Study finds less sex during menopause transition not associated to sexual pain

Women were most at risk for developing sexual pain in late perimenopause and postmenopause. Picture: Pexels

Women were most at risk for developing sexual pain in late perimenopause and postmenopause. Picture: Pexels

Published Jul 8, 2022

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According to a new study, having sex less frequently during the transition to menopause is not connected with an increased chance of acquiring pain with intercourse.

The findings of the research were published in the journal 'Obstetrics and Gynaecology'.

This 13-year study examined whether a reduction in the frequency of sex is responsible for women's symptoms of sexual pain during the transition to menopause. The study also examined other factors potentially associated with sexual pain.

"Women have been told by the popular media and some physicians that if you 'don't use it, you'll lose it,' meaning if women don't remain sexually active, especially through the menopause transition, they will lose the ability to have comfortable sex. But this study provides some empirical evidence against this popular notion," said Elaine Waetjen, primary investigator of the study and professor of obstetrics and gynaecology at UC Davis Health.

Painful intercourse is reported in 20 percent to 59 percent of perimenopausal and post-menopausal women. This study gathered questionnaire data annually across the first 10 visits of the Study of Women's Health Across the Nation (SWAN), a multi-centre, multiracial and multi-ethnic prospective study of the menopausal transition. Inclusion criteria for this study were those ages 42-52 years who self-identified as Black, Hispanic, Japanese, Chinese or White.

Of the 2,247 women with no sexual pain at the baseline, 1,087 (48.4 per cent) developed sexual pain at least "sometimes" up to 10 follow-up visits over 13 years. Participants completed questionnaires at each visit, gauging frequency of participation in sexual behaviours, genital or urinary symptoms and pain experienced during sexual activity. Some of the study's other findings:

1. Women were most at risk for developing sexual pain in late perimenopause and post-menopause, independent of age.

2. Use of systemic hormone therapy did not appear to reduce this risk of developing sexual pain.

3. Reporting of vaginal dryness had the strongest association with developing pain.

4. Engaging in oral sex and having a higher frequency of arousal were associated with a reduced chance of developing sexual pain.

5. History of sexual trauma was not associated with sexual pain among this older cohort.

"Our study results provide a critical public health and clinical message: women whose sexual intercourse activity declines do not appear to be at higher risk for developing sexual pain compared with women who maintain or increase sexual frequency," Waetjen said. "Women and their health care professionals should focus on developing individualised strategies to prevent and treat sexual pain and not attribute pain to reduced intercourse frequency."