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.