An Italian study highlights a link between a treatable condition called vaginal atrophy and a high number of women transitioning to menopause that are experiencing sexual dysfunction.
Perimenopause & Sexual Function
Perimenopause is a transition that takes place over several years, where the ovaries gradually begin to make less estrogen. It lasts until menopause when the ovaries completely stop releasing eggs. Perimenopause usually starts for women in their 40s but it can start when they are in 30s or even earlier.
A new cross-sectional study by Italian investigators points to a link between perimenopause and a sharp decline in sexual function. The results of the investigation were published in Menopause which stated that a treatable condition called vaginal atrophy has had the most impact on this negative trend.
The study enrolled 518 women aged 40 to 55 years at 30 centers across Italy. Researchers analyzed relationships between vaginal atrophy, the symptoms associated with it and the Female Sexual Function Index (FSFI) score of the patient. FSFI is a validated questionnaire that is composed of 19 questions around the domains of sexual satisfaction, lubrication, Dyspareunia (painful intercourse), orgasm, arousal, and desire. The score is the overall sexual function of the patient and can range from two to 36.
Vaginal atrophy, or Atrophic vaginitis, is when a woman’s body is producing less estrogen and experiences thinning, drying or inflammation of the vaginal walls. Vaginal atrophy is defined as the presence of a pH of less than five, where the patient is experiencing subjective vaginal dryness and that is objectively assessed by a medical doctor. Mucosal pallor, dryness, thinning of vaginal Rugae, mucosal fragility and presence of petechiae were the signs considered. Vaginal atrophy most often occurs after menopause and it may make intercourse painful or lead to distressing urinary symptoms.
Overall, 70.6% of participants had sexual dysfunction, as defined by an FSFI score of less than 26.55. It was seen in 55% of those aged 40 to 45, compared with 82.8% of those aged 52 to 55. From 48 to 51 versus 46 to 48 years as well as 48 to 51 vs. 52 to 55, the mean FSFI score and sexual dysfunction increased.
Factors like age, weight, ex-smoking status, sedentary lifestyle, menopausal status, subjective vaginal dryness, Dyspareunia, and vaginal atrophy were all inversely related to a woman’s FSFI score. The presence of vaginal dryness, vaginal atrophy and age were all individual determinants of FSFI. The score was independently correlated with weight, menopausal status, and vaginal dryness.
Vaginal atrophy was the only variable that correlated independently with each FSFI domain including desire, arousal, lubrication, orgasm, satisfaction, and Dyspareunia. The authors of the study concluded that it is the symptom most closely related to all domains of female sexuality. They believe that prospective studies are needed to determine whether selective treatment of vaginal dryness improves female sexual function in perimenopausal women.
According to the North American Menopause Society Medical Director, Dr. Stephanie Faubion, “Given the high prevalence of sexual dysfunction in women, identifying an eminently treatable contributing factor such as vaginal dryness may allow women to maintain their sexual function during the menopause transition.”
Vaginal atrophy can be uncomfortable and frustrating, but it is treatable. Viable treatment prospects like estrogen therapy or the Mona Lisa Touch are options for our patients with vaginal atrophy. If you have any questions, please call our office today at 530-345-0064, extension 281. We can assess your symptoms, run tests, find causes and find a treatment plan that works for you.
- Cagnacci A, Venier M, Xholil A, et al. Female sexuality and vaginal health across the menopausal age, Menopause, 2019.
- Orvos A, Judith, ELS, Perimenopause’s negative impact on sexual function, Sexual Health Updates, 2019.