Pathway Analysis to Identify Factors Affecting Sexual Function in Postmenopausal Women with Hypertension Not Receiving Hormone Replacement Therapy

Purpose: As women in middle age undergo the menopausal transition, they may encounter alterations in sexual function concomitantly with physical and emotional manifestations. The present research investigated the relationships between menopausal symptoms, depression, marital intimacy, and sexual function. Additionally, it aimed to identify the mediating influences of depression and marital intimacy in the relationship between menopausal symptoms and sexual function in naturally post-menopausal women with hypertension. Methods: The study included post-menopausal women aged between 45 and 60 years with hypertension who were not undergoing hormone replacement therapy. A total of 308 post-menopausal women were recruited from three provinces in Korea. Path analysis was conducted by AMOS employing maximum likelihood estimation and bootstrapping with 2000 samples. Results: The theoretical pathway model demonstrated strong alignment with empirical findings obtained from a cohort of postmenopausal women. The association between menopausal symptoms and sexual function was mediated by depression and marital intimacy. Ultimately, menopausal symptoms, depression, and marital intimacy collectively explained 64% of the overall variance in sexual function. Conclusion: This study highlights the importance of individualized interventions targeting sexual health in middle-aged women with hypertension undergoing menopause. Counseling and intervention programs focused on alleviating menopausal symptoms and improving sexual function should be integrated into clinical practice. Furthermore, a multidimensional approach is needed to address the various factors influencing sexual function in postmenopausal women.