Abstract

Abstract Introduction Female sexual dysfunction (FSD) can be a direct result of hormonal changes in a woman’s lifetime, including the use of birth control, postpartum, or menopausal. The FSFI (Female Sexual Function Index) measures sexual function based on six domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Studies have shown that vaginal lubrication can be affected by hormonal changes; however, it is unclear how lubrication relates to sexual desire among women with hormonal changes of varied etiology. Objective The objective of this study is to evaluate the relationship between vaginal lubrication and sexual desire among women who are on birth control, postpartum, or menopausal. Methods A post-market analysis was performed of all women who had utilized the sexual wellness application Rosy between February 2022 and November 2022. Application users had previously filled out the FSFI short form (6-item) and the desire and lubrication domain results were analyzed. We utilized multivariable linear regression models to determine significant effects between lubrication score and desire score controlling for whether the patient was on birth control, postpartum, or menopausal. Results A total of 11,407 women met the study criteria. 2,599 were menopausal, 3,394 were postpartum, and 8,013 were on birth control. The median age was 34.2 (range 17–80) years old. The mean FSFI short form scores for lubrication were as follows based on category: birth control = 3.03, postpartum = 2.0, and menopausal = 1.94. Mean FSFI short scores for desire were birth control = 2.44, postpartum = 2.23, and menopausal = 1.80. Regression modeling revealed a significant association between lubrication score and desire score (mean of 0.36 increase in desire score per point increase in lubrication score, 95% CI 0.35, 0.36, p<0.001). With women on birth control as a baseline, a menopausal status was associated with an increased desire (estimate 0.33, p<0.001). The interaction term between lubrication score and menopausal status was positive (0.06, p<0.001). Conclusions Iatrogenic or physiologic hormonal changes such as birth control, postpartum, or menopause can alter vaginal lubrication scores. Among these women, those with better vaginal lubrication have an associated increase in sexual desire. Improvements in lubrication can positively affect sexual desire in menopausal women. Our findings of a significant positive interaction between lubrication scores and menopausal status is interpreted as the magnified effect that increase lubrication has on sexual desire in this population. Furthermore, these findings reinforce that among this cohort, menopausal women are most effected by hormonal changes that can alter lubrication and ultimately sexual desire. While this data demonstrates interesting findings, potential confounders include users of Rosy who may have underlying sexual dysfunction, which may alter these results. Further studies are needed on this topic among the general population. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Rosy.

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