.2; P < 0.001) were more likely to have FSD. Using MHT was not associated with that risk nor with sexual function.

Conclusion: In women during menopausal transition, sexual behaviors were different in MHT users compared with non-users. However, in this cross-sectional observational study conducted in 210 women between the ages of 45 to 55 years, using MHT was not associated with modification of sexual function, decreasing the risk of sexual dysfunction, nor sexual problems.


Krzysztof NowosielskiMarcin Sidorowicz. Sexual behaviors and function during menopausal transition--does menopausal hormone therapy play a role? Menopause. 2020 Dec 21; Publish Ahead of Print. doi: 10.1097/GME.0000000000001693. Online ahead of print.

Content created 5 Jan 2021

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