Why sexual activity declines in some women in middle age

As women age, sexual activity typically declines. But that doesn't necessarily mean they are no longer interested in sex. The problem for many is physical. A new study demonstrates the impact on sexual activity of postmenopausal women as a result of vulvovaginal atrophy and lower urinary tract problems. The study results will be presented during The North American Menopause Society (NAMS) Annual Meeting in Philadelphia, October 11-14.

In recent years the medical community adopted the terminology "genitourinary syndrome of menopause" (GSM) to more accurately refer to the collective vaginal and bladder problems that affect many women during menopause. In simpler terms, GSM includes symptoms of painful sex as a result of a thinning of the vaginal walls, along with bladder problems that can lead to urine leakage during sexual activity, as well as during other unpredictable times. As part of this new study, researchers assessed the impact of these symptoms on a woman's ability to be sexually active and enjoy the sexual experience.

More than 1,500 women completed a questionnaire regarding their sexual activity. While both vulvovaginal atrophy and bladder problems negatively impacted sexual enjoyment and frequency of activity, the fear of experiencing pain during sex was reported as a reason for avoiding or restricting activity more often (?20%) than bladder problems, such as fear of wetting the bed or having to interrupt activity to go to the bathroom (?9%).

"Our findings underscore the need to further expand the sexual history after a woman reports that she is not currently sexually active," says Dr. Amanda Clark, lead author of the study from the Kaiser Permanente Center for Health Research in Portland, Oregon.

"This study provides just one more reason why healthcare providers need to have an open and honest discussion with peri- and postmenopausal women so that appropriate treatments options can be evaluated," says Dr. JoAnn Pinkerton, NAMS executive director.

Drs. Clark and Pinkerton are available for interviews before the presentation at the Annual Meeting.