The relative effects of hormones and relationship factors on sexual function of women through the natural menopausal transition.

OBJECTIVE

To investigate the relative effects of hormonal and relationship factors on female sexual function during the natural menopausal transition.

DESIGN

Prospective population-based questionnaire study.

SETTING

Interviews were conducted in the patients' homes.

PATIENT(S): Four hundred thirty-eight Australian-born women aged 45-55 years who were still menstruating at baseline. Eight years of longitudinal data were available for 336 of these women, none of whom were hysterectomized.

INTERVENTION(S): Hormonal levels, age, menopausal status, partner status, and feelings for partner were measured and evaluated with longitudinal structural equation modeling.

MAIN OUTCOME MEASURE(S): Short personal experiences questionnaire.

RESULT(S): Sexual response was predicted by prior level of sexual function, change in partner status, feelings for partner, and E2 level (R2 = .65); dyspareunia was predicted by prior level of dyspareunia and E2 level (R2 = .53); and frequency of sexual activities was predicted by prior level of sexual function, change in partner status, feelings for partner, and level of sexual response (R2 = .52). The minimum effective dose needed to increase sexual response by 10% (700 pmol/L E2) is twice that needed to decrease dyspareunia.

CONCLUSION(S): Prior function and relationship factors are more important than hormonal determinants of sexual function of women in midlife.