Are changes in sexual functioning during midlife due to aging or menopause?☆

Objective: To determine whether changes in women’s sexual functioning during midlife are due to aging or menopause.

Design: Prospective, observational study.

Setting: Population-based sample assessed in own homes.

Patient(s): Four hundred thirty-eight Australian-born women aged 45–55 years and still menstruating at baseline. One hundred ninety-seven were studied for effects of the natural menopausal transition. Control group A (n = 44) remained premenopausal or early perimenopausal for 7 years. Control group B (n = 42) remained postmenopausal over 5 years.

Intervention(s): Nil; questionnaires and blood sampling annually.

Main Outcome Measure(s): Shortened version of the Personal Experiences Questionnaire.

Result(s): By the late perimenopause, there was a significant decline in the factors we had derived of sexual responsivity and total score, and there was an increase in the partner’s problems factor. By the postmenopausal phase, there was a further decline in the factors sexual responsivity, frequency of sexual activities, libido, and in the total score, and a significant increase in vaginal dyspareunia and partner’s problems. Sexual responsivity significantly declined in both control groups.

Conclusion(s): Sexual responsivity is adversely affected by both aging and the menopausal transition. Other domains of female sexual functioning were significantly adversely affected when the women became postmenopausal. The relationship with the partner and his ability to perform sexually is adversely affected by the menopausal transition.