Muratore Laura A, Blanken Anna E, Huang Alison J, Gibson Carolyn J
From the Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco.
Menopause. 2025 Jan 1;32(1):5-11. doi: 10.1097/GME.0000000000002449. Epub 2024 Dec 17.
Midlife women experience menopause- and aging-related health changes that may impact sexual functioning. Research has historically relied on heteronormative constructs of sexuality, and little is known about the experiences of sexual minority women (SMW) during menopause. We therefore examined whether indices of sexual function differed between SMW and heterosexual midlife women Veterans.
Data were drawn from a cross-sectional survey designed to examine midlife women Veterans' experiences of menopause and aging. Participants self-reported sexual orientation, sociodemographic characteristics, vaginal symptoms, past-month engagement in sexual activity, and pain with sexual activity with structured-item responses. Sexual function was assessed with validated questionnaires. Logistic and linear regression models examined group differences adjusted for age, education, race, menopause status, and body mass index.
In this sample (n = 232, mean age = 56.0, SD = 5.14), 25% self-identified as SMW. Relative to heterosexual women, SMW were more likely to endorse recent sexual activity (odds ratio [OR], 2.20; 95% confidence interval [CI], 11.13-4.30), less likely to report pain during sex (OR, 0.07; 95% CI, 0.16-0.32), less likely to report past-month vaginal symptoms (OR, 0.33; 95% CI, 0.17-0.66), and endorsed lower impact of vaginal symptoms on sexual function (β = -0.24; 95% CI, -0.97 to -0.26). Both groups reported high levels of distress related to sexual dysfunction (sample mean = 19.9, SD = 8.0).
Midlife SMW Veterans reported better sexual functioning and less impact of vaginal symptoms compared with heterosexual peers. Despite this, both groups reported high levels of distress related to sexual function.
中年女性会经历与更年期和衰老相关的健康变化，这些变化可能会影响性功能。历史上的研究一直依赖于异性恋规范的性观念，对于性少数群体女性（SMW）在更年期的经历知之甚少。因此，我们研究了SMW和异性恋中年女性退伍军人在性功能指标上是否存在差异。
数据来自一项横断面调查，旨在研究中年女性退伍军人的更年期和衰老经历。参与者通过结构化项目回答自我报告性取向、社会人口学特征、阴道症状、过去一个月的性活动参与情况以及性活动时的疼痛。性功能通过经过验证的问卷进行评估。逻辑回归和线性回归模型检验了在调整年龄、教育程度、种族、更年期状态和体重指数后的组间差异。
在这个样本（n = 232，平均年龄 = 56.0，标准差 = 5.14）中，25%的人自我认定为SMW。与异性恋女性相比，SMW更有可能认可近期有性活动（优势比[OR]，2.20；95%置信区间[CI]，11.13 - 4.30），报告性交时疼痛的可能性更小（OR，0.07；95% CI，0.16 - 0.32），报告过去一个月有阴道症状的可能性更小（OR，0.33；95% CI，0.17 - 0.66），并且认可阴道症状对性功能的影响较小（β = -0.24；95% CI，-0.97至 -0.26）。两组都报告了与性功能障碍相关的高度痛苦（样本均值 = 19.9，标准差 = 8.0）。
与异性恋同龄人相比，中年SMW退伍军人报告的性功能更好，阴道症状的影响更小。尽管如此，两组都报告了与性功能相关的高度痛苦。
