Sexual Health in Menopause

Abstract

Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40-55%), poor lubrication (25-30%) and dyspareunia (12-45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.

Female orgasmic dysfunction and severe climacteric symptomatology in women aged 40 to 59 years: an independent association from an analysis of a multicenter Latin American study

“…10 The decrease in estrogen levels in postmenopausal women causes a decline in the elasticity of the vagina and a decrease in vaginal lubrication, dryness, pruritus, and dyspareunia, affecting libido and finally, the orgasm. 1,10 Estrogen, independently of its route of administration, has been shown to improve vaginal lubrication and sensitivity, reducing urogenital symptoms such as dyspareunia, OD, and finally sexual desire. Estrogen represents the most frequently used therapy for female sexual dysfunction, especially in peri-and postmenopausal women.…”

Changes of androgens levels in menopausal women

“…What should be taken into consideration are psychological changes dependent on aging and an increase in metabolic and cardiovascular comorbidities in elderly. Furthermore, it should be recalled that human-specific and highly sophisticated mechanisms of intracrinology permit each cell to control androgen availability according to its own needs, independently from the remaining of the body, that may cause variable response to declining levels of androgens in women after menopause [ 6 ].…”

Sexual quality of life and sexual self-efficacy among women during reproductive-menopausal transition stages and postmenopause: a comparative study

“…Reproductive-menopausal transition stage women may establish more desirable sexual relationships due to paying more attention to and deal more with sexual matters and giving higher priorities to sexual relationships in marital life. Menopause can reduce sexual and relationship satisfaction in women by reducing the level of sexual steroid hormones, and related factors such as hot flashes, vaginal dryness and reduced frequency of sexual intercourse [ 31 ]. Thus adopting preventive measures to reduce the number of complications and improve sexual satisfaction is important.…”