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Observational Study
. 2017 Apr;24(4):379-390.
doi: 10.1097/GME.0000000000000770.

Change in sexual functioning over the menopausal transition: results from the Study of Women's Health Across the Nation

Nancy E Avis  1 , Alicia Colvin, Arun S Karlamangla, Sybil Crawford, Rachel Hess, L Elaine Waetjen, Maria Brooks, Ping G Tepper, Gail A Greendale
Affiliations
Observational Study

Change in sexual functioning over the menopausal transition: results from the Study of Women's Health Across the Nation

Nancy E Avis et al. Menopause. 2017 Apr.

Abstract

Objective: The aim of the study was to identify whether there is a decline in sexual functioning related to the menopausal transition or to hysterectomy.

Methods: In a cohort of 1,390 women aged 42 to 52, with intact uterus and at least one ovary, not using hormone therapy, and pre- or early perimenopausal at baseline, we fit piecewise linear growth curves to 5,798 repeated measurements (seven visits spanning 14.5 y) of a sexual functioning score (range, 5-25) as a function of time relative to date of final menstrual period (FMP) or hysterectomy.

Results: Mean sexual functioning at baseline in women with a dateable FMP was 18.0 (SD, 3.4). There was no change in sexual function until 20 months before the FMP. From 20 months before until 1 year after the FMP, sexual function decreased by 0.35 annually (95% CI, -0.44 to -0.26) and continued to decline more than 1 year after the FMP, but at a slower rate (-0.13 annually, 95% CI, -0.17 to -0.10). The decline was smaller in African Americans and larger in Japanese than whites. Vaginal dryness, lubricant use, depressive symptoms, or anxiety did not explain decline in sexual function. Women who had a hysterectomy before the FMP did not show a decline in sexual function before hysterectomy, but scores declined afterward (0.21 annually, 95% CI, -0.28 to -0.14).

Conclusions: Decline in sexual function became apparent 20 months before FMP and slowed 1 year after FMP through 5 years afterward. A decline in sexual function was observed immediately after hysterectomy and persisted for the 5 years of observation.

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Conflict of interest statement

Conflict of interest/financial disclosure: No other authors have any competing financial conflicts of interest.

Figures

Figure 1
Figure 1
LOESS plots of sexual function score in the natural and surgical menopause women and hysterectomy women in the 10-year period bracketing the date of the final menstrual period or hysterectomy.
Figure 2
Figure 2
Model-predicted mean trajectories of sexual function over the menopausal transition.
See this image and copyright information in PMC

Comment in

  • Declining sexuality at midlife.
    Krychman ML. Krychman ML. Menopause. 2017 Apr;24(4):358-359. doi: 10.1097/GME.0000000000000852. Menopause. 2017. PMID: 28225428 No abstract available.

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