Non-heterosexual women report better sexual function during menopause transition

A woman’s libido may decline with age, in part due to problems with genitourinary symptoms during the transition to menopause. However, some older women lead very active sex lives. For what? A new study suggests one difference may be sexual identity, with non-heterosexual women more likely to report better sexual functioning, despite going through menopause. The study results are published online today in Menopausethe journal of the Menopause Society.

An estimated 25 to 85 percent of postmenopausal women report difficulties with sexual function, including sexual pain, difficulty with desire or libido, and distress regarding their sexual response. These symptoms often appear during the transition to menopause and can be chronic and progressive, with lasting implications on quality of life and sexual well-being.

Non-heterosexual women (also known as sexual minority women) generally have poorer mental and physical health due to the barriers and discrimination they face when engaging in the health care system. However, when it comes to sexual function, non-heterosexual women may fare better, according to a new study of more than 230 female veterans. Although they still report high levels of distress related to sexual function – similar to their heterosexual counterparts -; they report better sexual functioning and fewer effects of vaginal symptoms.

Women veterans represent a growing and diverse population for research, as the number of women enrolled in health care through the Veterans Health Administration (VHA) has more than doubled over the past two decades. Additionally, more than half of the women served by the VHA are in their 40s (generally between 40 and 60 years old); a critical window for health changes related to the transition to menopause.

Despite the growing number of studies conducted on the challenges of the menopause transition, there is a lack of systematic research examining menopause and age-related experiences among non-heterosexual women. That’s what prompted researchers to conduct this latest study, which found that non-heterosexual women were twice as likely to report sexual activity in the past month and less likely to report pain during sexual activity.

The results of this study highlight that menopause and aging significantly affect the sexual health and functioning of female veterans and, furthermore, that experiences can vary significantly based on sexual identity. Additional research is needed to better understand the unique needs of middle-aged sexual minority women and to promote the provision of affirming health care to sexual minority women veterans.

Dr. Stéphanie Faubion, medical director, The Menopause Society