Hormone replacement therapy: post‐menopausal sex life and attitudes towards sex (2005)

Abstract Background: Menopause is a natural phase of life, but it can bring about physical problems for women. It seems that hormone replacement therapy (HRT) can be helpful in preventing problems at this stage of life. Patient and physician attitudes regarding menopause and HRT may affect decisions about the use of HRT. This study was conducted to determine attitudes about the importance of sex in menopausal women and examine the relationship between HRT and sex life after menopause. Methods: This is a comparative study that was done in the year 2000. The questionnaire used had two main parts. One hundred and fifty‐four women receiving HRT were chosen from private gynecology clinics north of Tehran city and 130 women who were not receiving HRT were chosen from the neighborhood of the HRT group. The sex lives and attitudes towards sex of the women before and after menopause were then compared, and the results were tabulated in 55 tables. Descriptive and inferential statistical methods were used. Results: The average age in the HRT group was 53 years and that in the non‐HRT group was 56 years. There was a significant difference in the average age between the two groups ( P < 0.001). The average number of years post‐menopause was 3.9 in the HRT group and 5.9 in the non‐HRT group. In the HRT group, 91.9% of the women used the hormone as prescribed by their physician. In this group, 85.7% of the women were of the opinion that sex was important, but this proportion in the non‐HRT group was 25.4%. There was a significant difference between the HRT and non‐HRT groups ( P < 0.001). Compared to the attitudes before menopause, the attitudes about the importance of sex in 56.5% of the HRT group and 19.2% of the non‐HRT group did not change after menopause. Women receiving HRT fared better in all aspects of their sex life, including libido, sexual activity, sexual satisfaction, sexual pleasure, frequency of orgasms and sexual importance at the time of the study. There were significant differences between the HRT and non‐HRT groups ( P < 0.001). With respect to sexual pleasure, 6.5% of the HRT group and 4.6% of the non‐HRT group experienced greater pleasure; 68.5% of the HRT group and 11.5% of the non‐HRT group experienced no change; and 83.8% of the non‐HRT group experienced less pleasure. There was a significant difference between the two groups with respect to the change in sexual pleasure ( P < 0.001). Conclusion: Although the importance of sex decreased for elderly women in both the HRT group and non‐HRT group, HRT affected their attitudes about the importance of sex. There was a significant difference between the HRT group and non‐HRT group in this area ( P < 0.001). The importance of sex in the HRT group did not change much after menopause, compared to the non‐HRT group. There was a significant difference between the two groups ( P < 0.001). There were fewer changes in all aspects of sex life after menopause for those in the HRT group compared to those in the non‐HRT group. In the month before the interview, 30.5% of the HRT group and 10.8% of the non‐HRT group had experienced complete sexual satisfaction. The difference was significant between the two groups ( P < 0.001). On the basis of the importance of sex during post‐menopausal life, counseling on the benefits of HRT might be recommended.