Sexual dysfunction, dryness common in years before menopause

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[November 21, 2019]  By Lisa Rapaport

(Reuters Health) - Many women experience sexual health problems in the years leading up to menopause, and vaginal dryness is often responsible, a small study in Italy suggests.

Researchers examined data on 518 women ages 40 to 55 to see how often they had vaginal dryness during gynecological checkups and how often they reported difficulty with things like lubrication, desire, arousal, orgasm and sexual satisfaction.

While 55% of the women in their early- to mid-40s appeared to have sexual dysfunction based on their reported symptoms, this surged to 83% of women in their mid-50s.

Vaginal dryness appeared to independently increase the risk of every other type of sexual health problem in the study.

"Given the high prevalence of sexual dysfunction in women, identifying an eminently treatable contributing factor such as vaginal dryness may allow women to maintain their sexual function during the menopause transition," Dr. Stephanie Faubion, medical director of the North American Medical Society, said in a statement.

Women go through menopause when they stop menstruating, typically between ages 45 and 55. As the ovaries curb production of the hormones estrogen and progesterone in the years leading up to menopause and afterward, women can experience symptoms ranging from vaginal dryness to mood swings, joint pain, memory trouble and insomnia.

As estrogen levels drop, the lining of the vagina changes and releases less fluid. Intercourse can become painful due to this lack of lubrication and women may also experience more bacterial infections.

While previous studies have linked vaginal changes during menopause to sexual dysfunction, the current study offers fresh evidence that the process of declining sexual health may start sooner than women realize and persist throughout the menopause transition, Dr. Angelo Cagnacci of the University of Udine and colleagues write in the journal Menopause.

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The average age in the study was 49, and the average body mass index (BMI, a measure of weight relative to height) was at the low end of the overweight category. Roughly half of women in the study had completed menopause.

About 11% of the women were taking hormone replacement therapy, and about 18% were using vaginally administered therapies to address symptoms.

Women were more likely to experience sexual dysfunction when they were ex-smokers, overweight, sedentary or experiencing hot flashes, the study found.

They were more than twice as likely to experience sexual dysfunction when they had vaginal dryness, pain during intercourse or thinning and drying vaginal walls, the study also found.

The study included only white women seeing gynecologists, and it's possible the results might be different in a more diverse group or for women who didn't see specialists for sexual health care.

Even so, the results underscore the importance of screening for vaginal dryness and offering treatments for this issue as one way to help prevent or minimize the risk of sexual dysfunction before menopause, the researchers conclude.

Hormone therapies including pills, patches and sprays applied to the skin as well as vaginal rings and creams can all help ease sexual health problems that develop as estrogen production wanes leading up to menopause, according to the American College of Obstetricians and Gynecologists.

SOURCE: https://bit.ly/2O5VrEM Menopause, online October 31, 2019.

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