Menopause is the point in a woman’s life when she permanently stops having her period. Specifically, it occurs 12 months after a woman’s last period, but most women go through a transition called perimenopause that lasts several years.

During the menopausal transition, women may experience changes in their cycle, hot flashes, and changes in their sexual function including decreased lubrication, increased dyspareunia (pain during intercourse), and decreased sexual desire. Menopause and perimenopause are also associated with an increase in mental health conditions like depression and anxiety.

Certainly, not all menopausal women experience sexual dysfunction nor a mood disorder, and these health issues can affect women of all ages. However, given the increased prevalence of sexual dysfunction and mood disorders in women who are going through menopause, it is important to explore the potential causes.

A recent systematic scoping review in The Journal of Sexual Medicine did just that by compiling and analyzing the results of 19 peer-reviewed studies on sexual dysfunction and mood disorders in menopausal women. The result was a set of (menopause-related) factors that affect sexual function, a set of factors that affect mood, and a set of factors that affect both sexual function and mood. The following are the factors that were identified as affecting both sexual functioning and mood:

Age: As women age, their sexual functioning tends to decline because their bodies are producing fewer sex hormones, which prompts decreases in lubrication, sexual desire, and the elasticity of the vaginal tissues as they become thinner and more fragile. These declines in sex hormones, as well as potential losses in health and familial or social roles, may also negatively impact mood.

Attitudes toward menopause: The studies included in this review consistently showed that more positive attitudes toward menopause were associated with better sexual functioning scores (i.e., higher desire, arousal, orgasm, and satisfaction scores, as well as lower sexual pain scores). Conversely, more negative attitudes toward menopause were associated with lower sexual functioning scores and more depressive symptoms. Of course, it is impossible to know whether one’s attitude about menopause influences their experience with it, or if the attitude is the result of their overall experience with the transition (be it positive with few symptoms or negative with severe symptoms). 

Severity of menopausal symptoms: Perhaps unsurprisingly, severe menopausal symptoms are related to worse sexual functioning and greater depression.

Feelings of unattractiveness: Unfortunately, people (especially women) are often exposed to the message that beauty and attractiveness are synonymous with youth. As such, menopausal women may experience feelings of unattractiveness or negative body image that may cause them to avoid sex with a partner or enjoy intimacy less due to concerns about how they look. These feelings are also associated with mood disorders like anxiety and depression.

In the end, the results of this study confirmed that there is an association between sexual dysfunction and mood disorders in menopausal women, but the research on this topic is still limited. As more is known about the connection between these two important health issues and the factors that impact both, more can be done to support menopausal women with their sexual function and mental health during this time of transition.

References:

• Rahmani, A., Afsharnia, E., Fedotova, J., Shahbazi, S., Fallahi, A., Allahqoli, L., Ghanei-Gheshlagh, R., Abboud, S., & Alkatout, I. (2022). Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. The Journal of Sexual Medicine, 19(7), 1098-1115. DOI: https://doi.org/10.1016/j.jsxm.2022.03.614