Post-traumatic stress disorder symptoms and sexual function among midlife women

Post-traumatic stress disorder (PTSD) is related to adverse mental and physical health outcomes and reduced wellbeing, yet limited work has examined associations between PTSD symptoms and sexual function among midlife women. We investigated whether PTSD symptoms were related to poorer sexual function among midlife women who reported past-month sexual activity (partnered or unpartnered).

121 women aged 45-66 not taking hormone therapy self-reported PTSD symptom severity (PTSD Checklist-Civilian Version [DSM-IV]; yields a total score and symptom clusters: re-experiencing, avoidance/numbing, and hypervigilance), depressive symptoms (Center for Epidemiological Studies-Depression), alcohol use, medical history, and medication use; and completed physical measures (body mass index; BMI) and an actigraphy sleep protocol (total sleep time). Associations between PTSD symptom severity and sexual function were tested in linear regression models adjusted for age, race/ethnicity, education, partner status, vaginal estrogen use, alcohol use, years since final menstrual period, BMI, depressive symptoms, and total sleep time. Exploratory analyses examined associations between PTSD symptom clusters and sexual function.

Past-month sexual function (score on the 6-item Female Sexual Function Index; lower scores = poorer function).

The average score on the PTSD Checklist was 23.91 (6.81). Women with greater PTSD symptoms reported poorer sexual function [B(95% CI) = -6.52 (-10.86, -2.17), p = .004]. Considering PTSD symptom clusters, avoidance/numbing related to poorer sexual function [B(95% CI) = -3.69 (-6.90, -0.48), p = .025].

Overall PTSD symptom burden and avoidance symptoms were related to poorer sexual function. Results suggest the importance of assessing and addressing PTSD symptoms among midlife women to improve women's sexual health as they age.