A new analytical study using data from Study of Women’s Health Across the Nation (SWAN) has found the time of sexual function decline in women undergoing menopause – from the time of woman’s last period till one year, there is a drop 0.35% in sexual function scores. The scores continue to fall further but at a slower rate.
Dr JoAnn Pinkerton, MD, who is the executive director of the North American Menopause Society (NAMS) and the lead author of the study, says, “This study highlights the need for healthcare providers to have open conversations with their patients about their sexual issues, because there are many options for women to help maintain or improve their sexual lives as they transition to and beyond menopause.”
The study was designed using data from the SWAN and provides a detailed timetable of decline in sexual desire after menopause.
The menstrual cycle in women is regulated by the follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones make the ovaries release eggs to the uterus for fertilization. In contrast, the ovaries release the sex hormones estrogen and progesterone.
Menopause is the state in women when they stop ovulating due to hormonal changes in their body. It is a natural process and occurs after a woman has crossed the age of 50.
As part of a natural aging process the oocytes in the ovaries get slowly depleted and this causes an increase in FSH and LH but a decrease in estrogen. This decline in estrogen badly affects women’s bodies as they develop many health problems.
Normally women undergoing menopause face a lot of emotional changes as well. They experience hot flushes, night sweats and a change in mood and emotions. Due to these situations, menopause is very challenging for women.
Another challenge women face is a decrease in libido. The researchers at NAMS gathered data from nearly 1,400 women who were undergoing menopause, naturally or due to hysterectomy. They reported no decline in sexual functions until about 20 months before the last menstrual period.
The women reported a decline of 0.35% in sexual function scores until one year after the last menstrual cycle which continued to decline in the next year too but at a slower rate. The decline was accelerated in Japanese women, less in white women and lowest in black women.
All in all, sexual functions keep lowering for five years after last menstrual cycle. Moreover, the women who had a hysterectomy before the onset of menopause did not show a decline in sexual desire before surgery but experienced a decline afterwards.
The study was published in Menopause, a journal by (NAMS).
Menopause is associated also with vaginal dryness and emotional disturbances but these factors or surgery do not explain the effect of menopause on sexual decline. However, 75% of the women in the study indicated concern about this issue because they viewed sex as important in their life.
Can Hormonal Replacement Therapy Resume Sexual Function In Menopausal Women?
Hormonal Replacement Therapy (HRT) is suggested to women who have reached menopause. Because menopause decreases the production of estrogen in the body, it can put them at increased risk of heart diseases, osteoporosis and dementia.
For the very specific purpose of increasing estrogen, women are recommended estrogen replacement therapy which includes estradiol in the form of oral pills or a vaginal ring or patch.
The goal of HRT is too relieve menopausal symptoms in women like hot flushes, mood disorders, sleep disturbances, osteoporosis and vaginal atrophy, which is the thinning of the vaginal walls.
Estrogen replacement therapy (ERT) is the most common HRT among women which resumes and boosts sexual function in women. Studies have shown repeatedly that women taking HRT show an increase in sexual desire and researchers say that the therapy which contains estrogen and progesterone can help women increase their libido in addition to restoring vaginal cells pH and blood flow.
Conversely, another form of HRT are testosterone patches, which can also boost libido in women. Researchers say that the patches, which can be worn anywhere on the skin, result in an increase in sexual satisfaction in women with hypoactive sexual desire disorder and a decrease in psychological stress.
The combination of ERT and testosterone therapy was shown to have better effects than either of the therapies. There was also an improvement in self-esteem and emotional well-being though it requires regular monitoring of androgen serum levels.
However, opinion of experts over HRT is divided. They say that patients should carefully consider these treatments as they can also increase the risks of certain cancers because estrogen is a growth factor and can stimulate tumor growth as well. In addition, any extra testosterone in women can make them grow facial hair and acne so HRTs should be used with consideration.