Study of Sexual Health in Peri and Postmenopausal Solid Organ Transplant Recipients

As survival following solid organ transplantation (SOT) improves, attention has shifted to survivorship and quality of life (QoL) outcomes. Sexual function is an important component of women's health in transplant recipients. In the general population, sexual distress affects approximately 10%-15% of midlife women. Female SOT recipients may experience additional risk for sexual dysfunction related to surgery, body image, and immunosuppression. However, sexual health in this population remains understudied. This study assessed sexual function and its impact on QoL among female SOT recipients by menopausal status.

A cross-sectional study of female SOT recipients aged ≥ 18 years was conducted at a single tertiary transplant center from 2018 to 2023. Participants were within five years of kidney, liver, or pancreas transplantation. Validated questionnaires included female sexual function index (FSFI), female sexual distress scale (FSDS), menopause rating scale (MRS), linear analog scale assessment (LASA). Respondents were categorized as premenopausal or peri/postmenopausal. Sexual function, distress, and QoL were compared between groups, with exploratory analyses stratified by current sexual activity status.

The survey response rate was approximately 30%. Among 277 respondents, peri/postmenopausal patients were less likely to be sexually active (48.9% vs 69.4%, p = 0.002). They reported lower desire, arousal, and lubrication scores, and higher sexual distress than premenopausal SOT recipients. While overall QoL was rated highly across both groups, sexual distress negatively correlated with QoL across menopausal groups. Among the entire cohort, most women (≈74%) had not been asked about sexual health by any provider in the past year.

Sexual dysfunction is common among female SOT recipients and is associated with menopausal status, with higher rates observed than those reported in the general population. These findings highlight the importance of integrating sexual health into posttransplant survivorship care.