Sexual Health and Infection Risk During the Perimenopausal and Postmenopausal Transition

Sexual health in perimenopausal and postmenopausal women is shaped by complex interactions between hormonal fluctuations, physical changes, and psychosocial factors. Declines in estrogen and other sex hormones contribute to reduced sexual desire and arousal, while urogenital discomfort, fatigue, and mood disturbances further impact sexual well-being. Regular sexual activity is associated with lower symptom burden and improved quality of life in perimenopause. Most perimenopausal women remain fertile and require individualized contraceptive guidance. They are also at heightened risk of sexually transmitted infections, necessitating targeted screening and preventive measures. Proper genital hygiene and attention to vaginal microbiota are essential for maintaining sexual health. Complementary interventions – including aromatherapy, sauna, acupuncture, and vaginal hormonal therapies – may ease menopause-related symptoms and boost sexuality. A holistic, individualized approach is critical to support sexual health and overall well-being during perimenopause.