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

Objective: To determine whether changes in women's sexual functioning durin g 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 year s and still menstruating at baseline. One hundred ninety-seven were studied for effects of the natural menopausal transition. Control group A (n=44) r emained premenopausal or early perimenopausal for 7 years. Control group B (n=422) remained postmenopausal over 5 years. Intervention(s): Nil; questionnaires and blood sampling annually. Main Outcome Measure(s): Shortened version of the Personal Experiences Ques tionnaire. Result(s): By the late perimenopause, there was a significant decline in th e factors we had derived of sexual responsivity and total score, and there was an increase in the partner's problems factor. By the postmenopausal pha se, there was a further decline in the factors sexual responsivity, frequen cy of sexual activities, libido, and ty in the total score, and a significa nt increase in vaginal dyspareunia and partner's problems. Sexual responsiv ity-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 advers ely affected by the menopausal transition. (Fertil Steril(R) 2001;76:456-60 . (C) 2001 by American Society for Reproductive Medicine.).