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Sexual orientation affects sexual function in peri- and postmenopausal women

Women with same-sex attractions or partners are more likely to be sexually active with better sexual functioning and less pain during sexual activity.

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Sexual function changes with age, with some of the most dramatic changes occurring around the time of the menopause transition. A new study sought to determine whether sexual function, as well as accompanying adverse mental and physical health outcomes during menopause, differed by sexual orientation.

It’s no secret that, for many women, sexual function declines with age. An estimated 25% to 85% of postmenopausal women report challenges with sexual function. Evidence suggests that sexual minority women (SMW), a term encompassing a range of sexual orientations for women with same-sex attractions or partners, may have an increased risk of adverse mental and physical health outcomes in and after the menopause transition, including more severe menopause symptoms. However, research also suggests that SMW demonstrate more resilience during the menopause transition.

Overall research regarding SMW’s experiences of menopause, however, is extremely limited. A new study involving nearly 200 women veterans aimed to help fill that gap and identify what differences exist in the menopause experience relative to sexual function by sexual orientation. The researchers found that midlife and older SMW veterans were more likely to be sexually active and reported better sexual functioning and less pain during sexual activity compared with their heterosexual peers. Sexual minority women were also less likely to report some vaginal symptoms.

“Although not tested, we believe that SMW with same-sex partners may have more favorable sexual function outcomes during the menopause transition due to greater variation in sexual behaviors, compared to heterosexual women who are likely to engage in penetrative sex with men,” says Dr. Anna Blanken, lead author of the study from the San Francisco VA Health Care System. “Additionally, our data suggest that psychosocial factors such as depression, anxiety, and trauma may have greater impact on sexual function of heterosexual women, compared to SMW.”

“This study supports the value of healthcare professionals having open conversations with their patients so that they can better understand their lifestyles and preferences in order to offer appropriate treatment and care options,” says Dr. Stephanie Faubion, NAMS medical director.


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