Table 3.
Multivariable-adjusted associations with incident vaginal dryness in SWAN (1996–20013)
| Characteristic | Adjusted Hazard Ratio (95% CI)(a) | p-value |
|---|---|---|
| All women/All visits (N = 2246 women/10421 visits) | ||
| Concurrent partnered sexual activity, stratified by concurrent anxiety (b) | ||
| Anxiety symptom score < 4 | 2.21 (1.81, 2.70) | <0.001 |
| Anxiety symptom score ≥ 4 | 1.36 (1.03, 1.79) | 0.029 |
| Concurrent menopausal Status/HT use | <0.0001 | |
| Premenopausal | Reference | |
| Early perimenopausal | 1.67 (1.31, 2.13) | |
| Late perimenopausal | 2.98 (2.21, 4.02) | |
| Postmenopausal | 3.48 (2.57, 4.71) | |
| Postmenopausal-HT | 1.57 (0.94, 2.61) | |
| Bilateral salpingo-oophorectomy | 2.19 (0.99, 4.84) | |
| Bilateral salpingo-oophorectomy-HT | 2.70 (1.56, 4.67) | |
| Hysterectomy | 2.21 (1.19, 4.10) | |
| Hysterectomy-HT | 2.74 (0.67, 11.20) | |
| Not postmenopausal, HT | 2.03 (1.49, 2.77) | |
| Concurrent vaginal estrogen | 2.97 (1.62, 5.45) | 0.003 |
| Race/ethnicity: | 0.101 | |
| White | Reference | |
| African American | 1.08 (0.91, 1.29) | |
| Chinese | 0.86 (0.64, 1.16) | |
| Hispanic | 1.74 (1.08, 2.78) | |
| Japanese | 1.11 (0.82, 1.51) | |
| Concurrent BMI (kg/m2): | 0.011 | |
| < 25 | Reference | |
| 25 – 29.9 | 0.82 (0.70, 0.96) | |
| 30+ | 0.80 (0.68, 0.94) | |
| Concurrent anxiety ≥ 4 vs. < 4, stratified by concurrent partnered sexual activity(b) | ||
| Not sexually active visit | 2.56 (1.96, 3.35) | <0.001 |
| Sexually active visit | 1.57 (1.31, 1.89) | <0.001 |
| Symptom sensitivity, 1-unit increase | 1.02 (1.01, 1.04) | 0.011 |
| Currently married/partnered | 1.20 (1.02, 1.40) | 0.024 |
| Visits in Which Women Report No Hormone Therapy Use (N = 2068 – 2072 women/7196 – 7577 visits) | ||
| Concurrent log hormones, 0.5 SD:(c) | ||
| E2 | 0.94 (0.91, 0.98) | 0.002 |
| T | 1.02 (0.98, 1.05) | 0.382 |
| DHEAS | 1.01 (0.98, 1.05) | 0.555 |
| E2 change, prior visit to current visit(d) | 0.126 | |
| Decrease | 0.89 (0.74, 1.06) | |
| Stable | Reference | |
| Increase | 1.12 (0.92, 1.35) | |
| T change, prior visit to current visit(d) | 0.134 | |
| Decrease | 1.19 (0.99, 1.44) | |
| Stable | Reference | |
| Increase | 1.16 (0.96, 1.40) | |
| DHEAS change, prior visit to current visit(d) | 0.323 | |
| Decrease | 1.01 (0.84, 1.21) | |
| Stable | Reference | |
| Increase | 0.89 (0.75, 1.07) | |
| Visits in Which Women Report Partnered Sexual Activity(e) (N = 1771 women/6515 visits for concurrent-visit predictors, N=1745 women/5532 visits for prior-visit predictors) | ||
| Concurrent intercourse frequency: | 0.107 | |
| < monthly | Reference | |
| 1–2x/month | 0.74 (0.41, 1.32) | |
| ≥ weekly | 0.86 (0.48, 1.53) | |
| Concurrent lubricant use: | <0.001 | |
| Never | Reference | |
| Sometimes/almost never | 2.53 (2.14, 3.00) | |
| Always/almost always | 4.31 (3.53, 5.26) | |
| Concurrent pain with intercourse: | <0.001 | |
| Never | Reference | |
| Sometimes/almost never | 2.98 (2.56, 3.46) | |
| Always/almost always | 4.68 (3.36, 6.50) | |
| Prior-visit intercourse frequency: | 0.412 | |
| None | Reference | |
| < monthly | 1.17 (0.46, 2.97) | |
| 1–2x/month | 0.81 (0.59, 1.12) | |
| ≥weekly | 0.91 (0.67, 1.24) | |
| Prior-visit lubricant use: | <0.001 | |
| No intercourse | 1.30 (0.96, 1.76) | |
| Never | Reference | |
| Sometimes/almost never | 1.64 (1.34, 2.01) | |
| Always/almost always | 2.11 (1.58, 2.84) | |
| Prior-visit pain with intercourse: | <0.001 | |
| No intercourse | 1.44 (1.05, 1.96) | |
| Never | Reference | |
| Sometimes/almost never | 1.73 (1.46, 2.04) | |
| Always/almost always | 2.08 (1.16, 3.72) | |
Also adjusted for site and baseline age,
p-value for sexual activity × anxiety = 0.003
Visits with exogenous HT use excluded; analyses with log E2 adjusted for blood draw in days 2–5 of menstrual cycle; adjusted for partnered sexual activity through marital status, site and baseline age
Visits with concurrent/prior-visit exogenous HT use excluded; adjusted for current-visit log-transformed hormone; analyses with log E2 adjusted for blood draw in days 2–5 of menstrual cycle; stable indicates change ≤ 0.5 SD; adjusted for partnered sexual activity through marital status, site and baseline age
Adjusted for variables menopause status through marital status, site and baseline age