For some women, sex becomes less satisfying with age, with a pronounced decline during perimenopause. A new study indicates that sexual dysfunction increases by nearly 30% during perimenopause, and vaginal dryness most often has the greatest effect on desire, arousal, lubrication, and overall satisfaction. Study results were published this week in Menopause, the journal of The North American Menopause Society (NAMS).

There are many factors that can negatively affect sexual function, including mental and emotional status, aging, chronic medical problems, and menopause status. Decreasing estrogen levels during the menopause transition cause a variety of biological changes in a woman’s body, leading to vaginal atrophy, the thinning, drying, and inflammation of the vaginal walls.

Although previous studies have documented the effect of vaginal atrophy on menopausal women, this new study is one of only a few to assess effect during perimenopause, a transitional time before menopause when the ovaries gradually begin to make less estrogen. It shows that certain symptoms of vaginal atrophy, such as vaginal dryness, are much more prevalent during the menopause transition. Largely as a result of vaginal dryness, researchers noted that sexual satisfaction scores decreased while sexual dysfunction increased by about 30% during the perimenopause years.

Study results appear in the article “Female sexuality and vaginal health across the menopausal age.”

“This study examined sexual functioning in women aged 40 to 55 years and identified a link between vaginal dryness and worse sexual function. Given the high prevalence of sexual dysfunction in women, identifying an eminently treatable contributing factor such as vaginal dryness may allow women to maintain their sexual function during the menopause transition,” says Dr. Stephanie Faubion, NAMS medical director.