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Cheng V, Chi-Shing WT, Lee A, Lee R. The effects of a real-time temperature monitoring non-ablative monopolar radiofrequency technology on vulvovaginal atrophy symptoms in postmenopausal Chinese women. J Cosmet Dermatol 2024; 23:2030-2043. [PMID: 38450826 DOI: 10.1111/jocd.16251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/24/2024] [Accepted: 02/15/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Vulvovaginal atrophy (VVA) includes a wide range of conditions affecting the reproductive and urinary systems, often requiring careful evaluation and management for optimal health. AIMS This study aims to evaluate the symptom management effects of a real time temperature-monitored non-ablative RF device for the treatment of postmenopausal Chinese women with VVA symptoms. METHODS This pilot study involved 24 postmenopausal Chinese women with one or more VVA symptoms, who wished to remain sexually active. VHIS, VAS, and FSFI were used to track and evaluate various aspects of the patient's condition. Analyses were conducted at the end of the study to verify the statistical significance of the treatment's results. RESULTS All patients reported substantial, statistically significant, improvements on every VVA symptom tracked. Approximately 80% of the patients reported total symptom reversal at 12-week post-treatment follow-up. CONCLUSION This pilot study demonstrated that non-ablative, monopolar RF technology equipped with real time temperature monitoring is feasible and safe in the treatment of postmenopausal women with VVA symptoms, and efficacious at up to 12 weeks post-treatment.
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Affiliation(s)
| | - William Tai Chi-Shing
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
- The Laboratory for Probiotic and Prebiotic Research in Human Health, The Hong Kong Polytechnic University, Hong Kong, China
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Gassen J, Mengelkoch S, Shanmugam D, Pearson JT, van Lamsweerde A, Benhar E, Hill SE. Longitudinal changes in sexual desire and attraction among women who started using the Natural Cycles app. Horm Behav 2024; 162:105546. [PMID: 38640590 DOI: 10.1016/j.yhbeh.2024.105546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/21/2024]
Abstract
Many women experience sexual side effects, such as decreased libido, when taking hormonal contraceptives (HCs). However, little is known about the extent to which libido recovers after discontinuing HCs, nor about the timeframe in which recovery is expected to occur. Given that HCs suppress the activities of multiple endogenous hormones that regulate both the ovulatory cycle and women's sexual function, resumption of cycles should predict libido recovery. Here, using a combination of repeated and retrospective measures, we examined changes in sexual desire and partner attraction (among partnered women) across a three-month period in a sample of Natural Cycles users (Survey 1: n = 1596; Survey 2: n = 550) who recently discontinued HCs. We also tested whether changes in these outcomes coincided with resumption of the ovulatory cycle and whether they were associated with additional factors related to HC use (e.g., duration of HC use) or relationship characteristics (e.g., relationship length). Results revealed that both sexual desire and partner attraction, on average, increased across three months after beginning to use Natural Cycles. While the prediction that changes in sexual desire would co-occur with cycle resumption was supported, there was also evidence that libido continued to increase even after cycles resumed. Together, these results offer new insights into relationships between HC discontinuation and women's sexual psychology and lay the groundwork for future research exploring the mechanisms underlying these effects.
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Affiliation(s)
- Jeffrey Gassen
- Texas Christian University, Department of Psychology, 2955 S. University Dr., Fort Worth, TX 76129, United States of America; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, UCLA Medical Plaza 300, Los Angeles, CA 90095-7076, United States of America.
| | - Summer Mengelkoch
- Texas Christian University, Department of Psychology, 2955 S. University Dr., Fort Worth, TX 76129, United States of America; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, UCLA Medical Plaza 300, Los Angeles, CA 90095-7076, United States of America
| | - Divya Shanmugam
- Massachusetts Institute of Technology, Department of Electrical Engineering and Computer Science, Cambridge, MA 02139, United States of America
| | - Jack T Pearson
- Natural Cycles Nordic AB, Sankt Eriksgatan 63 B, 112 34 Stockholm, Sweden
| | | | - Eleonora Benhar
- Natural Cycles Nordic AB, Sankt Eriksgatan 63 B, 112 34 Stockholm, Sweden
| | - Sarah E Hill
- Texas Christian University, Department of Psychology, 2955 S. University Dr., Fort Worth, TX 76129, United States of America
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Christmas MM, Reed S. Sexual Dysfunction After Menopause: Guidelines for Assessment and Management. Obstet Gynecol Clin North Am 2024; 51:341-364. [PMID: 38777488 DOI: 10.1016/j.ogc.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Female sexual dysfunction commonly occurs during the menopause transition and post-menopause due to hormonal, physiologic, and psychosocial factors. Sexuality is important to aging women; however, many are reluctant to seek treatment for their sexual concerns. Clinicians should be adept at managing and treating sexual dysfunction in this population. A multi-dimensional treatment approach that addresses modifiable mental, physical, and psychosocial factors is warranted to improve sexual function and quality of life.
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Affiliation(s)
- Monica M Christmas
- Department of Obstetrics and Gynecology, University of Chicago Medicine and Biological Sciences, University of Chicago, 5841 South Maryland Avenue, MC 2050, Chicago, IL 60637, USA.
| | - Susan Reed
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific, Box 359865, Seattle, WA 98195, USA
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Coslov N, Richardson MK, Woods NF. "Not feeling like myself" in perimenopause - what does it mean? Observations from the Women Living Better survey. Menopause 2024; 31:390-398. [PMID: 38531011 DOI: 10.1097/gme.0000000000002339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
OBJECTIVE This study aimed to understand the meaning of the phrase "not feeling like myself" (NFLM) when used by those on the path to menopause by exploring the relationship of symptoms reported to ratings of NFLM. METHODS Participants responded to the item "Many women report just not feeling like themselves during this phase of life. How often was this true for you over the past 3 months?" choosing from "none of the time" to "all of the time." They rated bother associated with 61 symptoms and provided demographic information. Individual symptoms and the symptom bother scale scores were correlated with NFLM. Symptom scale scores were then entered in a two-stage multiple regression model to identify symptoms associated significantly with NFLM. RESULTS Sixty-three percent (63.3%) of participants reported NFLM 50% of the time or more over the previous 3 months. Individual symptom ratings correlated with NFLM ( r > 0.300) included the following: fatigue ( r = 0.491); feeling overwhelmed/less able to cope ( r = 0.463); low feelings ( r = 0.440); anxiety, more nervousness ( r = 0.398); being irritable ( r = 0.380); harder time concentrating ( r = 0.378); difficulty making decisions ( r = 0.357); feeling like "I can't calm down on the inside" ( r = 0.333); being more forgetful ( r = 0.332); tearfulness/crying ( r = 0.306); and worrying more ( r = 0.302). A two-stage regression analysis revealed less education completed and greater overall stress ratings as significant predictors in stage 1. In stage 2, five symptom groups met the P < 0.001 criterion: anxiety/vigilance, fatigue/pain, brain fog, sexual symptoms, and volatile mood symptoms. CONCLUSIONS NFLM was associated with anxiety/vigilance, fatigue/pain, brain fog, sexual symptoms, and volatile mood symptoms. Recognizing symptoms associated with NFLM may allow for more accurate expectations and improve perimenopause care.
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Affiliation(s)
| | | | - Nancy Fugate Woods
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA
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Avis NE, Crawford SL, Hess R, Colvin A, Neal-Perry G, Waetjen LE. The Role of Sexual Function in Quality of Life Among Midlife and Older Women: The Study of Women's Health Across the Nation. J Womens Health (Larchmt) 2024; 33:426-434. [PMID: 38330428 DOI: 10.1089/jwh.2023.0439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Objective: To examine how (1) partnered sexual activity, and (2) sexual functioning, contribute to global quality of life (QOL) and health-related quality of life (HRQL) among midlife and older women, and whether importance of sex modifies these associations. Materials and Methods: Women in the Study of Women's Health Across the Nation (SWAN), a multiethnic/racial cohort study, aged 42-52 at recruitment, were followed for ∼20 years. The Ladder of Life and Short Form-36 physical component summary (PCS) and mental component summary (MCS) assessed Global QOL (N = 3,263) and HRQL (N = 2,576), respectively. Primary predictors were (1) having partnered sexual activity (yes/no), and (2) sexual functioning among those with partnered sexual activity. Sociodemographic, health, lifestyle, and psychosocial covariates were included. Results: Importance of sex modified covariate-adjusted association of having partnered sexual activity with global QOL. Adjusted associations of partnered sexual activity with PCS and MCS were not statistically significant. Sexual functioning, among women with partnered sexual activity, was positively associated with global QOL (adjusted p = 0.03), regardless of importance of sex; unrelated to PCS; but positively associated with MCS (adjusted p = 0.03), particularly when sex was "very/quite important." Conclusions: Partnered sexual activity and better sexual functioning are related to QOL for mid-aged and older women, and are stronger when sex is considered important. Partnered sexual activity and sexual functioning are less consistently related to HRQL when adjusted for covariates, and importance modifies only the association between sexual functioning and MCS. Understanding the importance of sex to midlife and older women contextualizes the impact of sex on QOL.
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Affiliation(s)
- Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Sybil L Crawford
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Rachel Hess
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Alicia Colvin
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Genevieve Neal-Perry
- School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - L Elaine Waetjen
- Department of Obstetrics and Gynecology, School of Medicine, University of California Davis, Sacramento, California, USA
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Woods NF, Shaver JF, Berg JA. Genitourinary Syndrome of Menopause: Prevalence and Predictors. Clin Obstet Gynecol 2024; 67:27-42. [PMID: 38126336 DOI: 10.1097/grf.0000000000000847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
The genitourinary syndrome of menopause (GSM) has been proposed as a diagnosis by a consensus of clinicians and investigators. Our purpose for this paper is to review extant evidence about: 1) the breadth of symptoms and symptom clusters as related to the syndrome; 2) the prevalence of GSM (includes vulvar and vaginal atrophy); 3) factors that are associated with, predict, or explain the syndrome; and 4) what should be pursued for expanding meaningful evidence. Within recent literature, we found a wide range of prevalence estimates, likely a function of the differing populations studied, study design, and methods of data collection. Factors related to the prevalence of GSM included age and aging; reproductive aging stage; hormones, especially estrogen; and culture and language. We recommend further specification of diagnostic criteria for GSM; clarification of urinary symptoms in GSM; use of longitudinal study designs; validation of GSM-related measures; exploration of cultural equivalence of GSM measures; and assessing biases in completed research.
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Affiliation(s)
- Nancy F Woods
- University of Washington School of Nursing, Seattle, Washington
| | - Joan F Shaver
- The University of Arizona College of Nursing, Tucson, Arizona
| | - Judith A Berg
- The University of Arizona College of Nursing, Tucson, Arizona
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Armeni A, Armeni E, Augoulea A, Delialis D, Angelidakis L, Papaioannou M, Kaparos G, Alexandrou A, Georgopoulos N, Vlahos N, Stamatelopoulos K, Lambrinoudaki I. Sexual function scores are associated with arterial stiffness in postmenopausal women. J Sex Med 2024; 21:145-152. [PMID: 38048636 DOI: 10.1093/jsxmed/qdad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Female sexual dysfunction (FSD) has been suggested to be correlated with the burden of cardiovascular risk factors. AIM We aimed to evaluate the possible association between functional indices of vascular function and FSD scores in apparently healthy postmenopausal women. METHODS This cross-sectional study included 116 postmenopausal women who underwent assessment of endothelial function with measurement of flow-mediated dilation (FMD) of the branchial artery and arterial stiffness estimation with measurement of the carotid-femoral pulse wave velocity (PWV). We used the Greene Climacteric Scale to evaluate vasomotor symptomatology, the Female Sexual Function Index (FSFI) to evaluate FSD and the Beck Depression Inventory to evaluate mood disorder. Low sexual function was defined as an FSFI score <26.55. OUTCOMES These included FSFI and low sexual function scores as well as measures of PWV and FMD. RESULTS Sexual function scores were associated with measures of blood pressure (normal vs low sexual function; systolic blood pressure: 120.2 ± 15.0 mm Hg vs 113.4 ± 14.6 mm Hg; analysis of covariance P = .026; diastolic blood pressure: 75.9 ± 10.5 mm Hg vs 70.3 ± 9.9 mm Hg; analysis of covariance P = .012; both adjusted for age, body mass index, current smoking, and PWV). Systolic blood pressure, but not diastolic blood pressure, was associated with FSFI (B = 0.249, P = .041) and PWV (B = 0.392, P < .001). PWV measures were associated with FSFI (B = -0.291, P = .047) and pulse pressure (B = 0.355, P = .017). FMD measures were also associated with FSFI (B = 0.427, P = .033). All models were adjusted for age, body mass index, current smoking, insulin resistance, vasomotor symptomatology, and Beck Depression Inventory. CLINICAL IMPLICATIONS Our findings demonstrate that lower scores of sexual function are associated with deteriorated vascular function mainly manifested as arterial stiffening, further contributing to systolic blood pressure changes. STRENGTHS AND LIMITATIONS The strength of this study is the carefully selected healthy sample of postmenopausal women, with simultaneous assessment of climacteric symptomatology and mood disorders. The limitations include the small sample size, the cross-sectional design, and the recruitment of consecutive outpatients of a university menopause clinic. CONCLUSION Longitudinal studies and interventions to improve FSD should further assess the clinical relevance of these findings.
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Affiliation(s)
- Anastasia Armeni
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University Hospital, University of Patras Medical School, GR-26504 Patras, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
- Royal Free Hospital NHS Foundation Trust, UCL Medical School, London NW3 2QG, United Kingdom
| | - Areti Augoulea
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Dimitrios Delialis
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - Lasthenis Angelidakis
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - Maria Papaioannou
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - George Kaparos
- Biochemical Laboratory, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Andreas Alexandrou
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Neoklis Georgopoulos
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University Hospital, University of Patras Medical School, GR-26504 Patras, Greece
| | - Nicolaos Vlahos
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
| | - Kimon Stamatelopoulos
- Laboratory of Vascular Pathophysiology, Department of Therapeutics, Alexandra Hospital, University of Athens, GR-11528 Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, University of Athens, GR-11528 Athens, Greece
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Chen J, Zhai H, Jin H, Li X, Zhang P, Chen R. Sexual experiences of postmenopausal women in China: a qualitative study. Sex Med 2023; 11:qfad062. [PMID: 38058407 PMCID: PMC10696166 DOI: 10.1093/sexmed/qfad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 10/09/2023] [Accepted: 10/23/2023] [Indexed: 12/08/2023] Open
Abstract
Background Sexual dysfunction is common among postmenopausal women and can have a significant negative impact on quality of life. Aim This study aimed to explore perceptions, experiences, and coping strategies related to sex among postmenopausal women in China. Methods We used phenomenologic qualitative methods in this study. On the basis of purposive sampling and the data saturation principle, 21 volunteers from a community cohort study were selected for semistructured interviews. The data were analyzed and themes were extracted. Outcomes Thematic codes pertaining to sexual experiences and coping strategies were defined and assessed in this study. Results Four themes and 12 subthemes were extracted from the interview data. The sexual concepts were relatively conservative for most of the Chinese women; the majority experienced physical and psychological distress with respect to sex, although negative and positive psychological experiences were described. The women often passively accepted and adapted to negative changes to their sex lives during the postmenopause period. Clinical Implications This study highlights the importance of and need for effective dissemination of sexual health-related knowledge and the opening of appropriate communication channels. Strengths and Limitations By using a qualitative approach, this study provides individuals with the opportunity to describe their cognition and attitudes toward sexuality. Limitations include limited generalizability, as is true for most qualitative research. Additionally, the study is based solely on the female perspective and cannot fully reflect the sex life of couples. Conclusion The sexual experiences of our respondents exhibited distinct Chinese cultural characteristics. The interviews show the importance of paying attention to postmenopausal women's sexual health and providing relevant professional support and guidance to improve women's overall health-related quality of life.
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Affiliation(s)
- Jie Chen
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing,100730, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Haina Zhai
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing,100730, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Hongyun Jin
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing,100730, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xiang Li
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing,100730, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Pan Zhang
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing,100730, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Rong Chen
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing,100730, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
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Armeni A, Armeni E, Augoulea A, Stergiotis S, Kaparos G, Alexandrou A, Eleftheriadis M, Georgopoulos N, Vlahos N, Lambrinoudaki I. Climacteric symptoms, age, and sense of coherence are associated with sexual function scores in women after menopause. J Sex Med 2023; 20:313-323. [PMID: 36763958 DOI: 10.1093/jsxmed/qdac031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/26/2022] [Accepted: 10/19/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Postmenopausal sexual function presupposes the integration of hormonal, neural, and vascular interactions and is subject to optimal crosstalk among psychological, interpersonal, cultural, and environmental factors. Sense of coherence (SOC) reflects a person's ability to cope with stressors and may influence the occurrence of menopausal symptoms and sexual dysfunction. AIM To investigate the association of severity of climacteric symptoms, cardiometabolic risk factors, and SOC with sexual function in postmenopausal women. METHODS Overall 281 sexually active postmenopausal women without significant psychopathology or cardiovascular disease attending the Menopause Unit of Aretaieion Hospital were evaluated by the Female Sexual Function Index (FSFI), Greene Climacteric Scale, Beck Depression Scale, and Sense of Coherence Scale. Hormonal and biochemical parameters and cardiometabolic risk factors were evaluated. FSFI scores <26.5 were considered pathologic. OUTCOMES Total and subdomain scores of sexual response were determined. RESULTS Pathologic FSFI scores were found in 79.7% of the sample. Linear models of multivariable regression analysis showed that FSFI scores were associated with (1) Beck scores (b = -0.200; 95% CI, -0.472 to -0.073, P = .001), vasomotor symptom severity (b = -0.324; 95% CI, -0.985 to 0.051; P < .001), and age and (2) SOC (b = 0.150, 95% CI, 0.036-0.331; P = .008), vasomotor symptom severity (b = -0.361; 95% CI, -0.743 to 0.245; P < .001), and age. Both models were adjusted for menopausal age, diabetes mellitus, hypertension, type of menopause, and menopausal hormone therapy intake. SOC was associated with Beck depression scores (β = -0.487, P < .001; Greene Climacteric Scale total scores, β = -0.199, P < .001). FSFI score <26.5 vs >26.5 was associated with SOC (odds ratio, 0.982; 95% CI, 0.563 to 1.947; P = .006) and moderate to severe vasomotor symptom severity (odds ratio, 2.476; 95% CI, 1.478 to 3.120; P = .009) independent of age, diabetes mellitus, hypertension, menopausal hormone therapy intake, type of menopause, or Beck depression classification. CLINICAL IMPLICATIONS The results indicate the importance of psychometric assessment of postmenopausal women when presenting with scores of low sexual function. The severity of vasomotor symptoms should also be addressed in any case. STRENGTHS AND LIMITATIONS This is the first study investigating the relationship between SOC and sexuality in menopause in a carefully selected homogenous population. Limitations included the cross-sectional design and the fact that sexual distress was not assessed. CONCLUSIONS Pathologic FSFI scores were highly prevalent in this sample of postmenopausal women. FSFI is associated positively with age and severity of vasomotor symptoms and negatively with SOC.
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Affiliation(s)
- Anastasia Armeni
- Second Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Aretaieion Hospital, GR-11528 Athens, Greece.,Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, University Hospital, GR-26504 Patras, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Aretaieion Hospital, GR-11528 Athens, Greece
| | - Areti Augoulea
- Second Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Aretaieion Hospital, GR-11528 Athens, Greece
| | - Stefanos Stergiotis
- Second Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Aretaieion Hospital, GR-11528 Athens, Greece
| | - George Kaparos
- Biochemical Laboratory, National and Kapodistrian University of Athens, Aretaieion Hospital, GR-11528 Athens, Greece
| | - Andreas Alexandrou
- Second Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Aretaieion Hospital, GR-11528 Athens, Greece
| | - Makarios Eleftheriadis
- Second Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Aretaieion Hospital, GR-11528 Athens, Greece
| | - Neoklis Georgopoulos
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, University Hospital, GR-26504 Patras, Greece
| | - Nicolaos Vlahos
- Second Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Aretaieion Hospital, GR-11528 Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Aretaieion Hospital, GR-11528 Athens, Greece
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10
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Woods NF, Coslov N, Richardson MK. Perimenopause meets life: observations from the Women Living Better Survey. Menopause 2022; 29:1388-1398. [PMID: 36194844 DOI: 10.1097/gme.0000000000002072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The purpose of these analyses was to test a predictive quantitative model relating personal characteristics, reproductive aging stages, health behaviors, roles, stressors, and satisfaction with life roles to bothersome symptoms experienced during the late reproductive stage and the menopausal transition (MT). METHODS Participants (N = 2,406) aged 35 to 55 years completed the Women Living Better Survey online between March to August 2020, and 1,529 met the inclusion criteria and provided menstrual cycle data for staging reproductive aging. They were recruited from the Women Living Better newsletter and from other online groups of midlife women. Hierarchical regression analysis using a two-stage model tested the effect of several factors on each of five bothersome symptom groups: brain fog, volatile mood, fatigue/pain, vasomotor/sleep disruption, and anxiety/vigilance symptoms. In stage I, personal characteristics, reproductive aging stage, and health behaviors were examined, and in stage II roles (ie, caregiver, partner, employment-related), satisfaction with life roles and stressors associated with roles were added. RESULTS More bothersome brain fog symptoms were associated with less education, MT (vs late reproductive stage), low satisfaction with life roles, and greater health-related and overcommitment stress (all P < 0.005). More bothersome volatile mood symptoms were associated with health-related, partner relationship, and other relationship stress. More bothersome fatigue/pain symptoms were associated with less education and greater difficulty paying for basics and health-related and other relationship stress. Vasomotor/sleep-onset symptoms were associated with less education, MT, and health-related and work stress. More bothersome anxiety/vigilance symptoms were associated with less education, more difficulty paying for basics, and health and work stress. CONCLUSIONS Recognizing that midlife stress comes from many role- and relationship-related sources and that several of these stressors are associated with greater symptom bother supports the importance of proactive identification and management of sources of stress.
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Affiliation(s)
- Nancy Fugate Woods
- From the Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA
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Kaur M, Kaur M. Assessment of menopausal symptoms with changing hormone milieus in different menopausal transitional stages. Health Care Women Int 2022:1-16. [PMID: 36282199 DOI: 10.1080/07399332.2022.2134390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/26/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
The present cross-sectional study is an attempt to evaluate menopausal symptoms with changing hormone milieus among women of different menopausal transitional stages. Out of all the symptoms, sexual dysfunction was the most commonly occurring symptom. Results of the correspondence analysis exhibited a significant association of symptoms like 'feeling unhappy', 'feeling dizzy', 'parts of body feeling numb' and 'muscle & joint pain' with late postmenopausal stage. Therefore, the assessment of menopausal health of women in rural settings of developing countries like India is of considerable significance for promoting their post reproductive health as well as for enhancing their quality of life.
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Affiliation(s)
- Mankamal Kaur
- Department of Anthropology, Panjab University, Chandigarh, India
| | - Maninder Kaur
- Department of Anthropology, Panjab University, Chandigarh, India
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Farag AGA, El Shazly MA, Badr EAE, El Desoqy BAA, Elsayed Elshaib M. Relationship of steroid sex hormones with female sexual dysfunction in female patients having urinary incontinence. Steroids 2022; 179:108963. [PMID: 35121167 DOI: 10.1016/j.steroids.2022.108963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 12/17/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
To investigate serum estradiol, progesterone and dehydroepiandrosterone levels on FSD in females having urinary incontinence (UI), we studied 150 females [100 having UI (50 with FSD and 50 without FSD) and 50 controls]. There were significant lower estradiol and progesterone and higher DHEA serum levels in patients than controls (P = 0.001for all). In UI patients, females having sexual disruption had significantly low levels of estradiol (p = 0.001). Low estradiol serum level represented an isolated predictive factor for sexual dysfunction in incontinent female patients (p = 0.001). A low estradiol serum level might be a possible risk factor for FSD in women having UI.
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Affiliation(s)
- Azza G A Farag
- Dermatology, Andrology and STDs Department, Faculty of Medicine, Menoufia University, Egypt
| | | | - Eman A E Badr
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Menoufia University, Egypt.
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Abstract
Objective: Hormone therapy (HT) is used to treat menopause-related conditions and symptoms. The small intestine plays key roles in metabolic and endocrine function, but the effects of HT on the small intestinal microbiome are unknown. Here, we characterize duodenal microbiome differences, and the effects of HT, in postmenopausal women. Methods: Female participants undergoing esophagogastroduodenoscopy who were postmenopausal and taking HT (HT+), postmenopausal but not taking HT (HT−), or of reproductive age and not taking exogenous hormones (RA), were identified and matched for body mass index (±3 kg/m2). DNAs were isolated from duodenal aspirates obtained during upper endoscopy. V3 and V4 libraries were used for 16S rRNA sequencing. Serum hormone levels were analyzed by Luminex FlexMap. Results: The core duodenal microbiome was different in HT− participants (n = 12) when compared with RA participants (n = 10), but more similar in HT+ (n = 13) and RA participants. HT− participants had increased Proteobacteria taxa, leading to greater microbial dysbiosis compared with HT+ participants, and had decreased prevalence of Bacteroidetes, which was associated with higher fasting glucose levels, lower duodenal microbial diversity, and lower testosterone levels. HT+ participants had significantly higher estradiol (P = 0.04) and progesterone (P = 0.04), and lower fasting glucose (P = 0.03), than HT− participants, and had increased relative abundance of Prevotella (P = 0.01), and decreased Escherichia (P = 1.12E-7), Klebsiella (P = 5.93E-7), and Lactobacillus (P = 0.02), all associated with lower cardiovascular disease risks. Conclusions: These findings support previous studies suggesting that HT may have beneficial effects following menopause, and although preliminary, may also support a beneficial effect of HT on the duodenal microbiome.
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Arıkan MK, İlhan R, Günver G, Öksüz Ö, Turan Ş, Metin B. Alpha oscillations predict paroxetine response to low sexual desire in depression. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Transitioning to the menopausal transition: a scoping review of research on the late reproductive stage in reproductive aging. ACTA ACUST UNITED AC 2021; 28:447-466. [PMID: 33470754 DOI: 10.1097/gme.0000000000001707] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
IMPORTANCE AND OBJECTIVE In 2001 Staging Reproductive Aging Workshop conferees described the late reproductive stage (LRS) of reproductive aging as preceding the onset of the menopausal transition, yet there has been little attention to this aspect of reproductive aging. The aim of this scoping review was to examine scientific publications characterizing the LRS to map what is known about this stage with particular focus on reproductive endocrine patterns, menstrual cycle changes, and symptoms. METHODS The initial search strategy included PubMed and CINAHL searches for the phrase LRS and "human." Given a low yield of research articles, a second stage used "late reproductive age" (LRA) as a search term. These strategies yielded 9 and 26 research articles, respectively. Publications meeting inclusion criteria (data-based research studies, focus on LRS or LRA and hormonal patterns, menstrual characteristics, and symptoms) published in English were reviewed by coinvestigators. Excluded studies were related to specific diseases, such as cardiovascular disease, and treatment studies. Data were summarized using qualitative methods. To ensure adequate coverage of published research we expanded our review to a third phase in which we identified longitudinal studies of the menopausal transition. DISCUSSION AND CONCLUSIONS Studies of the LRS focused on: symptoms (anxiety and mood symptoms, bladder symptoms, urinary incontinence, urinary frequency, and nocturia) and associated factors, such as endocrine levels and gene polymorphisms; symptom clusters women experienced during the LRS; cognitive function testing results; changing patterns of physiology such as cytokines and chemokines, lipids, hormone patterns/levels; and association of lifestyle factors such as smoking with hormone levels and symptoms. The LRA search yielded a preponderance of studies of reproductive hormones (such as anti-Mullerian hormone) and menstrual cycle patterns. Remaining studies focused on symptoms, gene variants, health-related behaviors and approaches to classifying menstrual cycles. Longitudinal studies revealed reports of symptoms as well as attempts to classify the progression from the reproductive years to the menopausal transition. Study of the LRS has not been systematic and the limited number and scope of completed studies have yet to contribute a clear and complete picture of the LRS. In some, LRS provided a comparison stage against which to evaluate menopausal transition hormonal and cycle patterns and symptoms. Harmonizing the results of studies of the LRS and LRA is essential to understand more completely women's experiences of the LRS and to allow clinicians to provide better support for women during this time. The LRS also represents an ideal inflection point to promote lifestyle choices that could alter the trajectories of chronic diseases that arise in the fifth, sixth, and seventh decades of women's lives.
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Changes in hot flash experiences and related factors in women with breast cancer. ACTA ACUST UNITED AC 2020; 27:535-542. [PMID: 32068690 DOI: 10.1097/gme.0000000000001507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Taiwanese women are younger than women in western countries when diagnosed with breast cancer, and many of them are still menstruating. One of many distressing side effects reported by premenopausal women treated for breast cancer are hot flashes (HFs). The purposes of this study were to identify: (1) the trajectories of hot flash (HF) occurrence, frequency, and interference and (2) potential factors associated with HF changes. METHODS Peri- or premenopausal women newly diagnosed with breast cancer scheduled to receive chemotherapy and hormonal therapy were enrolled. HF frequency, HF interference, and other symptoms were measured six times from prechemotherapy to 24 months after chemotherapy. Data were analyzed using hierarchical linear modeling. RESULTS A total of 90 women were eligible for the study. The prechemotherapy occurrence rate of HFs was 7.9%, but rapidly increased to 42.5% immediately after chemotherapy. The change curve of HF frequency and interference appeared quadratic, increasing first and slightly decreasing later. At any time point, increased body mass index (BMI) was associated with both higher HF frequency (P = 0.020) and HF interference (P = 0.002), whereas anxiety (P < 0.001) and loss of sexual desire (P = 0.038) were associated with higher HF interference. Six months after completing chemotherapy, premenopausal women reported significantly higher HF frequency than perimenopausal women (P = 0.041). CONCLUSION A significant proportion of pre- and perimenopausal women experienced HFs after receiving breast cancer treatment. Our findings on HF trajectories can educate patients newly diagnosed with breast cancer. Special attention should be paid to those with increased body mass index changes and those still regularly menstruating.
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Dąbrowska-Galas M, Dąbrowska J, Michalski B. Sexual Dysfunction in Menopausal Women. Sex Med 2019; 7:472-479. [PMID: 31371259 PMCID: PMC6963159 DOI: 10.1016/j.esxm.2019.06.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Hormone-related changes in menopause may negatively affect sexual function. AIM The primary aim of this study was to evaluate sexual functioning in Polish women with the Female Sexual Function Index (FSFI). The secondary aim was to evaluate the major factors affecting sexual functions in middle-aged Polish women. METHODS The Menopause Rating Scale was used to assess the menopausal symptoms. The Polish translation of the FSFI was used to assess sexual function. OUTCOMES 69.73% of respondents had sexual dysfunction according to FSFI (FSFI score ≤ 26.55). RESULTS 80.61% of women experienced menopausal symptoms during the 4-week period of study. Psychological and urogenital symptoms were the most frequently reported among all the women enrolled in the study (78.23% and 77.21%). Sexual problems were observed in women who did not use hormone therapy (β = 0.09, t = -1.97, P = .048) and showed no somatic symptoms (β = 0.03, t = 2.95, P = .002). CLINICAL IMPLICATIONS It is important for health care providers to ask women about this problem and understand the factors that may influence sexual problems in menopause. STRENGTHS & LIMITATIONS A validated survey tool was used. The limitation was selection of participants in the clinical setting and sample population size. CONCLUSION Sexual problems were much more common in women who did not use hormone therapy and showed no somatic symptoms. Dąbrowska-Galas M, Dąbrowska J, Michalski B. Prevalence and Associated Risk Factors of Sexual Problems Among Polish Middle-Aged Women. Sex Med 2019;7:472-479.
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Affiliation(s)
- Magdalena Dąbrowska-Galas
- Department of Kinesitherapy and Special Methods, Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Jolanta Dąbrowska
- Department of Kinesitherapy and Special Methods, Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogdan Michalski
- Department of Nursing in Gynaecology and Obstetrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Sleep quality and fatigue in women with premature ovarian insufficiency receiving hormone therapy: a comparative study. ACTA ACUST UNITED AC 2019; 26:1141-1145. [DOI: 10.1097/gme.0000000000001379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lindmark U, Bülow PH, Mårtensson J, Rönning H. The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review. Nurs Open 2019; 6:664-675. [PMID: 31367388 PMCID: PMC6650790 DOI: 10.1002/nop2.249] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 12/03/2018] [Accepted: 01/15/2019] [Indexed: 11/20/2022] Open
Abstract
AIMS To continuing the quest of the concept of transition in nursing research and to explore how the concept of transition is used in occupational therapy, oral health and social work as well as in interdisciplinary studies in health and welfare, between 2003-2013. DESIGN An integrative literature review. METHODS PubMed, CINAHL, PsycINFO, DOSS, SocIndex, Social Science Citation Index and AMED databases from 2003-2013 were used. Identification of 350 articles including the concept of transition in relation to disciplines included. Assessment of articles are in accordance to Meleis' typologies of transition by experts in each discipline. Chosen key factors were entered into Statistical Package for the Social Sciences (SPSS). RESULTS Meleis' four typologies were found in all studied disciplines, except development in oral health. The health-illness type was the most commonly explored, whereas in social work and in occupation therapy, situational transitions dominated.
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Affiliation(s)
- Ulrika Lindmark
- Department of Natural Science and Bio Medicine, Center for Oral Health, School of Health and WelfareJönköping UniversityJönköpingSweden
| | - Pia H. Bülow
- Department of Social Work, School of Health and WelfareJönköping UniversityJönköpingSweden
- Department of Social WorkUniversity of the Free StateBloemfonteinSouth Africa
| | - Jan Mårtensson
- Department of Nursing, School of Health and WelfareJönköping UniversityJönköpingSweden
| | - Helén Rönning
- School of Health and WelfareJönköping UniversityJönköpingSweden
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Abstract
OBJECTIVE Women experience a variety of changes at midlife that may affect sexual function. Qualitative research approaches can allow a deeper understanding of women's experiences. We conducted 20 individual interviews and three focus groups among sexually active women aged 45 to 60 years (total n = 39) to explore how sexual function changes during midlife. METHODS Interviews and focus groups were conducted by a trained facilitator using a semistructured guide. All data were audio-recorded and transcribed. Two investigators used a subsample of data to iteratively develop a codebook. The primary investigator coded all data. A second investigator coded a randomly selected 25% of interviews. Codes regarding changes in sexual function were examined and key themes emerged. RESULTS The mean age was 52, and most women were peri- or postmenopausal. Fifty-four per cent of women were white, 36% black, and 10% of another race. Participants discussed positive and negative changes in sexual function. The most common negative changes were decreased frequency of sex, low libido, vaginal dryness, and anorgasmia. Participants attributed negative changes to menopause, partner issues, and stress. Most participants responded to negative changes with adaptation, including changing sexual behavior and prioritizing different aspects of sex. Participants also reported positive changes, attributed to higher self-confidence, increased self-knowledge, and better communication skills with aging. CONCLUSIONS In this qualitative study, women described experiencing both positive and negative changes in sexual function during midlife. When negative changes occurred, women often adapted behaviorally and psychologically. Providers should recognize that each woman's experience is unique and nuanced, and they should provide tailored care regarding sexual function at midlife.
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von Hippel C, Adhia A, Rosenberg S, Austin SB, Partridge A, Tamimi R. Sexual Function among Women in Midlife: Findings from the Nurses' Health Study II. Womens Health Issues 2019; 29:291-298. [PMID: 31130435 DOI: 10.1016/j.whi.2019.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 03/28/2019] [Accepted: 04/11/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Women's sexual well-being is an important determinant of overall health and quality of life across the life course. Yet the factors associated with women's levels of sexual activity and sexual function in midlife are little understood. This study sought to assess the prevalence of recent sexual activity and sexual dysfunction symptoms among middle-aged women and evaluate the associations of partner status, menopause, and health status factors with sexual dysfunction. METHODS Participants of this cross-sectional study were 68,131 women who responded to the 2013 Nurses' Health Study II observational cohort questionnaire when they were age 48-68 years. Sexual activity and dysfunction symptoms were assessed with the Female Sexual Function Index. Age-adjusted multivariable regression models estimated risk ratios for the association of health-related factors with past month sexual dysfunction symptoms among women who were sexually active over the past month, overall and stratified by partner status. RESULTS Of middle-aged women participants, 73% were sexually active (n = 49,701) and 50% of sexually active women reported symptoms of sexual dysfunction. Symptoms of sexual dysfunction were less common among unpartnered than partnered women (42% vs. 51%; p < .0001). A positive association between menopause and sexual dysfunction was greater for unpartnered women (risk ratio, 2.37, 2.99; p < .001) than partnered women (risk ratio, 1.89, 2.00; p < .001). CONCLUSIONS Difficulty with sexual function is common among women in midlife, but less so than previously estimated. Regular monitoring of women's sexual function could enable clinicians to offer women timely, supportive interventions tailored by partner status and menopausal status.
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Affiliation(s)
- Christiana von Hippel
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Avanti Adhia
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shoshana Rosenberg
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ann Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Rulla Tamimi
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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George WH. Alcohol and Sexual Health Behavior: "What We Know and How We Know It". JOURNAL OF SEX RESEARCH 2019; 56:409-424. [PMID: 30958036 DOI: 10.1080/00224499.2019.1588213] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Alcohol, despite salutary associations with sexuality, has been implicated in sexual health problems. This review examines the relationship between alcohol and outcomes related to sexual health. Methodological considerations limiting causal assertions permissible with nonexperimental data are discussed, as are advantages of experimental methods. Findings from laboratory experiments are reviewed evaluating causal effects of acute alcohol intoxication on a variety of outcomes, including sexual arousal, sexual desire, orgasm, and sexual risk behaviors related to sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Several variables exerting mediating and moderating influences are identified. It is concluded that acute alcohol intoxication is capable of exerting a causal impact on multiple constituent components of sexual responding related to sexual health. Both alcohol expectancy and alcohol myopia theories have been supported as explanations for these causal effects. Furthermore, for sexual risk behavior, noteworthy recent developments include research highlighting the importance of women's sexual victimization history and men's condom use resistance. Limitations and implications associated with this body of research are also discussed.
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Impact of gender on sexual problems and perceptions among urban Malay elderly in Malaysia. Arch Gerontol Geriatr 2019; 81:240-244. [PMID: 30669017 DOI: 10.1016/j.archger.2019.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 10/16/2018] [Accepted: 01/05/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Physical and pathological changes associated with advancing age affect sexual behaviours of the elderly. The aim of this study was to explore the impact of gender on sexual problems and perceptions among the urban Malay elderly. METHODS A cross-sectional study was conducted among 160 Malaysian elderly participants aged 60 years and older who live in Kuala Lumpur. Twelve neighbourhood associations were randomly selected using multi-stage cluster sampling. Data was collected using standardized and validated questionnaire by face-to-face interview technique with which was conducted by trained interviewers. RESULTS Mean age of the participants was 65.33 (5.87) year old with majority were still married. Female (55.7%) reported more sexual problems as evidenced by the higher proportion of those with lacked interest in having sex (72.5%), find sex is unpleasant (34.8%) and unable to come to orgasm (55.1%). Gender was found to have significant impact on every model obtained in the analysis for both sexual problems and perceptions. Female elderly were 10.6 times more likely to have sexual problem compared to male elderly (OR = 10.64, P < 0.001, 95% CI 3.61, 31.35) and 033 less likely to have good sexual perception (OR = 0.33, P = 0.027, 95% CI 0.12, 0.88). CONCLUSION Gender is a crucial factor towards sexual problem and perceptions among older persons. Older women were reported to have more sexual problems and poor sexual perceptions, reflecting the needs for sexual awareness and education to improve the perceptions and sexuality in later life.
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Kong F, Wang J, Zhang C, Feng X, Zhang L, Zang H. Assessment of sexual activity and menopausal symptoms in middle-aged Chinese women using the Menopause Rating Scale. Climacteric 2019; 22:370-376. [PMID: 30612483 DOI: 10.1080/13697137.2018.1547702] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- F. Kong
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - J. Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - C. Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
- Department of Obstetrics and Gynecology, The Affiliated Zhongshan Hospital of Dalian University, Dalian, P.R. of China
| | - X. Feng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - L. Zhang
- Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - H. Zang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
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Zhou Y, Li C, Jin F, Shao H, Teng Y, Tao M. Prevalence and predictors of sexual function in midlife partnered Chinese women assessed by two simple indicators: Sexual frequency and sexual desire. J Obstet Gynaecol Res 2018; 45:210-216. [PMID: 30259615 DOI: 10.1111/jog.13790] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 07/28/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Yang Zhou
- Department of Gynecology and Obstetrics; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
| | - Changbin Li
- Center of Reproductive Medicine; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
| | - Feng Jin
- Department of Gynecology and Obstetrics; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
| | - Hongfang Shao
- Center of Reproductive Medicine; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
| | - Yincheng Teng
- Department of Gynecology and Obstetrics; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
- Center of Reproductive Medicine; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
| | - Minfang Tao
- Department of Gynecology and Obstetrics; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai China
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Johansen N, Liavaag AH, Mørkrid L, Michelsen TM. Hormone Levels and Sexual Functioning After Risk-Reducing Salpingo-Oophorectomy. Sex Med 2018; 6:143-153. [PMID: 29631858 PMCID: PMC5960032 DOI: 10.1016/j.esxm.2018.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/29/2018] [Accepted: 02/04/2018] [Indexed: 12/27/2022] Open
Abstract
Introduction Women after risk-reducing salpingo-oophorectomy (RRSO) can have impaired sexual functioning, but whether there is an association between hormone levels and sexual functioning is unclear. Aim To determine whether hormone levels are associated with sexual functioning in women after RRSO. Methods This is a retrospective cohort study of 198 sexually active and 91 inactive women after RRSO. Participants completed the Sexual Activity Questionnaire, questionnaires concerning hormone replacement therapy (HRT), quality of life, care from partner, body image, and comorbidity and provided blood samples. Associations between sexual functioning scores and covariates were examined by linear regression. Variables associated with sexual activity were examined by logistic regression. Main Outcome Measures Associations with sexual pleasure and sexual discomfort scores were expressed by multivariable regression coefficients and associations with sexual activity were expressed by odds ratios. Results None of the hormone levels were associated with sexual pleasure in contrast to age (P = .032), current use of systemic HRT (P = .002), and more care form partner (P < .001). Increased free androgen index (P = .016), more care from partner (P = .017), systemic HRT (P = .002), and no history of cardiovascular disease (P = .001) were associated with less sexual discomfort. The odds ratio of being sexually active increased with younger age, no breast cancer, better quality of life, and more care from partner. Conclusions Our results indicate that other factors than hormone levels are important for sexual functioning, although systemic HRT can have a positive impact on sexual functioning in women who have undergone RRSO. Testosterone therapy could improve women's sexual functioning after RRSO; however, the inverse association between free androgen levels and sexual discomfort should be addressed in future studies. Johansen N, Liavaag AH, Mørkird L, Michelsen TM. Hormone Levels and Sexual Functioning After Risk-Reducing Salpingo-Oophorectomy. Sex Med 2018;6:143–153.
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Affiliation(s)
- Nora Johansen
- Department of Gynecology, Sørlandet Hospital Arendal, Arendal, Norway.
| | - Astrid H Liavaag
- Department of Gynecology, Sørlandet Hospital Arendal, Arendal, Norway
| | - Lars Mørkrid
- Department of Medical Biochemistry, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Trond M Michelsen
- Department of Obstetrics, Rikshospitalet, Division of Obstetrics and Gynecology, Oslo University Hospital Rikshospitalet, Oslo, Norway
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Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T. Symptoms of menopause - global prevalence, physiology and implications. Nat Rev Endocrinol 2018; 14:199-215. [PMID: 29393299 DOI: 10.1038/nrendo.2017.180] [Citation(s) in RCA: 278] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The symptoms of menopause can be distressing, particularly as they occur at a time when women have important roles in society, within the family and at the workplace. Hormonal changes that begin during the menopausal transition affect many biological systems. Accordingly, the signs and symptoms of menopause include central nervous system-related disorders; metabolic, weight, cardiovascular and musculoskeletal changes; urogenital and skin atrophy; and sexual dysfunction. The physiological basis of these manifestations is emerging as complex and related, but not limited to, oestrogen deprivation. Findings generated mainly from longitudinal population studies have shown that ethnic, geographical and individual factors affect symptom prevalence and severity. Moreover, and of great importance to clinical practice, the latest research has highlighted how certain menopausal symptoms can be associated with the onset of other disorders and might therefore serve as predictors of future health risks in postmenopausal women. The goal of this Review is to describe in a timely manner new research findings on the global prevalence and physiology of menopausal symptoms and their impact on future health.
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Affiliation(s)
- Patrizia Monteleone
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Giulia Mascagni
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea Giannini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea R Genazzani
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
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Sexual activity and function assessment in middle-aged Chinese women using the female sexual function index. Menopause 2018; 24:669-676. [PMID: 28072610 DOI: 10.1097/gme.0000000000000812] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To assess sexual activity, sexual function, and their correlation with vaginal maturation status among middle-aged Chinese women. METHODS A cross-sectional study with comparisons across age groups was carried out. In all, 120 women aged 45 to 60 years were recruited into three groups: 45 to 50 (youngest group), 51 to 55 (intermediate group), and 56 to 60 years old (eldest group). Sexual function was assessed through the Female Sexual Function Index (FSFI); vaginal maturation status was determined through the Vaginal Maturation Index (VMI) and pH value. Sexual activity was recorded with self-administered questionnaires. RESULTS Low sexual frequency was present in a higher proportion of women, but sexual distress was identified within a lower proportion of women in the eldest group. The total FSFI score was significantly lower in the eldest group than in the youngest and intermediate groups (P < 0.01 and 0.05, respectively); however, the domain score of sexual desire, arousal, and satisfaction was lower in the eldest group than in the youngest group (P < 0.01, 0.05, and 0.05) only. The domain score for lubrication was lower in the eldest group than in both the youngest and intermediate groups (P < 0.01 and 0.05), and the pain score was lower in both the intermediate and eldest groups than in the youngest group (P < 0.01 and 0.05). A lower VMI (P < 0.001) and a higher pH value (P < 0.01) were observed in the eldest group, compared with the youngest group. Moreover, VMI was positively correlated with the total FSFI score, the domain score for sexual desire, and lubrication (r = 0.26, 0.25, 0.34; P < 0.05, 0.05, 0.01), but the opposite associations were demonstrated for pH value (r = -0.47, -0.37, -0.38; P < 0.01, respectively), especially with vaginal pain (r = -0.44, P < 0.01). CONCLUSIONS Among middle-aged Chinese women, sexual desire is lower in 56 to 60-year-old women, compared with those aged 45 to 55 years, whereas vaginal dryness and dyspareunia become more prevalent with age. Importantly, sexual function is associated with vaginal maturation status in women at midlife.
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Change in sexual functioning over the menopausal transition: results from the Study of Women's Health Across the Nation. Menopause 2018; 24:379-390. [PMID: 27801705 DOI: 10.1097/gme.0000000000000770] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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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Chadwick SB, Burke SM, Goldey KL, van Anders SM. Multifaceted Sexual Desire and Hormonal Associations: Accounting for Social Location, Relationship Status, and Desire Target. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2445-2463. [PMID: 28444531 DOI: 10.1007/s10508-017-0959-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 02/03/2017] [Accepted: 02/09/2017] [Indexed: 05/25/2023]
Abstract
Sexual desire is typically measured as a unitary erotic phenomenon and is often assumed by biological and biomedical researchers, as well as the lay public, to be directly connected to physiological parameters like testosterone (T). In the present study, we empirically examined how conceptualizing sexual desire as multifaceted might clarify associations with T and contextual variables. To do so, we used the Sexual Desire Questionnaire (DESQ), which assesses multifaceted dyadic sexual desire, to explore how contextual variables such as social location, relationship status, and desire target (e.g., partner vs. stranger) might be meaningful for reports of sexual desire and associated hormonal correlations. We focused on women (N = 198), because sexual desire and testosterone are generally unlinked in healthy men. Participants imagined a partner or stranger while answering the 65 DESQ items and provided a saliva sample for hormone assay. Analyses showed that the DESQ factored differently for the current sample than in previous research, highlighting how sexual desire can be constructed differently across different populations. We also found that, for the Intimacy, Eroticism, and Partner Focus factors, mean scores were higher when the desire target was a partner relative to a stranger for participants in a relationship, but equally high between partner versus stranger target for single participants. DESQ items resolved into meaningful hormonal desire components, such that high endorsement of Fantasy Experience was linked to higher T, and higher cortisol was linked with lower endorsement of the Intimacy factor. We argue that conceptualizing desire as multifaceted and contextualized when assessing hormonal links-or questions in general about desire-can clarify some of its complexities and lead to new research avenues.
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Affiliation(s)
- Sara B Chadwick
- Departments of Psychology & Women's Studies, University of Michigan, Ann Arbor, MI, USA
| | - Shannon M Burke
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | | | - Sari M van Anders
- Departments of Psychology & Women's Studies; Program in Neuroscience; Reproductive Sciences Program; Science, Technology, & Society Program, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA.
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Chadwick SB, Burke SM, Goldey KL, Bell SN, van Anders SM. Sexual Desire in Sexual Minority and Majority Women and Men: The Multifaceted Sexual Desire Questionnaire. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2465-2484. [PMID: 28070802 DOI: 10.1007/s10508-016-0895-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 08/16/2016] [Accepted: 10/27/2016] [Indexed: 05/10/2023]
Abstract
Sexual desire is increasingly understood to be multifaceted and not solely erotically oriented, but measures are still generally unitary and eroticism-focused. Our goals in this article were to explore the multifaceted nature of sexual desire and develop a measure to do so, and to determine how multifaceted sexual desire might be related to gender/sex and sexual orientation/identity. In the development phase, we generated items to form the 65-item Sexual Desire Questionnaire (DESQ). Next, the DESQ was administered to 609 women, 705 men, and 39 non-binary identified participants. Results showed that the DESQ demonstrated high reliability and validity, and that sexual desire was neither unitary nor entirely erotic, but instead was remarkably multifaceted. We also found that multifaceted sexual desire was in part related to social location variables such as gender/sex and sexual orientation/identity. We propose the DESQ as a measure of multifaceted sexual desire that can be used to compare factor themes, total scores, and scores across individual items in diverse groups that take social context into account. Results are discussed in light of how social location variables should be considered when making generalizations about sexual desire, and how conceptualizations of desire as multifaceted may provide important insights.
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Affiliation(s)
- Sara B Chadwick
- Departments of Psychology and Women's Studies, University of Michigan, Ann Arbor, MI, USA
| | - Shannon M Burke
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | | | - Sarah N Bell
- Departments of Psychology and Women's Studies, University of Michigan, Ann Arbor, MI, USA
| | - Sari M van Anders
- Departments of Psychology and Women's Studies, Program in Neuroscience, Reproductive Sciences Program, Science, Technology, and Society Program, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA.
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Bahri N, Latifnejad Roudsari R, Azimi Hashemi M. "Adopting self-sacrifice": how Iranian women cope with the sexual problems during the menopausal transition? An exploratory qualitative study. J Psychosom Obstet Gynaecol 2017; 38:180-188. [PMID: 27626135 DOI: 10.1080/0167482x.2016.1216962] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE In the menopausal transition sexual problems are an important issue and one of the most frequently presented health concerns of women attending menopause clinics. This study aimed to explore the ways of managing sexual dysfunctions during the menopausal transition among Iranian women. METHODS This exploratory qualitative study was conducted in Iran, from May 2013 to April 2015. Twenty-one women in three stages of menopausal transition, aged 42-55 years old, were purposively selected from urban health centers in Mashhad and Gonabad, Iran. Semi-structured in depth interviews were conducted for data collection until data saturation was achieved. All interviews were recorded electronically and transcribed verbatim. Conventional content analysis was used for data analysis using Granehiem and Lundman (2004) recommended method. MAXQDA 2007 software was used for organizing data and managing the process of analysis. RESULTS Data analysis demonstrated one overarching theme entitled "Adopting self-sacrifice" consisting of three categories and seven sub-categories. Major categories included: (1) Confronting decline of libido with two subcategories of women's libido decline and inability to fulfill husbands' sexual needs, (2) Seeking strategies for coping with two subcategories of looking for experiences of peer menopausal women and choosing how to interact with the husband and (3) Achieving problem solving strategies with three sub-categories of obedience in sexual relationships (Tamkin), employing affection based on religious advice, and giving up own right to reach mutual understanding. CONCLUSIONS The major finding of this study was "Adopting self-sacrifice" in the process of managing sexual dysfunctions during the menopausal transition. The reason for choosing this passive approach by the majority of women has deep roots in their cultural and traditional beliefs.
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Affiliation(s)
- Narjes Bahri
- a Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences , Mashhad , the Islamic Republic of Iran
| | - Robab Latifnejad Roudsari
- b Evidence-Based Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences , Mashhad , the Islamic Republic of Iran
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Factors associated with sexual quality of life among midlife women in Serbia. Qual Life Res 2017; 26:2793-2804. [PMID: 28580495 DOI: 10.1007/s11136-017-1608-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess factors associated with better sexual quality of life (QOL) in midlife period among women who are and are not sexually active. METHODS Participants were 500 women aged 40-65 years from Belgrade, Serbia. Data were collected through general questionnaire (regarding socio-demographic characteristics, lifestyle habits, general medical, and gynecological history) in which one item investigated having partnered sexual activity (heterosexual intercourses). The sexual domain of the Utian Quality of Life Scale was used to assess the sexual QOL. The sexual QOL consisted of reflections on the satisfaction with frequency of sexual interactions, as well as sexual and romantic life in general. Higher scores indicated better sexual QOL. RESULTS Most women were sexually active in midlife (81.6%). The mean sexual QOL score for the overall sample was 9.99 (range 3-15). The level of sexual QOL did not differ between sexually active and non-active women. Factors associated with better sexual QOL in sexually active menopausal women were being married or coupled, being physically active, having more children, having hot flushes, and not having tachycardia. Factors associated with better sexual QOL in sexually inactive menopausal women were drinking alcohol, being physically active, not having insomnia or skin rash. CONCLUSIONS Sexual QOL among Serbian urban midlife women was good and did not differ between women who were sexually active and those who were not. Further studies are needed to determine in what manner women who are not sexually active in midlife achieve high level of satisfaction with their sexual QOL.
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Pellow J, McGrath L. Herbal medicine for low sexual desire in menopausal women: A clinical review. Complement Ther Clin Pract 2016; 25:122-129. [PMID: 27863600 DOI: 10.1016/j.ctcp.2016.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/16/2016] [Indexed: 10/21/2022]
Abstract
Many women typically experience a significant reduction in sexual desire during the late perimenopausal and early postmenopausal stages, with the biggest decline in sexual desire occurring from three years prior to two years after the final menstrual period. Despite being a prevalent female complaint, currently no standard treatment for low sexual desire exists. Herbal medicines have been used therapeutically all around the world, and are an important component of Traditional and Complementary Medicine. There have been numerous trials and pharmacological studies of specific herbal preparations related to the treatment of low sexual desire. This article serves to provide a clinical review of the evidence relating to the herbal treatment options for this common condition.
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Affiliation(s)
- Janice Pellow
- Department of Homoeopathy, University of Johannesburg, Doornfontein Campus, P.O. Box 17011, Doornfontein, Gauteng, 2028, South Africa.
| | - Linda McGrath
- Department of Homoeopathy, University of Johannesburg, Doornfontein Campus, P.O. Box 17011, Doornfontein, Gauteng, 2028, South Africa.
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Woods NF, Mitchell ES. The Seattle Midlife Women's Health Study: a longitudinal prospective study of women during the menopausal transition and early postmenopause. Womens Midlife Health 2016; 2:6. [PMID: 30766702 PMCID: PMC6299967 DOI: 10.1186/s40695-016-0019-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 10/20/2016] [Indexed: 11/10/2022] Open
Abstract
Background The need for longitudinal, population-based studies to illuminate women’s experiences of symptoms during the menopausal transition motivated the development of the Seattle Midlife Women’s Health Study. Methods Longitudinal, population-based study of symptoms women experienced between the Late Reproductive stage of reproductive aging and the early postmenopause. Data collection began in 1990 with 508 women ages 35–55 and continued to 2013. Entry criteria included age, at least one period in past 12 months, uterus intact and at least 1 ovary. Women were studied up to 5 years postmenopause. Data collection included yearly health questionnaires, health diaries, urinary hormonal assays, menstrual calendars and buccal cell smears. Results Contributions of the study included development of a method for staging the menopausal transition; development of bleeding criteria to differentiate bleeding episodes from intermenstrual bleeding from menstrual calendars; identification of hormonal changes associated with menopausal transition stages; assessment of the effects of menopausal transition factors, aging, stress-related factors, health factors, social factors on symptoms, particularly hot flashes, depressed mood, pain, cognitive, sexual desire, and sleep disruption symptoms, and urinary incontinence symptoms; identification of naturally occurring clusters of symptoms women experienced during the menopausal transition and early postmenopause; and assessment of gene polymorphisms associated with events such as onset of the early and late menopausal transition stages and symptoms. Conclusions Over the course of the longitudinal Seattle Midlife Women's Health Study, investigators contributed to understanding of symptoms women experience during the menopausal transition and early postmenopause as well as methods of staging reproductive aging. Electronic supplementary material The online version of this article (doi:10.1186/s40695-016-0019-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nancy Fugate Woods
- 1Department of Biobehavioral Nursing, University of Washington, Seattle, WA 98195 USA
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Simoncig Netjasov A, Tančić-Gajić M, Ivović M, Marina L, Arizanović Z, Vujović S. Influence of obesity and hormone disturbances on sexuality of women in the menopause. Gynecol Endocrinol 2016; 32:762-766. [PMID: 27871199 DOI: 10.3109/09513590.2016.1161746] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess influence of obesity and hormone disturbances on sexuality in the menopause. METHODS The study included 73 menopausal women, who were divided into groups according to body mass index (BMI) ≥ 26.7 kg/m2. Anthropometric characteristics and blood pressure were measured. Blood was taken at 08:00 for hormones. All the participants filled in McCoy Female Sexual Questionnaire for the assessment of sexual life. STATISTICS Student's t-test, correlation, analysis of variance (ANOVA). RESULTS Follicle-stimulating hormone (FSH), luteinizing hormone (LH) and sex hormone-binding globulin (SHBG) were very significantly lower in obese compared to controls. E2 and systolic blood pressure were very significantly, while diastolic blood pressure significantly higher in obese compared to controls. Obese women had significantly decreased frequency of pain during sexual intercourse (3.48 ± 2.64 vs. 4.09 ± 2.81). Influence of age on frequency of sexual intercourse was very significant. Significant influence in interaction between BMI and age on frequency of sexual fantasies as well as significant influence of BMI on satisfaction with partner as lover is also found. CONCLUSION Obesity has influence on different aspects of sexuality in the postmenopausal women. Our results suggest the need of awareness toward obesity and its impact on sexuality in the menopause.
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Affiliation(s)
| | - Milina Tančić-Gajić
- b Clinical Center of Serbia, Institute of Endocrinology, Diabetes and Metabolic Disorders , Dr Subotića 13 , Belgrade , Serbia
| | - Miomira Ivović
- b Clinical Center of Serbia, Institute of Endocrinology, Diabetes and Metabolic Disorders , Dr Subotića 13 , Belgrade , Serbia
| | - Ljiljana Marina
- b Clinical Center of Serbia, Institute of Endocrinology, Diabetes and Metabolic Disorders , Dr Subotića 13 , Belgrade , Serbia
| | - Zorana Arizanović
- b Clinical Center of Serbia, Institute of Endocrinology, Diabetes and Metabolic Disorders , Dr Subotića 13 , Belgrade , Serbia
| | - Svetlana Vujović
- b Clinical Center of Serbia, Institute of Endocrinology, Diabetes and Metabolic Disorders , Dr Subotića 13 , Belgrade , Serbia
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Thomas HN, Thurston RC. A biopsychosocial approach to women's sexual function and dysfunction at midlife: A narrative review. Maturitas 2016; 87:49-60. [PMID: 27013288 PMCID: PMC4808247 DOI: 10.1016/j.maturitas.2016.02.009] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/15/2016] [Indexed: 01/21/2023]
Abstract
A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to define sexual function and dysfunction, (b) to present theoretical models of female sexual response, (c) to examine longitudinal studies of how sexual function changes during midlife, and (d) to review treatment options. Four types of female sexual dysfunction are currently recognized: Female Orgasmic Disorder, Female Sexual Interest/Arousal Disorder, Genito-Pelvic Pain/Penetration Disorder, and Substance/Medication-Induced Sexual Dysfunction. However, optimal sexual function transcends the simple absence of dysfunction. A biopsychosocial approach that simultaneously considers physical, psychological, sociocultural, and interpersonal factors is necessary to guide research and clinical care regarding women's sexual function. Most longitudinal studies reveal an association between advancing menopause status and worsening sexual function. Psychosocial variables, such as availability of a partner, relationship quality, and psychological functioning, also play an integral role. Future directions for research should include deepening our understanding of how sexual function changes with aging and developing safe and effective approaches to optimizing women's sexual function with aging. Overall, holistic, biopsychosocial approaches to women's sexual function are necessary to fully understand and treat this key component of midlife women's well-being.
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Affiliation(s)
- Holly N Thomas
- University of Pittsburgh, Department of Medicine, United States.
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Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. Sexual Function and Exercise in Postmenopausal Women Residing in Chalous and Nowshahr, Northern Iran. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e30120. [PMID: 27437131 PMCID: PMC4939225 DOI: 10.5812/ircmj.30120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 06/16/2015] [Accepted: 07/11/2015] [Indexed: 02/05/2023]
Abstract
Background The sexual function of menopausal women is influenced by several factors. Objectives We aimed to investigate the association between exercise and sexual function among postmenopausal women residing in Northern Iran. Patients and Methods Using a multistage, randomized sampling method, 405 postmenopausal women, aged 40 to 65 years, were recruited to participate in this population-based, cross-sectional study. The female sexual function index (FSFI) questionnaire and a researcher-designed questionnaire were completed by every subject. Results Overall, 61% of the women reported having experienced sexual dysfunction, and 53.6% reported that they had not performed any kind of exercise within the last 6 months; among those who did exercise, the most common form was walking (79.8%). The FSFI total scores (P = 0.013), as well as the scores in the lubrication (P = 0.007) and pain (P < 0.001) domains, were significantly lower for the women who performed exercises other than walking compared to those who only walked or who did not exercise at all. The frequency of weekly exercise had a positive correlation with the scores in the lubrication (r = 0.18, P = 0.014) and orgasm (r = 0.146, P = 0.045) domains. The logistic regression analysis demonstrated that the chances of reduced sexual desire were decreased by 80.2% (P = 0.044) with every unit increase in the frequency of weekly exercise. Conclusions More frequent exercise will improve the sexual function of post-menopausal women.
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Affiliation(s)
- Soheila Nazarpour
- Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Masomeh Simbar
- Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Masomeh Simbar, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-212257571, Fax: +98-2188202516, E-mail:
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Carpenter JS, Reed SD, Guthrie KA, Larson JC, Newton KM, Lau RJ, Learman LA, Shifren JL. Using an FSDS-R Item to Screen for Sexually Related Distress: A MsFLASH Analysis. Sex Med 2015; 3:7-13. [PMID: 25844170 PMCID: PMC4380908 DOI: 10.1002/sm2.53] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction The Female Sexual Distress Scale-Revised (FSDS-R) was created and validated to assess distress associated with impaired sexual function, but it is lengthy for use in clinical practice and research when assessing sexual function is not a primary objective. Aim The study aims to evaluate whether a single item from the FSDS-R could be identified to use to screen midlife women for bothersome diminution in sexual function based on three criteria: (i) highly correlated with total scores; (ii) correlated with commonly assessed domains of female sexual functioning; and (iii) able to differentiate between women reporting high and low sexual concerns during the prior month. Methods Data from 93 midlife women were collected by the Menopause Strategies Finding Lasting Answers to Symptoms and Health (MsFLASH) research network. Main Outcome Measures Women completed the FSDS-R, Female Sexual Function Index (FSFI), and Menopausal Quality of Life Scale (MENQOL). Those who reported a change in the past month on the MENQOL sexual were categorized into a high sexual concerns group, while all others were categorized into a low sexual concerns group. Results Women were an average of 54.6 years old (SD 3.1) and mostly Caucasian (77.4%), college educated (60.2%), married/living as married (64.5%), and postmenopausal (79.6%). The FSDS-R item number 1 “Distressed about sex life” was: (i) highly correlated with FSDS-R total scores (r = 0.90); (ii) moderately correlated with FSFI total scores (r = −0.38) and FSFI desire (r = −0.37) and satisfaction domains (r = −0.40); and (iii) showed one of the largest mean differences between high and low sexual concerns groups (P < 0.001). Other FSDS-R items met one or two, but not all three of the prespecified criteria (i, ii, iii). Conclusions A single FSDS-R item may be a useful screening tool to quickly identify midlife women with sexually related distress when it is not feasible to administer the entire scale, though further validation is warranted. Carpenter JS, Reed SD, Guthrie KA, Larson JC, Newton KM, Lau RJ, Learman LA, and Shifren JL. Using an FSDS-R item to screen for sexually related distress: A MsFLASH analysis. Sex Med 2015;3:7–13.
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Affiliation(s)
- Janet S Carpenter
- Science of Nursing Care, School of Nursing, Indiana University Indianapolis, IN, USA
| | - Susan D Reed
- University of Washington School of Medicine Seattle, WA, USA
| | | | | | | | - R Jane Lau
- School of Medicine, Indiana University Indianapolis, IN, USA
| | - Lee A Learman
- School of Medicine, Indiana University Indianapolis, IN, USA
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Randolph JF, Zheng H, Avis NE, Greendale GA, Harlow SD. Masturbation frequency and sexual function domains are associated with serum reproductive hormone levels across the menopausal transition. J Clin Endocrinol Metab 2015; 100:258-66. [PMID: 25412335 PMCID: PMC4283018 DOI: 10.1210/jc.2014-1725] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine whether reproductive hormones are related to sexual function during the menopausal transition. DESIGN The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of the menopausal transition located at seven US sites. At baseline, the 3302 community-based participants, aged 42-52, had an intact uterus and at least one ovary and were not using exogenous hormones. Participants self-identified as White, Black, Hispanic, Chinese, or Japanese. At baseline and at each of the 10 follow-up visits, sexual function was assessed by self-administered questionnaires, and blood was drawn to assay serum levels of T, estradiol, FSH, SHBG, and dehydroepiandrosterone sulfate. MAIN OUTCOME MEASURES Self-reported frequency of masturbation, sexual desire, sexual arousal, orgasm, and pain during intercourse. RESULTS Masturbation, sexual desire, and arousal were positively associated with T. Masturbation, arousal, and orgasm were negatively associated with FSH. Associations were modest. Estradiol was not related to any measured sexual function domain. Pain with intercourse was not associated with any hormone. CONCLUSIONS Reproductive hormones were associated with sexual function in midlife women. T was positively associated, supporting the role of androgens in female sexual function. FSH was negatively associated, supporting the role of menopausal status in female sexual function. The modest associations in this large study suggest that the relationships are subtle and may be of limited clinical significance.
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Affiliation(s)
- John F Randolph
- University of Michigan Health System (J.F.R.), Division of Reproductive Endocrinology and Infertility, Ann Arbor, Michigan 48109; University of Michigan School of Public Health (J.F.R., H.Z., S.D.H.), Department of Epidemiology, Ann Arbor, Michigan 48109; Wake Forest School of Medicine (N.E.A.), Department of Social Sciences and Health Policy, Winston-Salem, North Carolina 27157; and Geffen School of Medicine at University of California Los Angeles (G.A.G.), Los Angeles, California 90095
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Rabiee M, Nasirie M, Zafarqandie N. Evaluation of Factors Affecting Sexual Desire During Menopausal Transition and Post Menopause. WOMEN’S HEALTH BULLETIN 2014. [DOI: 10.17795/whb-25147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Personal factors that contribute to or impair women’s ability to achieve orgasm. Int J Impot Res 2014; 26:177-81. [DOI: 10.1038/ijir.2014.8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 11/07/2013] [Accepted: 02/20/2014] [Indexed: 01/12/2023]
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Gilmore AK, George WH, Nguyen HV, Heiman JR, Davis KC, Norris J. Influences of situational factors and alcohol expectancies on sexual desire and arousal among heavy-episodic drinking women: acute alcohol intoxication and condom availability. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:949-59. [PMID: 23661324 PMCID: PMC3772722 DOI: 10.1007/s10508-013-0109-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Revised: 09/21/2012] [Accepted: 02/13/2013] [Indexed: 05/09/2023]
Abstract
Although studies suggest that alcohol increases women's sexual desire, no studies to our knowledge have examined the effects of acute alcohol intoxication on women's sexual desire. The majority of research examining alcohol's effects on sexual arousal in women suggests that alcohol increases self-reported arousal. In an alcohol administration study in which women projected themselves into an eroticized scenario depicting a consensual sexual encounter with a new male partner, we examined the effects of alcohol and condom condition on women's sexual desire and arousal. The moderating effects of sex-related alcohol expectancies were also examined. Results revealed that alcohol intoxication was related to less desire to engage in sex with a new partner and condom presence was related to more desire. Alcohol interacted with sexual disinhibition alcohol expectancies, indicating that more expectancy endorsement was associated with greater sexual desire and self-reported arousal in the alcohol condition, but not the control condition. Condom condition had no effect on self-reported sexual arousal. The present research suggests that sexual desire merits research attention in non-clinical samples, and experimental methodology can provide valuable information about alcohol's influence on women's sexual desire, thus advancing our understanding of this relationship beyond cross-sectional correlations. The current findings also provide evidence that sex-related alcohol expectancies may play an important role in alcohol-involved sexual experiences including desire and arousal.
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Affiliation(s)
- Amanda K Gilmore
- Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA.
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Urogenital consequences in ageing women. Best Pract Res Clin Obstet Gynaecol 2013; 27:699-714. [PMID: 23764480 DOI: 10.1016/j.bpobgyn.2013.03.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 02/20/2013] [Accepted: 03/22/2013] [Indexed: 12/18/2022]
Abstract
Various anatomical, physiological, genetic, lifestyle and reproductive factors interact throughout a woman's life span and contribute to pelvic floor disorders. Ageing affects pelvic floor anatomy and function, which can result in a variety of disorders, such as pelvic organ prolapse, lower urinary tract symptoms, dysfunctional bowel and bladder evacuation, and sexual dysfunction. The exact mechanisms and pathophysiological processes by which ageing affects pelvic floor and lower urinary and gastrointestinal tract anatomy and function are not always clear. In most cases, it is difficult to ascertain the exact role of ageing per se as an aetiological, predisposing or contributing factor. Other conditions associated with ageing that may co-exist, such as changes in mental status, can result in different types of pelvic floor dysfunction (e.g. functional incontinence). Pelvic organ dysfunction may be associated with significant morbidity and affect quality of life. These groups of patients often pose difficult diagnostic and therapeutic dilemmas owing to complex medical conditions and concurrent morbidities. In this chapter, we summarise the current evidence on the management of pelvic floor disorders, with emphasis on elderly women and the associations between the ageing process and these disorders. Clinicians with an understanding of the affect of ageing on the pelvic floor and lower urinary and gastrointestinal tract anatomy and function, and the complex interplay of other comorbidities, will be able to investigate, diagnose and treat appropriately there women. A holistic approach may result in substantial improvements in their quality of life.
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Ornat L, Martínez-Dearth R, Muñoz A, Franco P, Alonso B, Tajada M, Pérez-López FR. Sexual function, satisfaction with life and menopausal symptoms in middle-aged women. Maturitas 2013; 75:261-9. [PMID: 23684086 DOI: 10.1016/j.maturitas.2013.04.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/11/2013] [Accepted: 04/12/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To assess sexual function, satisfaction with life (SWL), and menopause-related symptoms among mid-aged Spanish women. MATERIALS AND METHODS Cross-sectional study of 260 women, aged 40-59, attending the public gynecology consultations completed the 14-item Changes in Sexual Functioning Questionnaire (CSFQ-14), the SWL Scale (SWLS), the Menopause Rating Scale (MRS), and a socio-demographic questionnaire. RESULTS Median [inter quartile range] age was 47 [8.0] years, 87.7% had a stable partner, 27.0% were postmenopausal, and 53.9% had increased body mass index (BMI). The prevalence of sexual dysfunction was 46.5% (CSFQ-14 score≤41). Postmenopausal status was associated with lower CSFQ-14 scores (worse sexual function) and severe menopausal symptoms whereas there were not significant differences in SWLS scores. CSFQ-14 scores correlated with SWLS (p<0.04), and inversely correlated with menopausal symptoms (p<0.02). Multiple linear regression analysis model predicted 26.6% of the total CSFQ-14 score variance, and higher scores (better sexual function) were correlated with better SWL, and inversely correlated to female age and worse menopausal symptoms. A second model predicted 38.4% of the SWLS score variance. The SWLS score correlated with the total CSFQ-14 score and BMI, and inversely correlated with economical problems, female tobacco use, lack of healthiness, menopausal symptoms, not having a partner, and partner's lack of healthiness. CONCLUSIONS Lower sexual function was related to low SWL, age and menopausal symptoms while low SWLS score was related with economical problems, smoking, menopausal symptoms, and partner factors.
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Affiliation(s)
- Lía Ornat
- Área Sanitaria III, Department of Obstetrics and Gynecology, Lozano Blesa University Hospital, Zaragoza, Spain
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Treatment options for depression during the menopausal transition. JAAPA 2013; 26:40-4. [DOI: 10.1097/01720610-201304000-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE The aim of this study was to examine the relationship between reproductive history and menopausal symptoms among urban women. METHODS This was a cohort study of women aged 35 to 47 years recruited in Philadelphia, PA. Two hundred ninety-one premenopausal women meeting the study eligibility criteria and contributing reproductive health history and infertility information completed the assessments of occurrence and severity of several menopausal symptoms over a 14-year period. Reproductive history included the number of pregnancies, live births, preterm deliveries, and miscarriages. Trying to get pregnant for more than 1 year was used as an assessment of infertility. The occurrence of severe hot flashes, vaginal dryness, and decreased libido was evaluated. RESULTS Women scoring positive on the infertility index were significantly more likely to report severe decreased libido (odds ratio [OR], 1.86; 95% CI, 1.05-3.31) and were more than twice as likely to report severe vaginal dryness (OR, 2.79; 95% CI, 1.19-6.94) in multivariable models. None of the other reproductive health indices were related to the report of severe hot flashes, vaginal dryness, or decreased libido. The race-specific models continued to find a significant increased risk of severe vaginal dryness (OR, 2.79; 95% CI, 1.22-6.36) and decreased libido (OR, 1.87; 95% CI, 1.04-3.34) among white women scoring positive on the infertility index; however, the relationship did not remain significant among African American women. CONCLUSIONS Severe vaginal dryness and decreased libido are common and important considerations of the menopausal transition, and the experience of infertility problems may influence the report of severe vaginal dryness and decreased libido particularly among white women.
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Depressive disorders and the menopause transition. Maturitas 2012; 71:120-30. [DOI: 10.1016/j.maturitas.2011.11.017] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 11/18/2011] [Indexed: 11/22/2022]
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