Heterosexual Women More Likely to Report Sexual Dysfunction During Menopause

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Sexual identity may play a role in sex quality and frequency of menopausal women, with sexual minority women reporting better sexual function during menopause than heterosexual women, according to the results of a recent study published in Menopause. The study reveals that despite accounting for only 25% of the sample, compared with heterosexual women, LGBTQ women were 2.2 times more likely to report sexual activity in the past month. Additionally, although 48.1% of straight women reported pain during sex, only 11.8% of LGBTQ women did. Finally, only 38.9% of LGBTQ women reported vaginal symptoms during sex while 63.5% of straight women did so.

A team of researchers, including corresponding author Anna E. Blanken, Ph.D., from the San Francisco Veterans Affairs Health Care System, surveyed 230 female veterans, who are a population of growing interest because of the number of women enrolled in healthcare through the Veterans Health Administration (VHA). Enrollment has also doubled in the last two decades. More than half the women with VHA coverage are also in midlife, a critical period for the menopause transition and research.

Up to 85% of postmenopausal women report sexual dysfunction challenges including pain with sex and low libido. Some of the most common menopause symptoms are vaginal dryness, irritation and/or itching. This is caused by the drop in estrogen levels that occurs during menopause.

Sexual function was self-reported using the Day-to-Day Impact of Vaginal Aging Questionnaire (DIVA). Subjective distress was measured using The Female Sexual Distress Scale–Revised edition (FSDS-R).

Reasons for the contrast may stem from a growing body of research that suggests sexual minority women seem to hold looser gender expectations and have a larger support network, whereas heterosexual women may view menopause as the end of femininity and therefore are more stressed by menopause.

“For example, among women newly diagnosed with breast cancer, lesbian women are more likely to acquire positive social support from partners (ie, partners are willing to listen, help with daily tasks, and make their partner feel loved and cared for) in comparison with heterosexual women who are more likely to report negative social support from their partner (ie, making demands),” the researchers write. “It may be the case that similar differences in partner support are at play during women's transitions into menopause.”

Another theory offered by the authors is that sexual minority women participate in a greater range of sexual activities such as vaginal, anal penetrative sex and masturbation, whereas heterosexual women are more likely to engage in only penetrative vaginal intercourse, leading to different satisfaction levels.

“Additional research is needed to better understand the unique needs of midlife sexual minority women and to promote the provision of affirming healthcare to sexual minority women Veterans,” Stephanie Faubion, M.D., medical director for The Menopause Society, said in the study news release.