Resilience and Sexual Health Among Menopausal Women

A Cross-sectional Study

Agustin Oliva, MD; Irene Serrano-García, MSc; Juan E. Asenjo, MD, PhD; Elisa Cedeira, MD; Inés Gil-Prados, MD; Miguel A. Herraiz, MD, PhD; Pluvio J. Coronado, MD, PhD


Menopause. 2022;29(4):408-414. 

In This Article

Abstract and Introduction


Objectives: Resilience can be defined as the capacity to overcome stressful situations, such as menopausal transition. Female sexual dysfunction is a problem that prevents women from experiencing satisfaction from sexual activity. In this study, we assessed resilience, sexual function, and quality of life among a sample of mid-aged Spanish menopausal women.

Methods: This cross-sectional study was performed in 101 symptomatic menopausal women. Participants filled out the 14-item Wagnild and Young Resilience Scale, the 19-item Female Sexual Function Index (FSFI), the 16-item Cervantes-SF form, and a sociodemographic questionnaire.

Results: Resilience scores were significantly higher among women with high sexual function scores (FSFI > 26), with a 14-item Wagnild and Young Resilience Scale total valuation of 86 [80–94] versus 74 [66–79.50] (P<0.001). Sexual function was significantly worse in the low resilience subgroup of participants, with an FSFI total score of 18.90 [14.10–24] versus 29.40 [24.60–33] in the mid-high resilience one (P<0.001). Menopauserelated quality of life was significantly worse among low resilient women, with a Cervantes-SF total score of 42.50 [34.17–56.70] versus 30.80 [20.80–44.90] in the mid-high resilience one (P = 0.004).

Conclusions: In our sample, resilience was related to sexual health. Higher resilience scores seem to be linked to a better quality of life during the menopausal transition.


Resilience is a multidimensional and dynamic concept that encompasses positive adaptation within the context of significant adversity.[1] Some individuals have a better outcome than others after experiencing an adverse or stressful situation.[2] Resilience interacts with different aspects of life, including intimate relationships and attachments[3] and has also been related to healthy aging.[4,5]

Promoting resilience has been encouraged by international organizations to improve health and quality of life, but it is complex and requires macro (health policy/legislation) and micro-level interventions (individual).[6] In order to do so, it is essential to identify the sources of resilience. Multiple related factors have been identified, such as personal (personality traits and self-esteem),[7] environmental (social support and good parenting),[8] and biological and genetic factors.[9]

The menopausal transition may be considered an adverse situation for most women, because it may be a long process of adaptations that could cause negative feelings and depressive mood.[10] Some authors have previously described the relationship between the severity of the climacteric syndrome and the resilience scores.[11]

Menopause is defined as the permanent cessation of menstruation, confirmed after 12 consecutive months of amenorrhea.[12] The transition to menopause is a period full of physical, psychological, and social changes that could have a severe impact over the health-related quality of life (HRQoL).[13] Menopausal women are more vulnerable to female sexual dysfunction (FSD), mainly because of endocrine changes (sexual hormone deficiency) but also due to psychosexual (affective disorders and body image) and contextual (culture and religion) factors.[14]

According to the World Health Organization, sexual health is a state of physical, emotional, mental, and social well-being in relation to sexuality.[15] This aspect is not only a key part of women's overall health but also a basic human right. FSD can be defined as the inability of women to participate in a sexual relationship as they would wish.[16–18] It is a multifactorial problem that prevents women from experiencing satisfaction from sexual activity, with reduced desire, vaginal dryness, dyspareunia, poor arousal, and difficulty reaching orgasm, which are the most common complaints.[19] Definition and criteria of FSD have being debated for decades,[20] and its prevalence is still unclear, but some authors report that could be in within the range of 42% to 88% among women experiencing their menopausal transition.[21] Various articles about this subject may be found,[22,23] but none of them take resilience into account. Nevertheless, it has been shown that sexual satisfaction is associated with HRQoL among menopausal women,[24,25] with lower general well-being among dissatisfied women.[26]

The aim of the present study was to analyze the impact of sexual health on the resilience scores of menopausal women and their quality of life. This specific study has never been carried out before.