Sexuality in menopausal Thai women.

ABSTRACT

Objective: To evaluate the type and incidence of sexual problems and their relationship to vaginal problems and hormonal replacement therapy (HRT) in menopausal Thai women. Design: Cross-sectional study. Patients 96 women, who were followed-up at the Menopause Clinic, Department of Obstetric Gynecology, Faculty of Medicine Siriraj Hospital from September 2001 to August 2002. Methods: All women were interviewed about sexual problems. The questionnaires requested demographic data, reproductive history, history of hormonal replacement therapy, postmenopausal complaints of sexual experience and responsiveness. Main outcome measurement Types of sexual problems, the relationship between sexual and vaginal problems and the effect of HRT on sexuality. Results: Common sexual problems encountered after menopause were loss of libido, orgasmic dysfunction and dyspareunia. Both sexual desire and sexual activity decreased in the premenopausal period. Forty-three percent of natural menopausal women had sexual activity less than once a month. Similar results were found in the surgical groups. Only 24% of the subjects occasionally reached orgasm. Vaginal problems were found to have a significant relationship to the loss of sexual desire, whereas the decrease in vaginal secretion had significant relationship to the lack of orgasm. About 45.2% of menopausal women with HRT did not have a significant change in libido and sexual response. Conclusion: There is a decline in sexual response and activity in menopausal Thai women. Women with surgical menopause demonstrated a similar kind of sexual dysfunction as women with natural menopause. HRT cannot alleviate all the symptoms of sexual dysfunction but it is beneficial for vaginal complaints . Counseling and health education in which a positive attitude towards menopause is portrayed is important.