Women aged 40 to 79 years who engaged in sexual activity within the past 3 months were significantly less likely to report vulvar symptoms associated with genitourinary syndrome of menopause, according to a cross-sectional study of 911 sexually active participants selected from the GENJA cohort of 4,134 Japanese women.

Participants were categorized into 2 groups based on sexual activity: those who had intercourse in the past 3 months (regular activity group, n=716) and those who had intercourse within the past year but not the past 3 months (lower activity group, n=195). After adjusting for age, menstrual status, and hormone therapy use, sexual activity within the past 3 months was associated with lower odds of vulvar pain (adjusted odds ratio [aOR], 0.18; 95% CI, 0.10-0.35), dryness (aOR, 0.40; 95% CI, 0.25-0.66), and irritation (aOR, 0.34; 95% CI, 0.19-0.58) in daily life (P < .001 for all).

In contrast, symptoms during intercourse, such as dyspareunia and vaginal dryness, did not differ significantly between the groups. The authors noted that more frequent sexual activity may increase the opportunity to experience such symptoms. The primary differences observed were in vulvar symptoms experienced outside of intercourse.

Participants completed validated instruments, including the Female Sexual Function Index adapted for Japanese women (FSFI-J) and the Vulvovaginal Symptoms Questionnaire (VSQ). Scores for sexual desire, arousal, and lubrication declined significantly with age, whereas orgasm and satisfaction remained relatively stable. Pain increased with age.

The proportion of women reporting sexual activity declined with age, from 33.1% of women in their 40s to 6.8% of those in their 70s. Women in the regular activity group were more likely to be younger, premenopausal, and to have a sexual partner.

The authors acknowledged that the study’s cross-sectional design does not allow conclusions about causality. Prospective research is needed to determine whether sexual activity helps reduce genitourinary syndrome of menopause (GSM) symptoms or whether women with fewer symptoms are more likely to remain sexually active.

These findings may inform clinical strategies for identifying individuals at increased risk of GSM-related symptoms. The authors reported no conflicts of interest.

Source: Menopause