Sexual Functioning Beyond Testosterone

1. Sexual Functioning Beyond Testosterone Rachel Hess, MD, MS hessr@upmc.edu

2. Background • Sexual function changes as women age • Up to 40% of US women report sexual dysfunction and 63% report difficulty • Poor sexual functioning can contribute to poor overall quality of life

3. What do we know from SWAN? • 79% of women are sexually active at baseline • 1/3 of women report that sex is very important • African American women are more likely to consider sex very important • Japanese and Chinese women are less likely to consider sex very important

4. What do we know from SWAN? • Emotional satisfaction with relationship and overall relationship quality are more closely associated with sexual desire than are hormone levels • In the late perimenopause, pelvic pain increases and desire decreases

5. Objective • Examine the role of the vagina in sexual functioning • Compared the vaginal mucosa of sexually active and sexually inactive postmenopausal women

6. Hypothesis • Sexually active postmenopausal women would have more mature vaginal epithelium • This effect would be independent of sex-steroid hormone levels

7. Definitions • Sexually active: • Vaginally penetrative partnered sexual activity at least twice a week • Sexually inactive: • No vaginally penetrative sexual active in the last 6 months

8. Methods: Participants • 40 postmenopausal women • Provided self-collected vaginal samples • 10cc of blood • Completed questionnaires

9. Results

10. Results

11. Conclusions • Sexual activity is more strongly associated with vaginal epithelial maturity than with sex steroid hormone levels • Sex steroid hormone levels are not independently associated with sexual activity

12. Questions?