Two million American women experiencing menopause this year want to know—how does "menopause" affect sex? According to scientists at the New England Research Institute (NERI) and the University of Massachusetts Medical School, Worcester, menopause may be related to lower sexual desire and to reports of being less easily sexually aroused than when younger. However, general health and social factors, such as marital status, at this age have a greater effect on sexual functioning than a woman's reduced production of the sex hormone estrogen that comes with menopause.
These findings were reported in the September/October 2000, issue of Menopause . The research, conducted by Nancy E. Avis, PhD; Rebecca Stellato, MA; Sybil Crawford, PhD; and Catherine Johannes, PhD; of NERI and Christopher Longcope, MD, of the Departments of Medicine and Obstetrics and Gynecology, University of Massachusetts Medical School, was supported by the National Institute on Aging (NIA).
These scientists analyzed data from 200 women, average age 54, already participating in the Massachusetts Women's Health Study II, a population-based sample of Massachusetts women transitioning through menopause. These women were pre-, peri-, or naturally postmenopausal, did not use hormone replacement therapy, and had a sexual partner. Beginning in 1986, they were interviewed, and blood samples were obtained to measure estrogen and FSH (follicle-stimulating hormone) levels. FSH helps stimulate the ovaries to release a new egg from a follicle each month. The women were classified as to whether they were premenopausal (still having menstrual cycles), perimenopausal (experiencing bleeding in the past 12 months, but not within the past 3), or postmenopausal (12 months without a menstrual period).
"Scientists have documented that some of the physical effects of diminished estrogen levels-- vaginal dryness and pain during intercourse—may affect a woman's sexual activity. This study is the first to examine a range of social and psychological factors, as well as health issues, in a representative sample of healthy women and to define how they relate to sexual functioning as women end their reproductive years," commented Dr. Marcia Ory, Chief, Social Science Research on Aging, Behavioral and Social Research, National Institute on Aging. This research was part of the NIH-supported Study of Women's Health Across the Nation (SWAN), a large-scale national effort to examine the health of women in their 40's and 50's, with special emphasis on the physical, psychological, and social changes that take place at mid-life.
Although the investigators found that reaching menopause influenced women's beliefs about aging and interest in sex, it did not contribute to how often the women had sexual intercourse, whether they were happy with their sexual relationship, whether they had problems having orgasms, or whether they experienced pain during or after intercourse.
If diminished levels of estrogen contributed to lessened sexual interest and activity, there should be a direct relationship between estrogen levels and sexual functioning. The researchers found that lower estrogen levels were only related to pain with intercourse. Therefore, hormonal levels, health and social changes associated with aging, and the mental and emotional effects of being recently menopausal probably work together to create any changes in a woman's sexual interest that occur at the time of menopause. Longer-term studies could determine whether reduced estrogen production does affect a woman's sexual functioning as she gets farther from menopause.
Many people think of menopause as the period in a woman's reproductive life when she is experiencing irregular menstrual cycles and hot flashes. Actually, menopause is the time of a woman's final menstrual cycle. Hormonal changes leading up to menopause begin to occur well before this time. Her ovaries are depleted of eggs, and her body is producing only very limited amounts of estrogen. Menopause usually occurs around the age of 51. It cannot be determined until a woman has been without a period for 12 months.
*N.E. Avis, R. Stellato, S. Crawford, C. Johannes, and C. Longcope, "Is There an Association Between Menopause Status and Sexual Functioning?" Menopause , 7:5, pp. 297-309, 2000.
The National Institute on Aging, part of the National Institutes of Health (NIH), leads the Federal effort supporting basic, clinical, epidemiological and social research on aging and the special needs of older people.