Discussion on the Relationship Among Sexual Health and Sleep Quality, Depressive Symptoms in Perimenopausal and Postmenopausal Women

Objective :To study the prevalence and types of sexual problems in perimenopausal and postmenopausal women, and to explore their relationship with sleep quality and anxiety-depressive symptoms, aiming to provide a basis and ideas for the treatment of sexual problems in this population. Methods : A total of 1572 women aged 40-60 who visited the clinic for menopausal symptoms were selected. Quantitative assessments of sexual function, sleep quality, anxiety, and depressive symptoms were conducted using the Female Sexual Function Index (FSFI), Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder Scale (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Multiple linear regression analysis and a mediation effect model were used to analyze the interactions between sexual function, sleep quality, and anxiety-depressive symptoms, with anxiety and depressive symptoms as mediating variables. Results : The overall prevalence of sexual dsyfunction in perimenopausal and postmenopausal women was 61.4%. The prevalence rates of decreased sexual desire, sexual arousal disorder, vaginal lubrication disorder, orgasmic disorder, and dyspareunia were 59.5%, 51.5%, 51.0%, 51.4%, and 41.4%, respectively. There were no significant differences in sleep quality, anxiety, or depressive symptoms between the two groups.The overall prevalence of sexual problems and the prevalence in each dimension were significantly higher in postmenopausal women than in perimenopausal women (P<0.01). The occurrence of Female Sexual Dysfunction (FSD) was related to the women's age, menopausal status, depressive symptoms, and sleep quality. Depressive symptoms had a mediating effect between sleep quality and sexual dysfunction. The indirect effect of sleep disorders affecting sexual dysfunction through depressive symptoms accounted for 44.83%. Conclusion : The prevalence of sexual problems is high among middle-aged women, and it is higher in postmenopausal women than in perimenopausal women. The prevalence is significantly correlated with age, menopausal status, depressive symptoms, and sleep quality. Clinically, improving depressive symptoms and sleep quality in middle-aged women can ameliorate sexual-related problems, thereby enhancing sexual satisfaction and quality of life for middle-aged and elderly women.