Sexual Function and Associated Factors in Postmenopausal Women: A Systematic Review and Meta-Analysis.

Background and aims: The sexual health of postmenopausal women is frequently neglected, resulting in the common manifestations of menopause that lead to sexual dysfunction remaining unaddressed. This study aimed to systematically review the status of sexual function and dysfunction, and its association with modulating factors; and to examine the effectiveness of interventions in improving the status of sexual function in postmenopausal women.

Methods: This systematic review and meta-analysis study was conducted based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) from inception until March 2022. Articles were searched through five electronic national and international databases including PubMed, Scopus, Scientific Information Database, Google Scholar, and Web of Science using the medical subject heading (MeSH) keywords related to the term "menopause", "sexual function", "sexual dysfunction", and "menopausal women".

Results: Thirty-seven studies with data from 9982 participants were eligible for the review, and 75% of the total studies reported sexual dysfunction among postmenopausal women. Age and education level significantly affected the risk of sexual dysfunction in women experiencing menopause. In the meta-analysis of 21 cross-sectional studies with 9262 participants found an overall effect size (ES) of 20.12 (95% CI: 17.39-22.86) for average sexual function and 0.65 (95% CI: 0.63-0.66) for the average percentage of sexual dysfunction among postmenopausal women. The pooled effect of the intervention on the average difference between the intervention and control groups was 3.08 (95% CI: 2.68-3.49), which was significantly different from zero (p < 0.001).

Conclusion: This review reveals a significant prevalence of sexual dysfunction among postmenopausal women. The findings underscore the significant impact of educational interventions on enhancing sexual function in menopausal women. Consequently, it is advantageous to incorporate tailored intervention programs into medical education and healthcare practices to address sexual dysfunction during this challenging phase.