What is the impact of androgen decline on sexual function in menopausal women?

• A. No change
• B. Reduced libido and sexual dysfunction
• C. No effect on sexual function
• D. Increased libido

Answer: (B)

Androgens play a meaningful role in female sexual desire and arousal. After menopause, ovarian production of androgens declines, and levels of free, bioavailable testosterone fall because SHBG increases with age. This reduction in bioavailable androgens is commonly linked to lower libido and difficulties with arousal, i.e., sexual dysfunction. Estrogen loss contributes to vaginal drying and thinning, which can affect comfort during sex, but the specific impact of androgen decline is primarily on desire and arousal rather than lubrication. Individual experiences vary, and multiple factors—health, mood, relationship factors, and overall well-being—also shape sexual function.