Representaton of sexual dysfunction among top menopause content creators on TikTok: a cross-sectional content analysis

OBJECTIVE: To evaluate how menopause-related sexual dysfunction is represented in content from top menopause creators on TikTok, including symptom frequency, content framing, and creator characteristics. METHODS: A cross-sectional content analysis was conducted in October 2025 using the keyword "menopause." The 100 most-viewed TikTok videos posted between April and October 2025 were identified, and the 10 most influential content creators were selected based on follower count and engagement metrics. All videos posted by these creators during the study period were screened for eligibility, and 834 videos meeting the inclusion criteria were analyzed. Videos were coded for mentions of sexual function symptoms (vaginal dryness, libido changes, arousal difficulties, dyspareunia, and orgasmic challenges), broader menopause-related symptoms (mood changes, fatigue, hot flashes, bone or joint pain, and urinary incontinence), and content framing (symptom validation or empowerment, management strategies, product endorsements, or other). RESULTS: Sexual symptoms were infrequently mentioned: vaginal dryness (3.5%), libido changes (7.9%), arousal difficulties (1.3%), dyspareunia (2.0%), and orgasmic challenges (0.1%). Broader menopause-related symptoms were discussed more frequently, including mood changes (31.2%), hot flashes (13.5%), and bone or joint pain (12.9%). Most videos focused on symptom validation or empowerment (51.6%), followed by management strategies (19.3%) and product endorsements (13.2%). Among the 10 most influential content creators, one was a medical professional. CONCLUSION: Menopause-related sexual dysfunction is underrepresented in content from top menopause creators despite its high prevalence. Its limited presence in widely viewed menopause content may reduce recognition of sexual dysfunction as a clinically relevant concern during menopause.