SEXUALITY AND THE MENOPAUSE

Sexual problems are often reported to clinicians by women in the midli fe years. Yet few of the epidemiological studies of women in midlife h ave investigated the relationship of the menopause to sexual functioni ng. This paper reports the results of a cross-sectional telephone surv ey of 2001 randomly selected Australian-born women aged between 45 and 55 years. The major outcome variables were questions relating to chan ges in sexual interest over the prior 12 months, reasons for any chang es, occurrence of sexual intercourse, and of unusual pain on intercour se. Logistic regression was used to identify explanatory variables for change in sexual interest. The majority of women (62%) reported no ch ange in sexual interest, although 31% reported a decrease. Decline in sexual interest was significantly and adversely associated with natura l menopause (p < 0.01) rather than age, decreased well-being (p < 0. 0 01), decreasing employment (p < 0.01) and symptomatology (vasomotor p < 0.05, cardiopulmonary p < 0.001 and skeletal p < 0.01). Eleven to tw elve years of education was associated with a lowered risk of decrease d sexual functioning (p < 0.01). Heterogeneous results were reported b y users of hormone replacement therapies. Longitudinal studies of larg e and representative samples are needed to determine the etiology of a dverse sexual changes with the menopause and the role of hormone repla cement therapies.