Midlife sexual health boosts for nonheterosexual women reported

Midlife sexual health boosts for nonheterosexual women reported | Image Credit: © Pixel-Shot - © Pixel-Shot - stock.adobe.com.

Sexual function during menopause years may be improved among nonheterosexual women, according to a recent study published in Menopause, the journal of The Menopause Society.¹

Challenges with sexual function occur in approximately 25% to 85% of postmenopausal women. These issues include pain with sex, difficulty with desire or libido, and stress toward sexual response, often leading to lasting impacts on sexual well-being and quality of life.

Mental and physical health is often worsened in nonheterosexual women because of barriers and discrimination within the health care system. However, this population may experience improvements in sexual function, based on data from female Veterans.

Investigators conducted a study to compare sexual function and related menopause symptoms between sexual minority women (SMW) and heterosexual women.² Participants included cisgender US women Veterans aged 45 to 64 years between March 2019 and May 2020.

Eligibility criteria included having at least 1 clinical encounter at a Veterans Health Administration (VHA) facility within 2 years of data collection and not being diagnosed with dementia or active psychosis. Data was obtained from Web- or mail-based questionnaires completed by participants.

Items on the survey were related to participant demographics, military history, menopause-related experiences, symptoms and onset date, general health problems, and mental health experiences. Postmenopausal status was determined by having no menstrual cycle in the previous 12 months.

Sexual orientation was determined through the question, “Do you think of yourself as:” with responses including “lesbian, gay, or homosexual,” “straight or heterosexual,” “bisexual,” “something else,” and “I don’t know.” Participants selecting “something else” elaborated in an open response. These responses were used to place women in the SMW or heterosexual group.

Vaginal symptoms were assessed using the 6-item Sexual Function subscale of the Day-to-Day Impact of Vaginal Aging Questionnaire (DIVA), while distress about sexual function was assessed using the Female Sexual Distress Scale–Revised edition (FSDS-R). Genitourinary symptoms were reported in structured-item questions, and additional questions asked about sexual activity.

There were 230 women aged a mean 56 years included in the final analysis. Of women, 73% were postmenopausal, 73% White, 10% Black, 4% Asian, 13% other race or multiracial, 75% heterosexual, and 25% SMW.

A vaginal symptom in the past month was reported by 75% of patients, and sexual activity within the past month was reported by 48%. FSDS-R scores indicating sexual functioning distress were identified in 80%. Overall, vaginal symptoms had a low impact on sexual health and functioning.

Demographic characteristics did not significantly differ between groups. However, engagement in sexual activity within the past month was more common in SMW, at 65% vs 47% for heterosexual women. Pain during sexual activity was less common in these women, at 12% vs 48%, respectively. Vaginal symptoms were reported in 10% and 49%, respectively.

DIVA scores indicated a reduced association between vaginal symptoms and sexual function in SMW vs heterosexual women. However, significant differences were not observed for FSDS-R scores.

Past-month sexual activity was twice more likely in SMW vs heterosexual women, with an odds ratio (OR) of 2.20. For pain during sexual activity, the OR was 0.07, indicating reduced odds.

These results indicated less sexual dysfunction and a greater chance of being sexually active among midlife SMW compared to their heterosexual counterparts. Investigators concluded the impact of sexual health and functioning may vary based on sexual identity.

References

1. Nonheterosexual women may maintain better sexual functioning during menopause transition. The Menopause Society. December 18, 2024. Accessed December 23, 2024. https://www.eurekalert.org/news-releases/1068602
2. Muratore LA, Blanken AE, Huang AJ, Gibson CJ. Sexual orientation and sexual functioning in midlife women veterans. Menopause. 2024. doi:10.1097/GME.0000000000002449