Women's sexual function decreases during menopause, which in turn reduces their quality of life. Some studies have suggested that physical activity is associated with increased serum levels of androgens and improved sexual function. The aim of this study was to investigate the effect of concurrent training on serum androgens levels and sexual function in postmenopausal women. 

 

 The study was performed quasi-experimentally. The statistical sample of this study consisted of 30 postmenopausal women with an average weight of 65.1±5.4kg. Subjects were randomly divided into two groups of simultaneous training and control. The training group performed 8 weeks of concurrent training. Serum levels of dehydroepiandrosterone, testosterone and sexual function were measured 48 hours before and after training. Data were analyzed using SPSS 23 (SPSS Inc., Chicago, Ill., USA) statistical software at a significance level of 0.05.

In this study, it was observed that 8 weeks of simultaneous endurance and resistance training in the intervention group significantly increased testosterone levels, total sexual function score and increased DHEA, although it was not statistically significant. In the subscales, the intervention also increased satisfaction and sexual desire in the intervention group. While in the control group, the difference in results was slight, and no significant difference was observed in pre-test and post-test in any area.
In this study, serum levels of testosterone and hydroepiandrosterone were used as androgen indicators, which are the most appropriate and common in human studies. Testosterone is the main male sex hormone, but it is also less common in women. The effect of endurance exercise on increasing plasma testosterone concentrations has been proven in various studies. This hormone is of great importance in postmenopausal women, including maintaining muscle and bone mass and improving sexual function. In this study, it was shown that endurance and resistance training causes a significant increase in testosterone in postmenopausal women (from 0.334 ± 0.133 before the intervention to 0.391 ± 0.096 after the intervention). Dehydroepiandrosterone (DHEA) is the most abundant adrenal steroid hormone in the circulation of healthy adults. In both men and women, serum DHEA levels peak around 25 and decline steadily from the third decade of life. DHEA affects peripheral tissues indirectly through conversion to androgens and estrogens or directly as a steroid (25). Similar results of this study have been observed in increasing androgen levels with exercise in several other studies. For example, a study by Eklund et al. (2017) found that in professional female athletes, serum levels of DHEA and estrogen (E1) were significantly higher than in the control group (28). Also, in the study of Jones et al. (2017), it was observed that resistance and endurance training increase serum testosterone levels in postmenopausal women (29). But the study of Ribeiro et al. (2020) showed that 12 weeks of regular and intermittent exercise reduces serum androgens (total testosterone) in women with polycystic ovary syndrome, which is inconsistent with the findings of the present study. The practice method of this study can be attributed (30).
Sexual function has a beneficial effect on people's quality of life. After menopause, many women feel that they have sexual dysfunction. According to a study by Carcelén et al. (2020), 22% of postmenopausal women engage in sexual activities solely for the sake of gaining their husband's consent and are reluctant to engage in such activities (31). In the present study, it is observed that the score of the overall scale of sexual function and the two components of satisfaction and sexual desire increase during 8 weeks of exercise. Since the sexual function of postmenopausal women is related to improving life, increasing self-confidence, and reducing the incidence of depression, resistance training and endurance exercises are very important for menopausal women. A study by Kjaergaard et al. (2021), which examined thyroid function, sex hormones, and sexual function, found that there was a significant relationship between thyroid hormones (T4 and TSH), sex hormones, and sexual function (32). In the present study, it is observed that the score of the overall scale of sexual function and the two components of satisfaction and sexual desire increase during 8 weeks of exercise. Since the sexual function of postmenopausal women is related to improving life, increasing self-confidence and reducing the incidence of depression, doing resistance and endurance exercises is very important for menopausal women. Also, consistent with the studies of the present study in the study of Nazarpour et al. (2016), a positive relationship was observed between exercise and lubrication score and orgasm (33). In a study by Hosseini et al. (2017) that aimed to determine the effect of resistance training on body image, eating disorders, and sexual function of lean non-athlete women, the authors found that resistance training improves female sexual function (34). In the end, the limitations of the present study include not examining and controlling the financial level, self-confidence, and lifestyle of the subjects, which in future research, researchers can explore and exploit as much as possible.
 
 

 In general, based on our findings, it seems that concurrent training improves sexual function in postmenopausal women by increasing serum testosterone levels.
 
 

This project has been done in the form of a research project with the credits of Arak University. The code of ethics has been obtained as described (IR.ARAKMU.REC.1399.172) in the ethics committee of research projects of Arak University of Medical Sciences. We would like to thank all the dear ones who helped us in this study at Arak School of Sports Sciences and Arak University of Medical Sciences.
 
 

The authors declared no conflict of interest.