The relative effects of hormones and relationship factors on sexual function of women through the natural menopause

Office for Gender and Health, Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.
Fertility and sterility (Impact Factor: 4.59). 08/2005; 84(1):174-80. DOI: 10.1016/j.fertnstert.2005.01.119
Source: PubMed


To investigate the relative effects of hormonal and relationship factors on female sexual function during the natural menopausal transition.
Prospective population-based questionnaire study.
Interviews were conducted in the patients' homes.
Four hundred thirty-eight Australian-born women aged 45-55 years who were still menstruating at baseline. Eight years of longitudinal data were available for 336 of these women, none of whom were hysterectomized.
Hormonal levels, age, menopausal status, partner status, and feelings for partner were measured and evaluated with longitudinal structural equation modeling.
Short personal experiences questionnaire.
Sexual response was predicted by prior level of sexual function, change in partner status, feelings for partner, and E2 level (R2 = .65); dyspareunia was predicted by prior level of dyspareunia and E2 level (R2 = .53); and frequency of sexual activities was predicted by prior level of sexual function, change in partner status, feelings for partner, and level of sexual response (R2 = .52). The minimum effective dose needed to increase sexual response by 10% (700 pmol/L E2) is twice that needed to decrease dyspareunia.
Prior function and relationship factors are more important than hormonal determinants of sexual function of women in midlife.

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    • "To examine the role of relationship factors in women's sexual functioning at mid-life, an Australian study interviewed 438 women between 45 to 55 years who were still menstruating at the time of their baseline interview and eight years of longitudinal data were available for 336 of these women.[22] Sexual response as well as frequency of sexual activity was found to be predicted by prior level of sexual function, change in partner status, feelings for partner, and estrogen level. "
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    ABSTRACT: Women's sexuality is highly capricious and multifaceted. Sexual functioning is an imperative component of women's lives and has progressively received public health, medical and even pharmaceutical attention. Sexual functioning, however, declines with age, leading to much debate about the contribution of menopause to sexual activity and functioning among women. The past two decades have witnessed an explosion of research into female sexuality. It is now understood that healthy and satisfying sexual function may extend all through the life cycle, and does not finish with end of child bearing years. Very few women's healthcare physicians are adequately trained to monitor a woman's sexual health through her menopausal transition and beyond, much less how to treat the sexual problems that can arise during this special time. The strong association of physical health and psycho-social factors with sexual functioning accentuates the clinical domineering to explore these factors when discussing women's apprehensions regarding sexual dysfunction. It is need of hour to create scientific evidence to help women's health care physicians understand the requirements of women in these special years of her life and help deliver the care they need and so rightly, deserve.
    03/2012; 3(2):61-65. DOI:10.4103/0976-7800.104452
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    • "Therefore, it seems that labia minora vascularization is sensitive to estrogen modifications . These findings suggest that the maximal genital ''responsivity'' (Dennerstein et al., 2005) may be reached in the periovulatory period (Battaglia et al., 2008, 2009b). Although in the present study possible bias may be present (the empirical definition of normo-ovulatory women and the fact that a translabial approach does not assure the complete avoidance of anatomical distortion or vulvo-clitoral stimulation ), efforts were made to analyze a homogeneous group of young healthy women. "
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    ABSTRACT: The aim of the study was to prospectively evaluate, by using 2D/3D ultrasonography and 3D color Doppler analysis, the morphological and vascular changes in the labia minora during the menstrual cycle of women not sexually aroused. A total of 81 young, healthy eumenorrheic women, in a stable heterosexual relationship (>1 year) and without any sexual dysfunction, underwent 2D/3D ultrasound and color Doppler examination of the labia minora on Days 3-5 and 12-14 of the menstrual cycle. Estradiol serum levels were also evaluated. Estradiol plasma levels increased in the periovulatory phase. The labia minora thickness increased from the follicular (3.8 ± 0.3 mm) to the periovulatory phase (4.6 ± 0.4 mm; p = .005). Furthermore, in the periovulatory phase, the vaginal introitus area and the angles were wider than in the follicular phase. The Pulsatility Index of the posterior labial artery significantly decreased in the periovulatory period. Three-dimensional power Doppler indices of vascularization and blood flow in the labia minora significantly increased in the periovulatory period. The relationship between the different parameters showed that estradiol was positively correlated with labia minora thickness and vaginal introitus area and angles. Furthermore, the circulating levels of estradiol were negatively correlated with posterior labial artery PI and positively correlated with other indices of labia minora vascularization. In conclusion, it seems that estrogen production may influence the anatomic and vascular changes of the labia minora during the menstrual cycle and these changes can be easily identified by ultrasound.
    Archives of Sexual Behavior 01/2012; 42(1). DOI:10.1007/s10508-012-9899-5 · 3.53 Impact Factor
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    • "Much of the early research on eti - ological factors relevant to orgasmic dysfunction focused on the individual woman , with relationship and socio - cultural aspects largely neglected . In recent years this focus has shifted , with recognition that partner and relationship factors are of crucial importance in sexual dysfunction ( Byers & Grenier , 2003 ; Dennerstein , Lehert , & Burger , 2005 ; Fisher , Rosen , Eardley , Sand , & Goldstein , 2005 ; King et al . , 2007 ; Oberg et al . "
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    ABSTRACT: This article reviews the DSM diagnostic criteria for Female Orgasmic Disorder (FOD). Following an overview of the concept of female orgasm, research on the prevalence and associated features of FOD is briefly reviewed. Specific aspects of the DSM-IV-TR criteria for FOD are critically reviewed and key issues that should be considered for DSM-V are discussed. The DSM-IV-TR text on FOD focused on the physiological changes that may (or may not) accompany orgasm in women; one of the major recommendations here is that greater emphasis be given to the subjective aspects of the experience of orgasm. Additional specific recommendations are made for revision of diagnostic criteria, including the use of minimum severity and duration criteria, and better acknowledgment of the crucial role of relationship factors in FOD.
    Archives of Sexual Behavior 09/2009; 39(2):256-70. DOI:10.1007/s10508-009-9542-2 · 3.53 Impact Factor
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