Sleep and female sexual function


Poor sleep quality is linked to female sexual dysfunction, whereas good sleep quality is associated with heightened sexual activity, according to a cross-sectional analysis of the Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS).

But the study in the journal Menopause did not find a connection between sleep duration and sexual dysfunction.

“We know that sleep and sexual dysfunction are common in women, and particularly in midlife women,” said senior author Stephanie Faubion, MD, MBA, director of the Mayo Clinic Center for Women’s Health in Rochester, Minnesota. “They are also both important contributors to quality of life and well-being. We wanted to investigated a potential link between the two.”

Stephanie Faubion, MD, MBA

Stephanie Faubion, MD, MBA

The analysis of DREAMS used self-reported questionnaires from 3,333 women (mean age 53) who presented for a menopause or sexual health consult at Mayo Clinic from December 2016 to September 2019. Overall, 72.4% of the women were sexually active.

The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R) assessed sexual function, whereas the Pittsburgh Sleep Quality Index (PSQI) assessed sleep parameters.

Associations between sleep quality (a PSQI global score ≥ 5 indicates poor sleep quality); sleep durations (< 5 hours; 5 to 6 hours; 6 to 7 hours; > 7 hours); and female sexual dysfunction (FSFI ≤ 26.55 represents significant sexual problems and FSDS-R ≥ 11 implies significant distress linked to sexual problems) were evaluated.

Primary analysis revealed that 75% of the total cohort experienced poor sleep quality, while 54% met criteria for female sexual dysfunction.

Women with poor sleep quality were nearly 50% more likely to report female sexual dysfunction (P < 0.001). And of women who reported sleeping < 5 hours nightly, 63.3% had sexual dysfunction.

The FSFI total and domain scores were significantly lower among women who reported sleeping less than 7 hours nightly than women sleeping more than 7 hours nightly. But this difference was not statistically significant in multivariable analysis.

In addition, sexually active women were more likely to report good sleep quality compared to sexually inactive women: 25.3% vs. 20.5%, respectively (P = 0.003).

For the most part, Faubion expected the study results. “The only real surprise is that there was not a direct link between sleep duration and sexual dysfunction,” Faubion told Contemporary OB/GYN. “We observed a correlation between sleep quality and sexual dysfunction after adjusting for multiple factors, but not for sleep duration.”

Both of these common entities in women “can and should be addressed by clinicians,” Faubion said. “However, clinicians are better about asking women about sleep than they are about sexual function.”

Faubion said the study should prompt practitioners to ask about sexual function when a woman reports sleep issues, and vice versa. “They should ask about sleep when a woman reports sexual dysfunction,” she said. “ Although clinicians should be asking all women about their sexual health, unfortunately this is not happening in clinical practice. Both of these issues are important and treatable.”

Therapies for sleep issues among midlife women depend on the cause, according to Faubion, who also is medical director of the North American Menopause Society (NAMS). “For example, a woman may be experiencing insomnia or night sweats related to the menopause transition. She may be getting up frequently to urinate because of the genitourinary syndrome of menopause (GSM),” she said.

A woman may also have a mood disorder, such as anxiety or depression, which can disrupt sleep, “or she may have a primary sleep disorder like obstructive sleep apnea (OSA) or restless legs syndrome (RLS),” Faubion said.

A woman’s partner may be able to help identify a cause, if he or she “notices disruptive snoring or their partner is kicking them due to RLS,” Faubion said. “Furthermore, the partner may have OSA that could contribute to the problem.”

The reality is that “a tired woman is likely to choose a good night’s sleep over sex any day,” Faubion said. “Addressing sleep is important for overall health, quality of life, sexual function and intimate relationship health.”



Faubion reports no relevant financial disclosures.


  1. Kling JM, Kapoor E, Mara K, et al. Associations of sleep and female sexual function: good sleep quality matters. Menopause. Published online April 19,2021. doi:10.1097/GME.0000000000001744
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