A longitudinal study of the effects of menopause on sexuality

doi:10.1016/0378-5122(85)90041-6

Maturitas

Volume 7, Issue 3, September 1985, Pages 203-210

https://doi.org/10.1016/0378-5122(85)90041-6 Get rights and content

Abstract

From an initial group of 39, 16 cycling peri-menopausal women completed a longitudinal study in which they recorded menstrual and sexual behavior daily and were interviewed at roughly 4-mth intervals until 1 yr or more without cycling. At each interview women gave 20-ml blood samples, completed sexuality questionnaires, and rated themselves for menopausal symptoms. As predicted, the difference in weekly rate of sexual intercourse before and after the cycle showed a significant decline (P < 0.05). For each subject, mean weekly rates of sexual intercourse for 13-wk periods over the entire transition period were plotted and the slope of the line was calculated. Overall, the mean slope was negative, as predicted, and was significantly different from zero (P < 0.05). The questionnaire data showed that compared with their pre-menopause data, the women had fewer sexual thoughts or fantasies (P < 0.001), suffered more from lack of vaginal lubrication during sex (P < 0.01), and were less satisfied with their partners as lovers (P < 0.05) after menopause. While estradiol (E) and testosterone (T) levels showed significant declines (P < 0.002), testosterone showed the most consistent association with coital frequency. The findings generally supported our initial hypothesis of a decline in sexual interest and coital frequency after menopause.

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Cited by (227)

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From previous studies, we hypothesized that olfactory exposure to β-caryophyllene stimulates women's libido. However, Japan's sex culture is so closed that it is difficult to test this possibility without accumulating scientific evidence. Therefore, it is necessary to measure the concentration of sex-related hormones in saliva, an experimental technique that is relatively easy to obtain research permission, and to obtain a scientific basis to convince ethics committee reviewers.
The aim of this study is to investigate whether β-caryophyllene increases salivary testosterone concentrations associated with libido and vaginal sensation during intercourse in women.
19 women in the follicular phase of the menstrual cycle participated in the study. The subjects then sat in front of the odor exposure device we had created. Each subject was exposed to dipropylene glycol for 20 minutes, followed by 3% β-caryophyllene for 20 minutes. Saliva was collected 4 times: before and after control exposure, and before and after β-caryophyllene exposure.
Salivary testosterone and estrogen concentrations were measured with a competition ELISA.
β-caryophyllene significantly increased the salivary concentration of testosterone (control vs β-caryophyllene; 0.97 ± 0.05 vs 1.13 ± 0.03, P = .00, 95% confidence interval of control: 0.84–1.09, 95% confidence interval of β-caryophyllene: 1.04–1.20) but not estrogen (control vs β-caryophyllene; 1.05 ± 0.03 vs 1.07 ± 0.04, P = .69, 95% confidence interval of control: 0.96–1.12, 95% confidence interval of β-caryophyllene: 0.98–1.15).
The personal preferences of the subjects and the order of exposure may have affected the results.
β-caryophyllene may be a remedy with fewer side effects for women with decreased libido. We believe that β-caryophyllene may be a remedy for women with decreased libido. However, this hypothesis must be tested by further clinical studies.
Wataru Tarumi, Kazuyuki Shinohara. Olfactory Exposure to β-Caryophyllene Increases Testosterone Levels in Women's Saliva. J Sex Med 2020;8:525–531.
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2017, Hormones and Behavior
Hormones orchestrate and coordinate human female sexual development, sexuality, and reproduction in relation to three types of phenotypic changes: life history transitions such as puberty and childbirth, responses to contextual factors such as caloric intake and stress, and cyclical patterns such as the ovulatory cycle. Here, we review the endocrinology underlying women's reproductive phenotypes, including sexual orientation and gender identity, mate preferences, competition for mates, sex drive, and maternal behavior. We highlight distinctive aspects of women's sexuality such as the possession of sexual ornaments, relatively cryptic fertile windows, extended sexual behavior across the ovulatory cycle, and a period of midlife reproductive senescence—and we focus on how hormonal mechanisms were shaped by selection to produce adaptive outcomes. We conclude with suggestions for future research to elucidate how hormonal mechanisms subserve women's reproductive phenotypes.
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Chromosomal and Endocrinological Origins of Sex
2016, Sex Differences In Physiology
Sexual differentiation begins in utero with the sex chromosomes dictating subsequent endocrine and physiological effects. Distinctly timed events influence each subsequent developmental phase. Although the sex-dependent developmental paths typically occur in predicted patterns, individual and environmental variations may produce alterations in the expected sex-typical profiles. As aging progresses, males and females experience varying endocrine fluctuations, some with far-reaching consequences and the roots of these variations may be grounded in prior developmental events. In order to understand, study, and treat diseases and disorders that are impacted by sex, an appreciation of the mechanisms of organizational differences between the sexes is essential.
Androgens and Female Sexual Function and Dysfunction-Findings From the Fourth International Consultation of Sexual Medicine
2016, Journal of Sexual Medicine
Citation Excerpt :
In 1986, Alder et al24 observed that low libido during lactation was associated with low E2 and T levels, and Appelt and Strauss25 reported an adverse effect of antiandrogen therapy on libido in women. In separate small studies, low T was associated with low coital frequency26 and loss of desire.27 In contrast, Bancroft and Cawood28 found no association between sex steroids and sexual function in a study of 141 women 40 to 60 years old.
Androgens have been implicated as important for female sexual function and dysfunction.
To review the role of androgens in the physiology and pathophysiology of female sexual functioning and the evidence for efficacy of androgen therapy for female sexual dysfunction (FSD).
We searched the literature using online databases for studies pertaining to androgens and female sexual function. Major reviews were included and their findings were summarized to avoid replicating their content.
Quality of data published in the literature and recommendations were based on the GRADES system.
The literature supports an important role for androgens in female sexual function. There is no blood androgen level below which women can be classified as having androgen deficiency. Clinical trials have consistently demonstrated that transdermal testosterone (T) therapy improves sexual function and sexual satisfaction in women who have been assessed as having hypoactive sexual desire disorder. The use of T therapy is limited by the lack of approved formulations for women and long-term safety data. Most studies do not support the use of systemic dehydroepiandrosterone therapy for the treatment of FSD in women with normally functioning adrenals or adrenal insufficiency. Studies evaluating the efficacy and safety of vaginal testosterone and dehydroepiandrosterone for the treatment of vulvovaginal atrophy are ongoing.
Available data support an important role of androgens in female sexual function and dysfunction and efficacy of transdermal T therapy for the treatment of some women with FSD. Approved T formulations for women are generally unavailable. In consequence, the prescribing of T mostly involves off-label use of T products formulated for men and individually compounded T formulations. Long-term studies to determine the safety of T therapy for women and possible benefits beyond that of sexual function are greatly needed.
Testosterone Therapy for Female Sexual Dysfunction
2015, Sexual Medicine Reviews
Citation Excerpt :
Androgens play a key role in female sexual pathophysiology. Low testosterone levels in postmenopausal women have been associated with loss of sexual desire and sexual pleasure, persistent fatigue, and feeling of diminished physical well-being [11-14]. Heard-Davison and colleagues have shown that increasing testosterone levels in postmenopausal women increased vaginal blood flow 4.5 hours after the dose [15].
Female sexual dysfunction (FSD) is a common condition that affects 9% to 43% of the female population. Some studies have found that over 50% of women suffer from FSD. Testosterone has been prescribed to women for decades throughout the world and has more recently been used to treat women with FSD. Currently, testosterone is not FSA approved in the United States and is used off-label in women.
The aim of this study is to provide an overview of the current literature regarding the use of testosterone therapy (TTh) for the treatment of FSD.
PubMed searches through 2014 were conducted using terms “female sexual dysfunction,” “testosterone,” and “androgens.” Expert opinion was based on review of the relevant scientific and medical literature.
Treatment of FSD with TTh from peer-reviewed published literature was assessed. In addition, diagnosis, treatment options, and adverse effects of TTh were also assessed.
The use of testosterone has been shown to improve components of FSD including sexual desire, arousal, pleasure, and overall satisfaction. While there can be adverse effects associated with TTh such as acne and hirsutism, there are no compelling data to support that TTh causes any type of cancers, such as breast cancer or endometrial cancer.
TTh appears to be safe and effective in improving FSD. Khera M. Testosterone therapy for female sexual dysfunction. Sex Med Rev 2015;3:137–144.

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A longitudinal study of the effects of menopause on sexuality

Abstract

Clin Obstet Gynecol

Sexual behavior in the human female

The sexual psychoendocrinology of aging