Androgens and sexual dysfunction in naturally and surgically menopausal women

Abstract

Aim: To evaluate the influence of surgical versus natural menopause on sexual dysfunction, and the role of androgens in that context.

Material & methods: Sexual functioning and androgen levels were studied in 35 surgically and 83 naturally menopausal women. Sexual dysfunction was defined as a total score of less than 23 on the Female Sexual Function Index.

Results: Sexual dysfunction was significantly more common in surgically than in naturally menopausal women (65.7% vs 44.6%; P = 0.036). The mean total testosterone level in women with sexual dysfunction was significantly lower than that in their counterparts (49.3 ± 21.0 vs 58.8 ± 23.6 ng/mL; P = 0.022). On the other hand, androgen levels did not differ significantly between surgically and naturally menopausal women. Androstenedione (B = 2.253; P = 0.039) and dehydroepiandrosterone sulfate levels (B = 0.222; P < 0.001), and time from menopause (B = -0.064; P = 0.040) were found to be independent determinants of total testosterone levels. While the duration of menopause was significantly longer in surgically menopausal women, this co-factor was not an independent predictor of sexual dysfunction. Logistic regression analysis proved mode of menopause and total testosterone levels to be the only two independent determinants of sexual dysfunction.

Conclusions: Our findings suggest that while surgical menopause is detrimental to sexual functioning by itself, lower testosterone levels are predictive of sexual dysfunction, especially in naturally menopausal women.