Some aspects of sexuality and vaginal symptoms during menopause and their relation to anxiety and depression

Vaginal symptoms and and loss of libido are common presenting complaints among patients of menopause clinics. Very often the cause and effect model used to explain and treat these complaints is one of simple oestrogen deficiency. However, factors other than menopausal status may play an important part in sexual and vaginal problems. This study investigated the relationship between vaginal symptoms and factors such as affective state, the importance of intercourse, satisfaction with sexual activity and strength of desire among 274 peri-menopausal patients at a menopause out-patient clinic. While vaginal dryness affects enjoyment and desire for intercourse, only dyspareunia was associated with a reduction in the frequency of intercourse. Depression was found to be an important factor in loss of libido and anxiety was the most important influence on reduced frequency of intercourse.