OBJECTIVE: The purpose of this study was to address whether: (1) there is an
association between menopause status and various aspects of sexual functioning,
and (2) the relative contributions of menopause status and other variables to
various aspects of sexual functioning.
DESIGN: Analyses are based on 200 women from the Massachusetts Women's Health
Study II, a population-based sample of women transitioning through the menopause
who were not HRT users, who had not had a surgical menopause, and who had
partners. The women were classified as pre-, peri-, or postmenopausal according
to menstrual cycle characteristics. Estradiol, estrone, and follicle-stimulating
hormone were also measured. Sexual functioning was measured in terms of
satisfaction, desire, frequency of sexual intercourse, belief that interest
declines with age, arousal compared with a younger age, difficulty reaching
orgasm, and pain. Predictor variables included sociodemographics, health,
vasomotor symptoms, psychological variables, partner variables, and lifestyle
behaviors.
RESULTS: Menopause status was significantly related to lower sexual desire, a
belief that interest in sexual activity declines with age, and women's reports of
decreased arousal compared with when in their 40s. Menopause status was unrelated
to other aspects of sexual functioning in either unadjusted or multiple
regression analyses. In analyses in which log estradiol (E2) was included in
addition to menopause status, log E2 was only related to pain. In multiple
regression analyses, other factors such as health, marital status (or new
partner), mental health, and smoking had a greater impact on women's sexual
functioning than menopause status.
CONCLUSIONS: Menopause status, but not E2, is related to some, but not all,
aspects of sexual functioning. This may be due to menopause per se or other
factors associated with menopause and aging (e.g., increased sexual dysfunction
among aging men). Menopause status has a smaller impact on sexual functioning
than health or other factors.