Dyspareunia is associated with decreased frequency of intercourse in the menopausal transition

The frequency of sexual intercourse declines as women enter midlife. Whereas partner availability and function probably play a role, menopausal symptoms, such as vaginal dryness, are also present. We examine the associations among vaginal dryness, dyspareunia, and frequency of sexual intercourse.

In the second year of a longitudinal study, women completed questionnaires that included menopause status and symptoms, participation in sexual activities, dyspareunia, marital status, and race. We used univariable and multivariable ordered logistic regression models to examine the associations among the frequency of sexual intercourse, vaginal dryness, use of lubrication during sex, and dyspareunia.

In multivariable analyses of the 363 sexually active women with complete data, women reporting more frequent dyspareunia, but not vaginal dryness, also reported less frequent intercourse. Advancing menopause status was associated with lower frequency of intercourse, whereas age was not. Dyspareunia and vaginal dryness were only moderately correlated (r = 0.4).

Women continue to participate in sexual intercourse through midlife. Women who report dyspareunia, but not vaginal dryness, report less frequent intercourse. Relief of dyspareunia should be addressed to maintain sexual functioning during midlife.