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Menopause. 2017 Jun;24(6):604-612. doi: 10.1097/GME.0000000000000824.

Association of sleep disturbance and sexual function in postmenopausal women.

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1Division of Women's Health, Mayo Clinic, Scottsdale, AZ 2Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 3Division of Population Sciences, Department of Internal Medicine, Ohio State University, Columbus, OH 4Division of Health Sciences Research, Mayo Clinic, Scottsdale, AZ 5Division of Endocrinology, Medstar Washington Hospital Center and Georgetown University, Washington, DC 6Department of Epidemiology and Ophthalmology, Wake Forest School of Medicine, Winston-Salem, NC 7Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY 8Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 9Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA 10Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX 11Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA.



Sleep disturbance and sexual dysfunction are common in menopause; however, the nature of their association is unclear. The present study aimed to determine whether sleep characteristics were associated with sexual activity and sexual satisfaction.


Sexual function in the last year and sleep characteristics (past 4 wk) were assessed by self-report at baseline for 93,668 women age 50 to 79 years enrolled in the Women's Health Initiative (WHI) Observational Study (OS). Insomnia was measured using the validated WHI Insomnia Rating Scale. Sleep-disordered breathing (SDB) risk was assessed using questions adapted from the Berlin Questionnaire. Using multivariate logistic regression, we examined cross-sectional associations between sleep measures and two indicators of sexual function: partnered sexual activity and sexual satisfaction within the last year.


Fifty-six percent overall reported being somewhat or very satisfied with their current sexual activity, and 52% reported partnered sexual activity within the last year. Insomnia prevalence was 31%. After multivariable adjustment, higher insomnia scores were associated with lower odds of sexual satisfaction (yes/no) (odds ratio [OR] 0.92, 95% CI, 0.87-0.96). Short sleep duration (<7-8 h) was associated with lower odds of partnered sexual activity (yes/no) (≤5 h, OR 0.88, 95% CI, 0.80-0.96) and less sexual satisfaction (≤5 h, OR 0.88, 95% CI, 0.81-0.95).


Shorter sleep durations and higher insomnia scores were associated with decreased sexual function, even after adjustment for potential confounders, suggesting the importance of sufficient, high-quality sleep for sexual function. Longitudinal investigation of sleep and its impact on sexual function postmenopause will clarify this relationship.

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